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Going to scale with community-based primary care: An analysis of the family health program and infant mortality in Brazil, 1999-2004

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  • Macinko, James
  • de Fátima Marinho de Souza, Maria
  • Guanais, Frederico C.
  • da Silva Simões, Celso Cardoso

Abstract

This article assesses the effects of an integrated community-based primary care program (Brazil's Family Health Program, known as the PSF) on microregional variations in infant mortality (IMR), neonatal mortality, and post-neonatal mortality rates from 1999 to 2004. The study utilized a pooled cross-sectional ecological analysis using panel data from Brazilian microregions, and controlled for measures of physicians and hospital beds per 1000 population, Hepatitis B coverage, the proportion of women without prenatal care and with no formal education, low birth weight births, population size, and poverty rates. The data covered all the 557 Brazilian microregions over a 6-year period (1999-2004). Results show that IMR declined about 13 percent from 1999 to 2004, while Family Health Program coverage increased from an average of about 14 to nearly 60 percent. Controlling for other health determinants, a 10 percent increase in Family Health Program coverage was associated with a 0.45 percent decrease in IMR, a 0.6 percent decline in post-neonatal mortality, and a 1 percent decline in diarrhea mortality (p

Suggested Citation

  • Macinko, James & de Fátima Marinho de Souza, Maria & Guanais, Frederico C. & da Silva Simões, Celso Cardoso, 2007. "Going to scale with community-based primary care: An analysis of the family health program and infant mortality in Brazil, 1999-2004," Social Science & Medicine, Elsevier, vol. 65(10), pages 2070-2080, November.
    • Handle: RePEc:eee:socmed:v:65:y:2007:i:10:p:2070-2080
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    1. Pinto, Rogério M. & da Silva, Sueli Bulhões & Soriano, Rafaela, 2012. "Community Health Workers in Brazil’s Unified Health System: A framework of their praxis and contributions to patient health behaviors," Social Science & Medicine, Elsevier, vol. 74(6), pages 940-947.
    2. Ronald Mendoza & Nicholas Rees, 2009. "Infant Mortality During Economic Downturns and Recovery," Working papers 0904, UNICEF,Division of Policy and Strategy.
    3. Luiz Felipe Campos Fontes & Otavio Canozzi Conceição & Paulo de Andrade Jacinto, 2018. "Evaluating the impact of physicians' provision on primary healthcare: Evidence from Brazil's More Doctors Program," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1284-1299, August.
    4. Ferreira-Batista, Natalia N. & Postali, Fernando Antonio Slaibe & Diaz, Maria Dolores Montoya & Teixeira, Adriano Dutra & Moreno-Serra, Rodrigo, 2022. "The Brazilian Family Health Strategy and adult health: Evidence from individual and local data for metropolitan areas," Economics & Human Biology, Elsevier, vol. 46(C).
    5. Natalia Nunes Ferreira‐Batista & Adriano Dutra Teixeira & Maria Dolores Montoya Diaz & Fernando Antonio Slaibe Postali & Rodrigo Moreno‐Serra & James Love‐Koh, 2023. "Is primary health care worth it in the long run? Evidence from Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1504-1524, July.
    6. Teixeira, Adriano Dutra & Postali, Fernando Antonio Slaibe & Ferreira-Batista, Natalia Nunes & Diaz, Maria Dolores Montoya & Moreno-Serra, Rodrigo, 2024. "The role of primary healthcare amid the COVID-19 pandemic: Evidence from the Family Health Strategy in Brazil," Social Science & Medicine, Elsevier, vol. 359(C).
    7. Mattos, Enlinson & Mazetto, Debora, 2019. "Assessing the impact of more doctors’ program on healthcare indicators in Brazil," World Development, Elsevier, vol. 123(C), pages 1-1.

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