Abstract
In 2003, the Brazilian federal government launched the Bolsa Família Programme (Programa Bolsa Família - PBF), a widespread conditional cash transfer to poor households when they comply with conditions related to health and education. A longitudinal ecological study using panel data from 1,133 municipalities of the Brazilian semiarid region was performed. The main goal was to assess the effect of the PBF on child mortality (CM) in the semiarid region of Brazil during the period of 2004-2010. Associations were estimated using a multivariate linear regression for the panel data with fixed effects. The child mortality rate (CMR) was considered the dependent variable, adjusted for relevant social and demographic covariates, and for the effect of the largest primary healthcare scheme in the country through the Family Health Strategy (FHS). The PBF and the FHS played significant roles in reducing CM, increasing prenatal consultations, reducing illiteracy rates, lowering fertility levels, and decreasing the number of individuals living in households with inadequate access to water supplies and sanitation. In conclusion, the PBF had a positive impact on reducing CM levels; its impact was boosted by the intervention of other social and demographic factors.
Highlights
Income inequality in Brazil is among the highest in the world[1]
The present study considers the need to understand the processes that regulate the reduction of child mortality (CM) levels and the lack of studies related to the subject, with the main objective of evaluating the effects of the Bolsa Família Programme on child mortality rate (CMR) of the Brazilian semiarid region in the period of 2004-2010
There are restrictions related to the reliability of CM estimates obtained from the Atlas of Human Development in Brazil, which was developed in partnership with the João Pinheiro Foundation (Fundação João Pinheiro - FJP), the Institute of Applied Economic Research (Instituto de Pesquisa Econômica Aplicada - IPEA) and the United Nations Development Program (UNDP), they were considered a satisfactory proxy of their levels for municipalities
Summary
Income inequality in Brazil is among the highest in the world[1]. To overcome this situation, conditional cash transfer programmes have been created with the purpose of crediting federal government monetary values to poor families, provided that the parents or guardians comply with certain specific conditions, usually with a focus on health, education, and social welfare[2,3,4].The Bolsa Família Programme (Programa Bolsa Família - PBF), created in Brazil in 2003, is one of the largest in terms of conditional cash transfers in the world and reached high coverage over the last decade as a programme of the social and popular safety network. The semiarid region is one of the largest beneficiaries of the PBF in Brazil and is the largest in the world in terms of area (982,563.3 km2) and population density (23.06 inhabitants/km2) with 22 million people in 2010. It is composed of nine states, including 1,133 municipalities, and is considered the least developed region in the country because it is affected by serious social and economic problems[5]
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