Impact evaluation of the Brazilian Integrated Border Health System

Abstract

IMPACT This article presents a methodological framework that can be used to evaluate interventions in border regions. The case study was SIS-Fronteiras: a Brazilian project to support municipalities providing healthcare for economic migrants from neighbouring countries. This article uncovers important opportunities and challenges during the implementation of this project. The project failed partly because of inadequate management of resources. Future policies in regions with significant trans-border flows (for example between the USA and Mexico in North America; and across some European and Asian borders) should incorporate mechanisms of cross-border governance, co-operation and co-financing to increase the chances of success. ABSTRACT This study evaluates Brazil’s Integrated Border Health System (SIS-Fronteiras). First, propensity score matching and difference in differences techniques were applied to analyse the health indicators of the 588 municipalities in the border strip of Brazil. Second, the authors conducted and analysed 23 interviews and 12 focus groups. The results suggest that the inadequacy of the governance model explains the failure to improve healthcare conditions in these areas. This article contributes to deepening our understanding of public policies and, in particular, public health interventions in border regions.