Health outcomes of the Bolsa Família program among Brazilian Amazonian children

Cash transfers and human capital outcomes of children in LMICs: A systematic review using PRISMA

With an increasing shift towards cash transfers and the proposition of Universal Basic Income (UBI) as a policy alternative to replace the existing schemes, there has been a rising discussion about the success and failure associated with cash transfers. Therefore, this article carries out a systematic review using PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) to draw inferences and generate evidences with respect to the influence of cash transfers on two aspects of human capital outcomes of children, viz., child health and nutrition, and educational outcomes in low- and middle-income countries (LMICs). Forty four studies were selected on the basis of a four-stage procedure that checked for identification, screening, eligibility and inclusion. The results indicate that majority of cash transfers based on conditionalities, like mandatory attendance in healthcare organisations and educational institutions, proved to be effective in the selected countries. While 7 studies (16%) showed no changes in the outcomes, 5 (11%) depicted negative impact and the rest (73%) presented a positive result. The selected studies suggest that a strong supply-side mechanism in place in LMICs, ensure functional and quality services at health centres and schools in the respective regions and reflect overwhelming outcomes. Furthermore, incentive design, anticipated termination, and supply-side interventions would be instrumental in avoiding a crisis or shock in the economic sense to recipient households.

Hunger and its associated factors in the western Brazilian Amazon: a population-based study

BACKGROUND

Hunger affects millions of people worldwide. In the current pandemic scenario of coronavirus Brazil has experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under 5 years of age in an urban area of a municipality of the western Brazilian Amazon.

METHODS

A household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value < 0.05 after adjustments were considered significantly associated with the outcome.

RESULTS

A prevalence of 76.5% (CI 1.36-2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI 1.31-2.83) and severe (CI 1.10-1.83) food insecurity. Moderate and severe FI was associated with low family income (P = 0.00), participation in governmental income transfer programs (P = 0.01), and heads of household with less than 7 years of schooling (P = 0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children.

CONCLUSIONS

The high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under 5 years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

Effect of a conditional cash transfer programme on infant up-to-date and timely vaccination

BACKGROUND

Conditional cash transfer (CCT) programmes are one of the strategies to increase vaccination coverage among underprivileged families by conditioning cash transfer to the up-to-date immunisation of children. However, there are gaps in knowledge of its impact on vaccination at the recommended age (timely).

METHODS

We performed two cross-sectional analyses of secondary data from a retrospective cohort, at the landmark ages of 12 and 24 months, to assess the effect of the Brazilian CCT on the up-to-date and timely vaccination in children born between 2014 and 2016 and resident in the city of Araraquara, São Paulo (Southeast Brazil). The Propensity Score Matching (PSM) was used to balance two pre-defined groups (beneficiaries and non-beneficiaries) according to the profile of socioeconomic and demographic characteristics.

RESULTS

From a total of 7386 children within the cohort, 22.2% (1636) were from beneficiary families of the CCT. After the pairing by PSM, the final sample size included in the analyses was 1440 for each group. We found higher up-to-date vaccination coverage, at 12 (92.1%, 95% CI=90.6% to 93.5%) and 24 months (83.8%, 95% CI=81.8% to 85.7%), among the CCT beneficiaries compared with the non-beneficiaries (85.1%, 95% CI=83.2% to 86.9% at 12 months and 73.6%, 95% CI=71.2% to 75.8% at 24 months). The coverage of timely vaccination did not statistically differ between beneficiaries (41.5%, 95% CI=38.9% to 44.1% and 17.4%, 95% CI=15.4% to 19.4%) and non-beneficiaries (40.7%, 95% CI=38.1% to 43.3% and 17.1%, 95% CI=15.2% to 19.1%) at 12 and 24 months, respectively.

CONCLUSION

The study highlights a positive effect of the CCT on vaccination coverage of the up-to-date infant vaccination schedule. However, there was no difference in timely vaccination.

Socioeconomic and nutritional aspects of pregnant women assisted by Programa Bolsa Família: cohort NISAMI

Abstract The objective of this study was to evaluate the socioeconomic and nutritional assistance factors of pregnant women who are beneficiaries of the Bolsa Família Program and were attended at a prenatal service in the city of Recôncavo da Bahia. A cohort study was conducted with 250 pregnant women from the prenatal service in 16 Family Health Units from August 2013 to December 2014. A structured and previously tested questionnaire was used to collect data. Socioeconomic and nutritional variables were used. It was identified that the average age was 28.3 years, of these, 85.2% studied until high school, 72.4% of pregnant women reported having income less than or equal to two minimum wages, with a mean of 1,036.3 and 26.8% reported receiving the benefit. It was observed that 40% had a pre-gestational Body Mass Index of overweight, 38% presented adequate weight gain for Gestational Age; 90.57% performed more than 7 consultations and 75.6% reported that they made use of alcoholic beverages or stopped in the gestation. The Bolsa Família Program as an integrated strategy for social inclusion and economic development seems to have a protective effect on the nutritional health of pregnant women in the municipality.

The Brazilian cash transfer program (Bolsa Família): A tool for reducing inequalities and achieving social rights in Brazil

Conditional cash transfer programs are strategies used by countries over the past two decades, and they play a key role in reducing income inequalities and expanding access to basic services such as health and education. The Brazilian Cash Transfer Program (Bolsa Família), the largest conditional cash transfer program in the world, aims to bring immediate poverty alleviation and eradicate hunger. The objective of this study was to analyse the contributions of the Brazilian Cash Transfer Program for reducing social inequalities and ensuring the right to health, food, education and social assistance in Brazil. A review of the scientific literature published between 2003 and 2020 was conducted, associated with documentary research on government websites. There was a relationship between the Brazilian Cash Transfer Program, reduction of child mortality and increase in access to Primary Health Care services; increased access to food, including in natura; higher school attendance and reduced dropout. However, no improvement in the nutritional status of the families entitled to the program was observed, nor the interruption of the intergenerational cycle of poverty was ensured. The Brazilian Cash Transfer Program continues as a potent intersectoral policy for reducing inequities, which reinforces the need to strengthen and combine complementary policies to expand its effects.