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FAMILY HEALTH AND CONDITIONAL CASH TRANSFER IN BRAZIL AND ITS EFFECT ON TUBERCULOSIS MORTALITY
Condições saudáveis
Efeitos de proteção social
Políticas de saúde pública
Author
Affilliation
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Federal University of the Vale do São Francisco. Salvador, BA, Brazil.
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Faculty of Epidemiology and Population Health. London, UK.
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Federal University of the Vale do São Francisco. Salvador, BA, Brazil.
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil.
London School of Hygiene & Tropical Medicine. Faculty of Epidemiology and Population Health. London, UK.
Federal University of Bahia. Institute of Collective Health. Salvador, BA, Brazil.
Abstract
Social protection can reduce poverty and act on the determinants of tuberculosis (TB). OBJ ECT IVE : To evaluate the impact of the Family
Health Strategy (FHS) and the Bolsa Fam´ılia Programme
on TB-related mortality in Brazil.
METHODS : This was an ecological study in which the
units of analysis were Brazilian municipalities between
2001 and 2012. The principal independent variables
were the levels of coverage of the primary health care
system and the conditional cash transfer programme.
The dependent variable was TB mortality rate (obtained
from national databases). Descriptive analysis and
negative binomial regression based on panel data using
fixed-effects models were performed. Crude and adjusted
estimates were calculated for continuous and
categorical variables.
R E SULT S : A high FHS coverage was significantly
associated with a reduction in the TB mortality rate
(RR 0.80, 95%CI 0.72–0.89). An increase in the
coverage of the Brazilian cash transfer programme was
significantly associated with a reduction in the TB
mortality rate (RR 0.87, 95%CI 0.81–0.96).
CONCLUS ION: FHS and the Bolsa Fam´ılia conditional
cash transfer programme had a positive impact on the
TB mortality rate in Brazil. Public policies should
include economic support combined with health promotion.
xmlui.dri2xhtml.METS-1.0.item-abstractfr
La protection sociale peut r ´eduire la
pauvret´e et agir sur les d´eterminants de la tuberculose
(TB).
OBJECTI F : Evaluer l’impact d’une Strat´egie de Sant´e
familiale (FHS) et du programme Bolsa Fam´ılia sur la
mortalit´e li´ee `a la TB au Br´esil.
ME´ THODE S : Etude ´ecologique dans laquelle les unit´es
d’analyse ont ´et´e les municipalit´es du Br´esil entre 2001
et 2012. Les principales variables ind´ependantes ont ´et´e
les niveaux de couverture du syst`eme de soins de sant´e
primaires et le programme de transfert d’esp`eces
conditionnel. La variable d´ependante a ´et´e le taux de
mortalit ´e de la TB, obtenu des bases de donn´ees
nationales. Une analyse descriptive a ´et´e r´ealis´ee et une
r´egression n´egative binomiale pour les donn´ees du panel
avec des mod`eles `a effets fixes. Les estimations brutes et
ajust´ees ont ´et´e calcul´ees pour les variables continues et
cat´egorielles.
RE´ SULTATS : Une couverture ´elev´ee de la FHS a ´et´e
significativement associ´ee `a une r´eduction du taux de
mortalit´e de la TB (risque relatif [RR] 0,80 ; IC95%
0,72–0,89). Un accroissement de la couverture du
programme br´esilien de transfert d’esp`eces a ´et ´e
significativement associ´e `a une r´eduction du taux de
mortalit´e de la TB (RR 0,87 ; IC95% 0,81–0,96).
CONCLUS ION : Il y a eu un impact positif de la FHS et
du programme de transfert d’esp`eces conditionnel du
Bolsa Fam´ılia sur le taux de mortalit´e auBr´esil, avec des
effets ind´ependants. Les politiques publiques devraient
inclure un soutien ´economique associ´e `a la promotion de
la sant´e.
Keywords in Portuguese
Condições sociaisCondições saudáveis
Efeitos de proteção social
Políticas de saúde pública
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