Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data

Detalhes bibliográficos
Autor(a) principal: Rasella, Davide
Data de Publicação: 2021
Outros Autores: Alves, Flávia Jôse Oliveira, Rebouças, Poliana, Jesus, Gabriela Santos de, Barreto, Maurício Lima, Campello, Tereza, Paixao, Enny S.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/47688
Resumo: Trust Training Fellowships in Public Health and Tropical Medicine scheme, DR the recipient Fellow (Grant reference number: 109949/Z/15/Z; https://wellcome.ac.uk/)
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spelling Rasella, DavideAlves, Flávia Jôse OliveiraRebouças, PolianaJesus, Gabriela Santos deBarreto, Maurício LimaCampello, TerezaPaixao, Enny S.2021-06-15T13:02:23Z2021-06-15T13:02:23Z2021RASELLA, Davide et al. Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data. BMC Medicine, v. 19, n. 127, p. 1-9, 1 June 2021.1741-7015https://www.arca.fiocruz.br/handle/icict/4768810.1186/s12916-021-01994-7Trust Training Fellowships in Public Health and Tropical Medicine scheme, DR the recipient Fellow (Grant reference number: 109949/Z/15/Z; https://wellcome.ac.uk/)Wellcome Trust (Grant reference 213589/Z/18/Z)Foundation for Research Support of the State of Bahia (FAPESB)Instituto de Salud Global de Barcelona. Barcelona, España / Universitat de Barcelona. Hospital Clínico y Provincial de Barcelona. Barcelona, España.Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Universidade Federal da Bahia. Escola de Nutrição. Salvador, BA, Brasil.Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / University of Nottingham. School of Biosciences. Centre for Research in Race and Rights. Future Food Beacon of Excellence. Nottingham, United Kingdom.Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / London School of Hygiene and Tropical Medicine. Faculty of Epidemiology and Population Health. London, United Kingdom.Background: Reducing poverty and improving access to health care are two of the most effective actions to decrease maternal mortality, and conditional cash transfer (CCT) programmes act on both. The aim of this study was to evaluate the effects of one of the world’s largest CCT (the Brazilian Bolsa Familia Programme (BFP)) on maternal mortality during a period of 11 years. Methods: The study had an ecological longitudinal design and used all 2548 Brazilian municipalities with vital statistics of adequate quality during 2004–2014. BFP municipal coverage was classified into four levels, from low to consolidated, and its duration effects were measured using the average municipal coverage of previous years. We used negative binomial multivariable regression models with fixed-effects specifications, adjusted for all relevant demographic, socioeconomic, and healthcare variables. Results: BFP was significantly associated with reductions of maternal mortality proportionally to its levels of coverage and years of implementation, with a rate ratio (RR) reaching 0.88 (95%CI 0.81–0.95), 0.84 (0.75–0.96) and 0.83 (0.71–0.99) for intermediate, high and consolidated BFP coverage over the previous 11 years. The BFP duration effect was stronger among young mothers (RR 0.77; 95%CI 0.67–0.96). BFP was also associated with reductions in the proportion of pregnant women with no prenatal visits (RR 0.73; 95%CI 0.69–0.77), reductions in hospital case-fatality rate for delivery (RR 0.78; 95%CI 0.66–0.94) and increases in the proportion of deliveries in hospital (RR 1.05; 95%CI 1.04–1.07). Conclusion: Our findings show that a consolidated and durable CCT coverage could decrease maternal mortality, and these long-term effects are stronger among poor mothers exposed to CCT during their childhood and adolescence, suggesting a CCT inter-generational effect. Sustained CCT coverage could reduce health inequalities and contribute to the achievement of the Sustainable Development Goal 3.1, and should be preserved during the current global economic crisis due to the COVID-19 pandemic.engBMCPobrezaDesenvolvimento sustentávelMortalidade maternaGestantesConditional cash transferBolsa Família ProgrammeMaternal mortalityLong-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal datainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83097https://www.arca.fiocruz.br/bitstream/icict/47688/1/license.txt36b51ef91c52b5338d9d29ba0cc807bcMD51ORIGINALRasella, David Long-term....pdfRasella, David 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dc.title.en.fl_str_mv Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
title Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
spellingShingle Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
Rasella, Davide
Pobreza
Desenvolvimento sustentável
Mortalidade materna
Gestantes
Conditional cash transfer
Bolsa Família Programme
Maternal mortality
title_short Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
title_full Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
title_fullStr Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
title_full_unstemmed Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
title_sort Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data
author Rasella, Davide
author_facet Rasella, Davide
Alves, Flávia Jôse Oliveira
Rebouças, Poliana
Jesus, Gabriela Santos de
Barreto, Maurício Lima
Campello, Tereza
Paixao, Enny S.
author_role author
author2 Alves, Flávia Jôse Oliveira
Rebouças, Poliana
Jesus, Gabriela Santos de
Barreto, Maurício Lima
Campello, Tereza
Paixao, Enny S.
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Rasella, Davide
Alves, Flávia Jôse Oliveira
Rebouças, Poliana
Jesus, Gabriela Santos de
Barreto, Maurício Lima
Campello, Tereza
Paixao, Enny S.
dc.subject.other.pt_BR.fl_str_mv Pobreza
Desenvolvimento sustentável
Mortalidade materna
Gestantes
topic Pobreza
Desenvolvimento sustentável
Mortalidade materna
Gestantes
Conditional cash transfer
Bolsa Família Programme
Maternal mortality
dc.subject.en.en.fl_str_mv Conditional cash transfer
Bolsa Família Programme
Maternal mortality
description Trust Training Fellowships in Public Health and Tropical Medicine scheme, DR the recipient Fellow (Grant reference number: 109949/Z/15/Z; https://wellcome.ac.uk/)
publishDate 2021
dc.date.accessioned.fl_str_mv 2021-06-15T13:02:23Z
dc.date.available.fl_str_mv 2021-06-15T13:02:23Z
dc.date.issued.fl_str_mv 2021
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.citation.fl_str_mv RASELLA, Davide et al. Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data. BMC Medicine, v. 19, n. 127, p. 1-9, 1 June 2021.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/47688
dc.identifier.issn.pt_BR.fl_str_mv 1741-7015
dc.identifier.doi.pt_BR.fl_str_mv 10.1186/s12916-021-01994-7
identifier_str_mv RASELLA, Davide et al. Long-term impact of a conditional cash transfer programme on maternal mortality: a nationwide analysis of Brazilian longitudinal data. BMC Medicine, v. 19, n. 127, p. 1-9, 1 June 2021.
1741-7015
10.1186/s12916-021-01994-7
url https://www.arca.fiocruz.br/handle/icict/47688
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