In this section
@article{Rasella:2018:10.1371/journal.pmed.1002570,
author = {Rasella, D and Basu, S and Hone, TV and Paes-Sousa, R and Octavio, Ocke'-Reis C and Millett, C},
doi = {10.1371/journal.pmed.1002570},
journal = {PLoS Medicine},
title = {Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: a nationwide microsimulation study},
url = {http://dx.doi.org/10.1371/journal.pmed.1002570},
volume = {15},
year = {2018}
}
TY - JOUR
AB - Background.Since 2015, a major economic crisis in Brazil has led to increasing poverty and the implementation of long-term fiscal austerity measures which will substantially reduce expenditure on social welfare programmes as a percentage of the country's GDP over the next 20 years. The Bolsa Familia Programme (BFP) - one of the largest conditional cash transfer programmes in the world - and the nationwide primary healthcare strategy (Estrategia Saude da Familia - ESF) are affected by fiscal austerity, despite being among the policy interventions with the strongest estimated impact on child mortality in the country. We compared how reduced coverage of BFP and ESF, or an alternative scenario where the level of social protection under these programmes is maintained, may affect the under-five mortality rate (U5MR) and socio-economic inequalities in child health in the country until 2030, the end date of the Sustainable Development Goals.Methods and Findings.We developed and validated a microsimulation model, creating a synthetic cohort of all 5,507 Brazilian municipalities for the period 2017-2030. This was based on the longitudinal dataset and effect estimates from a previously published study which evaluated the effects of poverty, BFP, and ESF on child health. We forecast the economic crisis and the effect of reductions in BFP and ESF coverage due to current fiscal austerity on U5MR, and compare with scenarios where these programmes maintain the levels of social protection by increasing or decreasing with the size of Brazil's vulnerable populations. We used fixed effects multivariate regression models including BFP and ESF coverage and accounting for secular trends, demographic and socioeconomic changes, and programme duration effects.With the maintenance of the levels of social protection provided by BFP and ESF, in the most likely economic scenario the U5MR is expected to be 8.57% (CI: 6.88%- 10.24%) lower in 2030 than under fiscal austerity - a cumulative 19,7
AU - Rasella,D
AU - Basu,S
AU - Hone,TV
AU - Paes-Sousa,R
AU - Octavio,Ocke'-Reis C
AU - Millett,C
DO - 10.1371/journal.pmed.1002570
PY - 2018///
SN - 1549-1277
TI - Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: a nationwide microsimulation study
T2 - PLoS Medicine
UR - http://dx.doi.org/10.1371/journal.pmed.1002570
UR - http://hdl.handle.net/10044/1/59239
VL - 15
ER -