CONDITIONAL CASH TRANSFER PROGRAM (BOLSA FAMÍLIA) IMPACT ON CHILD HEALTH INEQUITY REDUCTION ON THE NORTH-EASTERN REGION OF BRAZIL

INTRODUCTION: Understanding the complex relationship between health and socioeconomic conditions of the population is essential to build a public health system with equitable distribution of resources. This study provides an analysis on inequity in child health, based on the conditional cash transfer program (CCTP) of the Brazilian government. 

METHODS: The State of Ceará Mother and Child Health Survey provided information on children aged 0-3 years old and their mothers, based on cluster random sampling of 8,000 households. Population-based prevalence of child morbidity, use of health services and anthropometric indicators were calculated, according to quintiles of monthly income of families participating, or not, of the CCTP (bolsa família). General linear models with polynomial contrast tests were applied for statistical significance test. 

RESULTS: For indicators of access to health services, families not receiving supplemental income present statistically significant differences, as quintiles of monthly income were analyzed. The prevalence of acute malnutrition, however, was significantly higher for the 1st. quintile of family income (the poorest), as compared to the other quintiles (p = 0.031). The same pattern was observed in relation to stunting (p = 0.022). It was observed that families participating of the CCTP had lower rates of hospitalization for pneumonia and diarrhea, as compared to not participant families. 

CONCLUSIONS: In relation to child malnutrition, inequity persists, even within the group of extremely poor families attached to CCTP. The lowest proportion of child hospitalization in CCTP families could mean either reduction of severe morbidity, or less access to hospital care.