Childcare, Health and Income in Brazil: evaluation of Bolsa Família Program

Wednesday, 20 August 2014
Exhibit hall (Dena'ina Center)
Natália Stofel, MD , Federal University of Pelotas, Pelotas, Brazil
Luiz A Facchini, PhD , Federal University of Pelotas, Pelotas, Brazil
Suele M Silva, PhD , Federal University of Pelotas, Pelotas, Brazil
Elaine Tomasi, PhD , Federal University of Pelotas, Pelotas, Brazil
Elaine Thumé, PhD , Federal University of Pelotas, Pelotas, Brazil
Mirelle O Saes, MS , Federal University of Pelotas, Pelotas, Brazil
Bruno P Nunes, MS , Federal University of Pelotas, Pelotas, Brazil
Pâmela Volz, MS , Federal University of Pelotas, Pelotas, Brazil
Fernando V Siqueira, PhD , Federal University of Pelotas, Pelotas, Brazil
Denise S Silveira, PhD , Federal University of Pelotas, Pelotas, Brazil
INTRODUCTION:  Created in 2004, the Bolsa Família Program (BFP) benefits about 13 million Brazilian families in extreme poverty (income less than US$1/day) and poverty (income between US$1 and US$2/day). Through direct income transfers, the program aims to promote food and nutrition security as well as access to public services network. Families pledge to fulfill conditionality on health is keeping the immunization schedule and monitoring of nutritional status and development of children under 7 years old. The research objective was to evaluate the quality of childcare between BFP beneficiaries and non-beneficiaries. 

METHODS:  A cross-sectional study, community-based, linked to basic health care services, through an epidemiological survey conducted in the South and Northeast regions of Brazil in 2010. The data analysis was performed through chi-square test. 

RESULTS:  A sample of 14,347 children was located. Low quality childcare was higher among those living in extreme poverty and BFP non-beneficiaries (10%), followed by those who live in extreme poverty and were BFP beneficiaries (9%), compared with those who are richer and not receiving BFP benefit (3%). The frequency of high-quality childcare was 61% in the Northeast region and 88% in the South region. 

CONCLUSIONS:  High quality childcare occurred in groups with higher income, showing the strong influence of economic determinants in health care. It is estimated that the quality of care would be even worse if the beneficiaries do not receive the BFP. The fact that the South region has better indicators showed the Brazilian regional economic inequality. The effectiveness of BFP in improving health may be greater with better targeting, combined with increased benefit. The coverage and quality of health services targeting to the poorer and vulnerable social groups, can reduce even more the health inequities.

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