The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil

BackgroundEvidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to more...

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Bibliographic Details
Published in:BMJ global health 2019-01, Vol.4 (1), p.e001029-e001029
Main Authors: J Carter, Daniel, Daniel, Rhian, Torrens, Ana W, N Sanchez, Mauro, Maciel, Ethel Leonor N, Bartholomay, Patricia, Barreira, Draurio C, Rasella, Davide, Barreto, Mauricio L, Rodrigues, Laura C, Boccia, Delia
Format: Article
Language:English
Subjects:
Bolsa Família
causal inference
conditional cash transfer
Epidemiology
Global health
Households
Indoor air quality
Monetary incentives
Mortality
Poverty
propensity score matching
Public health
quasi-experimental design
Quasi-experimental methods
Sensitivity analysis
Social protection
Success
Tuberculosis
Variables
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Summary:BackgroundEvidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to more rigorously evaluate the effect of BFP on TB treatment success rate.MethodsPropensity scores were estimated from a complete-case logistic regression using covariates from a linked data set, including the Brazil’s TB notification system (SINAN), linked to the national registry of those in poverty (CadUnico) and the BFP payroll.ResultsThe average effect of treatment on the treated was estimated as the difference in TB treatment success rate between matched groups (ie, the control and exposed patients, n=2167). Patients with TB receiving BFP showed a treatment success rate of 10.58 percentage points higher (95% CI 4.39 to 16.77) than patients with TB not receiving BFP. This association was robust to sensitivity analyses.ConclusionsThis study further confirms a positive relationship between the provision of conditional cash transfers and TB treatment success rate. Further research is needed to understand how to enhance access to social protection so to optimise public health impact.
ISSN:2059-7908
2059-7908
DOI:10.1136/bmjgh-2018-001029