Family health and conditional cash transfer in Brazil and its effect on tuberculosis mortality

• Published in: The international journal of tuberculosis and lung disease 2018-11, Vol.22 (11), p.1300-1306
• Main Authors: de Souza, R. A., Nery, J. S., Rasella, D., Guimarães Pereira, R. A., Barreto, M. L., Rodrigues, L., Pereira, S. M.
• Format: Article
• Language: English
• Subjects: Brazil - epidemiology; Cities; Dependent variables; Ecological monitoring; Ecological studies; Economic factors; Family Health - economics; Health care; Health Conditions; Health promotion; Hospitalization - trends; Human capital; Humans; Incidence; Independent variables; Mortality; Municipalities; Population Surveillance; Poverty; Primary Health Care - economics; Public Assistance - statistics & numerical data; Public Assistance - trends; Public Health Policies; Reduction; Regression Analysis; Social Conditions; Social factors; Social Protection Effects; Tuberculosis; Tuberculosis - economics; Tuberculosis - mortality; Tuberculosis - prevention & control
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.17.0907

BACKGROUND: Social protection can reduce poverty and act on the determinants of tuberculosis (TB).OBJECTIVE: To evaluate the impact of the Family Health Strategy (FHS) and the Bolsa Família Programme on TB-related mortality in Brazil.METHODS: This was an ecological study in which the units of analysis were Brazilian municipalities between 2001 and 2012. The principal independent variables were the levels of coverage of the primary health care system and the conditional cash transfer programme. The dependent variable was TB mortality rate (obtained from national databases). Descriptive analysis and negative binomial regression based on panel data using fixed-effects models were performed. Crude and adjusted estimates were calculated for continuous and categorical variables.RESULTS: A high FHS coverage was significantly associated with a reduction in the TB mortality rate (RR 0.80, 95%CI 0.72-0.89). An increase in the coverage of the Brazilian cash transfer programme was significantly associated with a reduction in the TB mortality rate (RR 0.87, 95%CI 0.81-0.96).CONCLUSION: FHS and the Bolsa Família conditional cash transfer programme had a positive impact on the TB mortality rate in Brazil. Public policies should include economic support combined with health promotion.