21/11/2022 - 13:10 - 14:40
CC5.5 - REFLEXÕES SOBRE RAÇA, CLASSE E DESIGUALDADES DURANTE A PANDEMIA DA COVID-19
40288 - THE COMPREHENSIVE HEALTH IMPACT OF CASH TRANSFERS, SOCIAL PENSIONS AND PRIMARY CARE IN BRAZIL: AN ANALYSIS TO MITIGATE THE EFFECTS OF THE COVID19-RELATED ECONOMIC
TEMIDAYO JAMES ARANSIOLA - INSTITUTE OF COLLECTIVE HEALTH (ISC) AT THE FEDERAL UNIVERSITY OF BAHIA (UFBA), BAHIA, BRAZIL, JOSÉ ALEJANDRO ORDOñEZ - INSTITUTE OF COLLECTIVE HEALTH (ISC) AT THE FEDERAL UNIVERSITY OF BAHIA (UFBA), BAHIA, BRAZIL, DANIELLA CAVALCANTI - INSTITUTE OF COLLECTIVE HEALTH (ISC) AT THE FEDERAL UNIVERSITY OF BAHIA (UFBA), BAHIA, BRAZIL, PHILIPP HESSEL - UNIVERSITY OF LOS ANDES, BOGOTÁ, COLOMBIA / SWISS TROPICAL & PUBLIC HEALTH INSTITUTE, BASEL, SWITZERLAND, ANA MONCAYO - CENTRO DE INVESTIGACIÓN PARA LA SALUD EN AMÉRICA LATINA (CISEAL), PONTIFICIA UNIVERSIDAD CATÓLICA DEL ECUADOR, CARLOS CHIVARDI - HEALTH RESEARCH CONSORTIUM - CISIDAT, MEXICO CITY, MEXICO / CENTER FOR HEALTH ECONOMICS, UNIVERSITY OF YORK, UK, ALBERTO SIRONI - INSTITUTE OF GLOBAL HEALTH (ISGLOBAL), BARCELONA, SPAIN, RENATO TASCA - SCHOOL OF BUSINESS ADMINISTRATION AT THE GETULIO VARGAS FOUNDATION (EAESP/FGV), SAO PAULO, BRAZIL, TEREZA CAMPELLO - CENTER FOR EPIDEMIOLOGICAL RESEARCH IN NUTRITION AND HEALTH (NUPENS), AT THE UNIVERSITY OF SÃO PAULO (USP), SÃO PAULO, BRAZIL, RÔMULO PAES-SOUSA - RENÉ RACHOU INSTITUTE AT FIOCRUZ, BELO HORIZONTE, BRAZIL
Brazil has some of the world`s largest Conditional Cash Transfer (Bolsa Familia Program-BFP), Social Pension (Benefício de Prestação Continuada-BPC), and Primary Health Care (Family Health Strategy–FHS) programs. We evaluated the impact of these interventions on health indicators, and forecasted their mitigation effects on the adverse health impact of the current COVID19-related economic crisis.
We evaluated the comprehensive effect of the Brazilian CCT, SP and PHC on morbidity and mortality of the population over the last two decades, and forecast their potential mitigation effects during the COVID19-related economic crisis and beyond.
In the retrospective impact evaluation, we used fixed-effects negative binomial models with a cohort of Brazilian municipalities from 2004-19 to estimate the impact of BFP, BPC, and FHS coverage on hospitalizations and mortality, adjusted for all relevant demographic, social, and economic factors. Subsequently, we integrated the longitudinal dataset and estimated parameters with validated dynamic microsimulation models, projecting hospitalization and mortality trends up to 2030 according to a range of potential intensities and durations of the economic crisis, as well as a range of alternative policy responses.
Consolidated coverages of BFP, FHS, and BPC reduce the overall age-standardized mortality rate, with Rate Ratios of 0.94(95%CI:0.94-0.96), 0.93(95%CI:0.93-0.94), and 0.92(95%CI:0.91-0.92), respectively; stronger effects were found for under-five mortality, with RR of 0.87(95%CI:0.85-0.90), 0.90(95%CI:0.88-0.93), and 0.84(95%CI:0.82-0.86), respectively. A mitigation strategy that increases the coverage of the BFP, FHS, and BPC proportionally to the increase of poverty rates will avert 778,845 (95%CI:665,074- 893,674) deaths by 2030 if compared with the current coverage trends, and 1,424,624 (95%CI: 1,264,552 –1,587,859) deaths if compared with scenarios of fiscal austerity.
The Brazilian cash transfer, social pension, and primary health care programs had a comprehensive and large impact on the country’s hospitalizations and mortality over the last two decades in the country. Moreover, using robust forecasting methods, we show that mitigation strategies could avert up to 1.4 million overall deaths and 170,000 under-five deaths over the next decade, when compared to commonly implemented fiscal austerity measures.