scholarly journals Individual and contextual predictors of children’s hemoglobin levels from Southern Brazilian municipalities in social vulnerability

2020 ◽  
Vol 36 (12) ◽  
Author(s):  
Débora Letícia Frizzi Silva ◽  
Doroteia Aparecida Höfelmann ◽  
Cesar Augusto Taconeli ◽  
Regina Maria Ferreira Lang ◽  
Camila Dallazen ◽  
...  
Keyword(s):  
Social Vulnerability ◽  
Linear Models ◽  
Conditional Cash Transfer ◽  
Hemoglobin Level ◽  
Cash Transfer ◽  
Transfer Program ◽  
Ecological Data ◽  
Cross Sectional ◽  
Significance Level ◽  
The Individual

Abstract: Few studies have investigated the simultaneous effect of individual and contextual factors on the occurrences of anemia. This study aims to evaluate the variability of children’s hemoglobin levels from municipalities in social vulnerability and its association with factors of individual and municipal nature. This is a cross-sectional, multi-center study, with children data (12-59 months) collected from 48 municipalities of the Southern region of Brazil, that were included in the Brazil Without Poverty Plan. Individuals’ data were collected using a structured questionnaire, and secondary and ecological data of children’s municipalities were collected via national surveys and institutional websites. The outcome was defined as the hemoglobin level obtained by HemoCue. A multilevel analysis was performed using Generalized Linear Models for Location Scale and Shape using R, with a 5% significance level. A total of 1,501 children were evaluated. The mean hemoglobin level was 12.8g/dL (95%CI: 12.7-12.8), with significant variability between municipalities. Lower values of hemoglobin were observed in children who lived in municipalities with a higher urbanization rate and a lower number of Community Health Agents, in relation to the reference categories. At the individual level, lower hemoglobin values were identified for children under 24 months, not enrolled at daycares, who were beneficiaries of the conditional cash transfer program and diagnosed with underweight. The results shed light on important factors at the municipal and the individual levels that were associated to the hemoglobin levels of children living in municipalities in social vulnerability.

Dietary patterns of children aged 6–24 months assisted by the Bolsa Família Program

2021 ◽  
pp. 1-26
Author(s):  
Marília Moura e Mendes ◽  
Giovana de Montemor Marçal ◽  
Ana Elisa Madalena Rinaldi ◽  
Nassib Bezerra Bueno ◽  
Telma Maria de Menezes Toledo Florêncio ◽  
...  
Keyword(s):  
Dietary Patterns ◽  
Linear Regression Analysis ◽  
Principal Component ◽  
Conditional Cash Transfer ◽  
The State ◽  
Cash Transfer ◽  
Processed Foods ◽  
Transfer Program ◽  
Cross Sectional ◽  
Bolsa Familia

Abstract Objective: This study aimed to verify the association between socioeconomic and demographic characteristics and dietary patterns (DP) of children assisted by the Conditional Cash Transfer Program, Bolsa Família (BFP). Design: This is a cross-sectional study. DP were defined using a principal component analysis. The association of the predictive variables and DP was modelled using multilevel linear regression analysis. Setting: This study was conducted in six municipalities from the State of Alagoas, Brazil. Participants: The participants were children aged 6–24 months who were assisted by the BFP. Results: A total of 1,604 children were evaluated. Four DPs were identified (DP1, DP2, DP3, and DP4). DP1 is composed of traditional Brazilian food. DP2 is formed mostly from ultra-processed foods (UPF). DP3 consists of milk (non-breast) with added sugar, while DP4 consists of fresh and minimally processed foods. Caregivers with higher age and education (β = −0.008; 95%CI: [−0.017; −0.000]; β = −0.037; 95%CI: [−0.056; −0.018], respectively) were negatively associated with DP2. We observed a negative association between households with food insecurity (β = −0.204; 95%CI: [−0.331; −0.078]) and DP4 and a positive association between caregivers with higher age and education (β = 0.011; 95%CI: [0.003; 0.019]; β = 0.043; 95%CI: [0.025; 0.061], respectively) and DP4. Conclusion: This study identified the association between socioeconomic inequities and DP early in life, with an early introduction of UPF, in children assisted by BFP in the State of Alagoas.

scholarly journals Perceptions of beneficiaries and health professionals regarding a conditional cash transfer program to improve pregnancy follow-up: a qualitative analysis of the NAITRE randomized controlled study

2020 ◽  
Author(s):  
AURELIE GODARD MARCEAU ◽  
Nicolas Meunier-Beillard ◽  
Philippe Deruelle ◽  
Mathieu Morin ◽  
Claude Virtos ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Professionals ◽  
Access To Health Care ◽  
Conditional Cash Transfer ◽  
Economic Incentives ◽  
Cash Transfer ◽  
Controlled Study ◽  
Transfer Program ◽  
Cross Sectional

Abstract Background: Economic incentives have been used in several countries to improve pregnancy follow-up, to encourage families to bring their infants to see a doctor, and to promote school attendance. However, these conditional cash transfer programs (CCTs) are often subject to criticism. The NAITRE study, which is currently underway in France, assesses the use of CCT to promote prenatal care in women with low socioeconomic backgrounds and has also been the focus of such criticism. The objective of the qualitative study was to analyse how the CCT is perceived by the women and health professionals involved in the project. These data are essential for in-depth understanding of the elements that could encourage or deter a generalization of the process. Methods: A multicentre, cross-sectional, qualitative study was conducted among 26 women included in the NAITRE trial and 8 health professionals (physicians and midwives). All data were collected through semi-structured individual interviews and transcribed in their entirety. A thematic content analysis was then used to generate the results. Results: In the interviews, the women expressed surprise regarding the offer of a cash incentive. However, they did not perceive the CCT negatively, but saw it rather as a significant source of aid for women with limited financial resources. Some even expressed feeling as though they were supported far beyond the financial support. The health professionals were much less positive. Still, though they all stressed the ethical considerations related to the premise of the trial, they recognized the need for such an evaluation. Conclusions: In a country where access to health care is facilitated by a nationalized health insurance system, the use of a CCT to improve medical follow-up during pregnancy raises ethical questions for the health professionals involved. However, an analysis of the interviews conducted with the women who received compensation showed that they did not feel stigmatized. While the women generally reported that the CCT money allowed them to better prepare for the birth, none indicated that they changed their behaviour relative to medical follow-up during the pregnancy.

scholarly journals Women and health professionals’ perspectives on a conditional cash transfer program to improve pregnancy follow-up: a qualitative analysis of the NAITRE randomized controlled study

2020 ◽  
Author(s):  
AURELIE GODARD MARCEAU ◽  
Nicolas Meunier Beillard ◽  
Philippe Deruelle ◽  
Mathieu Morin ◽  
Claude Virtos ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Prenatal Care ◽  
Health Professionals ◽  
Medical Condition ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Controlled Study ◽  
Transfer Program ◽  
Cross Sectional

Abstract Objectives. Many types of conditional cash transfer (CCTs) programs have been developed and their effects demonstrated, including programs to improve prenatal care, but ethical critiques have included paternalism and lack of informed choice. These criticisms were levelled at the French NAITRE randomized clinical trial, which is assessing a CCT program that promotes prenatal care among women of low socioeconomic backgrounds. We conducted qualitative research to determine if women in the study and health professionals (HP) shared these concerns.Study design. We conducted a multicenter, cross-sectional, qualitative study of 26 participating post-delivery women and 8 HP (physicians and midwives, participants and non-participants) to assess their perspectives on CCT, purposively selecting a sample of women with diverse experiences. We excluded women who had miscarried or whose babies had died, or whose new-born suffered from a severe medical condition. We invited health professionals to participate even if they or their center had not participated in the trial. Participants agreed to semi-structured face-to-face or phone interviews, which we recorded as audio and transcribed. Our approach to identifying patterns was inductive; we highlighted topics that repeatedly emerged, characterized them, and organized them into themes.Results. Women expressed surprise that the CCT was offered, but did not perceived it negatively. They never mentioning feeling stigmatized. They described CCT as a significant source of aid for women with limited financial resources. HP described the CCT in less positive terms, e.g., expressing concern about discussing cash transfer at their first medical encounter with women. Though they emphasized ethical concerns about the basis of the trial, they recognized that CCT needed to be evaluated.Conclusion. In France, a high-income country where prenatal follow-up is free, health professionals were concerned that the CCT program would change their relationship with patients and wondered if it was the best use of funding, but women who received a cash incentive said they did not feel stigmatized and indicated that these payments helped them prepare for their baby’s birth. Trial registration: NCT02402855- Clinical Trial – first registration 30 march 2015 -

scholarly journals Combination of conditional cash transfer program and environmental health interventions reduces child mortality: an ecological study of Brazilian municipalities

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anelise Andrade de Souza ◽  
Sueli Aparecida Mingoti ◽  
Rômulo Paes-Sousa ◽  
Leo Heller
Keyword(s):  
Environmental Health ◽  
Solid Waste ◽  
Total Population ◽  
Conditional Cash Transfer ◽  
Cash Transfer ◽  
Transfer Program ◽  
Waste Collection ◽  
High Coverage ◽  
Solid Waste Collection ◽  
Access To Water

Abstract Background This study aims to assess the interactive effects of Brazilian public interventions, environmental health programs (access to water, sanitation and solid waste collection) and a Conditional Cash Transfer Program (PBF), on the mortality reduction due to diarrhea and malnutrition among children under 5 years old. Methods The study design is ecological, with longitudinal analysis in a balanced panel. The period covered is 2006 to 2016, including 3467 municipalities from all regions of the country, which resulted in 38,137 observations. The generalized linear models were adjusted considering the Negative Binomial (NB) distribution for the number of deaths due to malnutrition and diarrhea, with fixed effects. NB models with and without zero-inflation were assessed. Subsequent interaction models were applied to assess the combined effects of the two public policies. Results In relation to the decline of mortality rates due to diarrhea in the municipalities, positive effect modification were observed in the presence of: high coverage of the target population by the PBF and access to water, 0.54 (0.28–1.04) / 0.55 (0.29–1.04); high coverage by the total population by the PBF and access to water, 0.97 (0.95–1.00) and high coverage by the total population by the PBF and access to sanitation, 0.98 (0.97–1.00). Decline on diarrhea mortality was also observed in the joint presence of high coverage of solid waste collection and access to water, categories 1 (> 60% ≤85%): 0.98 (0.96–1.00), 0.98 (0.97–1, 00) and 2 (> 85% ≤ 100%): 0.97 (0.95–0.98), 0.97 (0.95–0.99). Negative effect modification were observed for mortality due to malnutrition in the presence of simultaneous high coverage of the total population by the PBF and access to sanitation categories 1 (≥ 20 < 50%): 1.0061 (0.9991–1.0132) and 2 (≥ 50 < 100%): 1.0073 (1.0002–1.0145) and high coverage of the total population by the PBF and solid waste collection, 1.0004 (1.0002–1.0005), resulting in malnutrition mortality rates increase. Conclusion Implementation of environmental health services and the coverage expansion by the PBF may enhance the prevention of early deaths in children under 5 years old due to diarrhea, a poverty related disease.

Interactions between Conditional Cash Transfers and Preferred Secondary Schools in Jamaica

2021 ◽  
Author(s):  
Diether Beuermann ◽  
Andrea Ramos Bonilla ◽  
Marco Stampini
Keyword(s):  
Secondary School ◽  
Secondary Schools ◽  
Conditional Cash Transfer ◽  
School Enrollment ◽  
Cash Transfer ◽  
Transfer Program ◽  
High Stakes ◽  
Dynamic Interactions ◽  
Post Secondary ◽  
Selective School

We explore whether the academic benefit from attending a preferred secondary school differs between beneficiaries and non-beneficiaries of the Jamaican Conditional Cash Transfer Program, Programme of Advancement through Health and Education (PATH). The academic outcomes assessed include end of secondary and post-secondary high-stakes examinations independently administered by the Caribbean Examinations Council. Among girls, receiving PATH benefits before secondary school enrollment does not influence the academic gains from attending a more selective school. However, boys who received PATH benefits prior to secondary school enrollment benefit significantly less from subsequently attending a more selective school with respect to comparable peers who did not receive PATH benefits. These results suggest negative dynamic interactions between PATH and selective secondary schools among boys.

Anti-Poverty Transfers and Poverty Reduction

2018 ◽  
Author(s):  
Armando Barrientos
Keyword(s):  
Poverty Reduction ◽  
Conditional Cash Transfer ◽  
Conditional Cash Transfers ◽  
Cash Transfer ◽  
Political Crisis ◽  
Transfer Program ◽  
Policy Initiatives ◽  
Poverty And Inequality ◽  
Bolsa Familia ◽  
Conditional Cash Transfer Program

This chapter examines the role that public policy initiatives—specifically anti-poverty transfers—have played in the reduction of poverty and inequality in Brazil. A number of anti-poverty initiatives are considered in turn, and not just the widely known Bolsa Familia conditional cash transfer program. The analysis establishes that such transfers—including conditional cash transfers—have proved surprisingly effective, even helping to tackle long-standing income inequality. It is recognized that explicit anti-poverty initiatives were not the only drivers of the reduced incidence of poverty and inequality: factors such as growth and improved access to labor markets also played a role. However, progress is now threatened by the recent economic and political crisis.

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