The Bolsa Família Program (BFP) is one of the largest conditional cash transfer programs in the world, providing cash transfers and intersectoral actions. The aim of this study was to compare whether there is a difference in access to health services, intersectoral actions and social control, between families entitled or not, to the BFP. A cross-sectional study was carried out. A representative sample of a peripheral, socioeconomically vulnerable population from a large urban center in southeastern Brazil was calculated, totaling 380 families. Chi-square or Fisher’s exact tests and multiple correspondence analysis were used to compare groups. Families entitled to the BFP had worse living conditions in general and greater access to health services, such as: medical care (p-value 0.009), community healthcare agent (p-value 0.001) and home visits (p-value 0.041). Being entitled or not affected the variability in the pattern of access to services by 31%; low access to intersectoral actions was identified in both groups; social control was incipient. There was an adequate focus on the program; greater access to health services was related to compliance with conditionalities; low access to intersectoral actions can restrict the interruption of the cycle of intergenerational transmission of poverty.
WarbyB.Long-term societal impacts of conditional cash transfers: Bolsa Família a decade in. Int Multidiscip J Soc Sci. 2018; 7: 79–103.
2.
PeñaCRPinheiroDSAlbuquerquePHMFernandesLM.A eficácia das transferências de renda: as tendências da desigualdade antes e depois do Programa Bolsa Família. Rev Adm Pública. 2015; 49: 889–913.
3.
PorterCGoyalR.Social protection for all ages? Impacts of Ethiopia‘s Productive Safety Net Program on child nutrition. Soc Sci Med. 2016; 159: 92–99.
4.
WitvorapongNFoshanjiAI.The impact of a conditional cash transfer program on the utilization of non-targeted services: evidence from Afghanistan. Soc Sci Med. 2016; 152: 87–95.
5.
KandpalEAldermanHFriedmanJFilmerDOnishiJAvalosJ.A conditional cash transfer program in the Philippines reduces severe stunting. J Nutr. 2016; 146: 1793–1800.
6.
SidneyKTolhurstRJehanKDiwanVDe CostaA.The money is important but all women anyway go to hospital for childbirth nowadays: a qualitative exploration of why women participate in a conditional cash transfer program to promote institutional deliveries in Madhya Pradesh, India. BMC Pregnancy Childbirth. 2016; 16: 47.
7.
BehrmanJRGallardo-GarcíaJParkerSWToddPEVélez-GrajalesV.Are conditional cash transfers effective in urban areas? Evidence from Mexico. Educ Econ. 2012; 20: 233–259.
8.
VasconcelosFAGMachadoMLMedeirosMATNevesJARecineEPasquimEM. Public policies of food and nutrition in Brazil: from Lula to Temer. Revi Nutrição. 2019; 32: e180161.
9.
BohnSVeigaLFDa DaltSBrandãoAAPGouvêaVHC. Can conditional cash transfer programs generate equality of opportunity in highly unequal societies? Evidence from Brazil. Rev Sociol Polit. 2014; 22: 111–133.
10.
MendesRAkermanM. Intersetorialidade: reflexões e práticas. In: JCFFernandezMendesR (eds). Promoção da Saúde e gestão local/ organização. 2nd ed.São Paulo: Hucitec; Cepedoc Cidades Saudáveis; 2014.
11.
ChiariAPGFerreiraRCAkermanMAmaralJHLMachadoKMSennaMIB. Rede intersetorial do Programa Saúde na Escola: sujeitos, percepções e práticas. Cadernos de Saúde Pública. 2018; 34: e00104217.
12.
DiasPCHenriquesPFerreiraDMBarbosaRMSSoaresDSBLuquezTMS, et al. Desafios da intersetorialidade nas políticas públicas: o dilema entre a suplementação nutricional e a promoção da alimentação saudável em escolas. Cadernos de Saúde Pública. 2018; 34: e00035218.
13.
FioratiRCArcêncioRAPozoJSRamasco-GutiérrezMSerrano-GallardoP.Intersectoriality and social participation as coping policies for health inequities-worldwide. Gac Sanit. 2018; 32: 304–314.
14.
SheiACostaFReisMGKoAI.The impact of Brazil’s Bolsa Família conditional cash transfer program on children‘s health care utilization and health outcomes. BMC Int Health Hum Rights. 2014; 14: 10.
15.
GuanaisFC.The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998–2010. Am J Public Health. 2013; 103: 2000–2006.
16.
RasellaDAquinoRSantosCATPaes-SousaRBarretoML.Effect of a conditional cash transfer programme on childhood mortality: a nationwide analysis of Brazilian municipalities. Lancet. 2013; 382: 57–64.
17.
NevesJAVasconcelosFAGMachadoMLRecineEGarciaGSMedeirosMAT. The Brazilian cash transfer program (Bolsa Família): a tool for reducing inequalities and achieving social rights in Brazil. Glob Public Health. Epub ahead of print 30 November 2020. DOI: 10.1080/17441692.2020.1850828.
18.
LimaLPZangirolaniLTO. Bolsa Família Program: profile, intersectorial actions and perceptions of service managers, in a case study in Morros de Santos, Brazil. DEMETRA: Alimentação, Nutrição & Saúde.2016; 11: 1297–1315.
19.
SilvaNN.Amostragem Probabilística. São Paulo: Editora da USP; 1998.
20.
R Core Team.R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing; 2019.
21.
SchmidtKHLabrecqueJSantosISMatijasevichABarrosFCBarrosAJD. Focus and coverage of Bolsa Família Program in the Pelotas 2004 birth cohort. Rev Saúde Pública. 2017; 51: 22.
22.
SilvaFSQueirozRCSBrancoMRFCHabenschusMIATScorzafaveLGSaraivaMCP, et al. Targeting and coverage of the Bolsa Família program in children from the BRISA Birth Cohorts, Ribeirão Preto (São Paulo State) and São Luís (Maranhão State), Brazil. Cad Saúde Pública. 2019; 35: e00159718.
23.
StampiniMTornarolliL.The Growth of Conditional Cash Transfers in Latin America and the Caribbean: Did They Go Too Far?Bonn: Institute for the Study of Labor; 2012.
24.
LabrecqueJAKaufmanJS.Health profile differences between recipients and non-recipients of the Brazilian Income Transfer Program in a low-income population. Cadernos de Saúde Pública. 2019; 35: e00141218.
25.
AnafJBaumFFreemanTLabonteRJavanparastSJolleyG, et al. Factors shaping intersectoral action in primary health care services. Prim Health Care Gen Pract. 2014; 38: 553–559.
26.
SircarNRFriedmanEA.Financial security and public health: how basic income & cash transfers can promote health. Glob Public Health. 2018; 13: 1878–1888.
SilvaACFRecineEJohnsPGomesFSFerrazMAFaersteinE. History and challenges of Brazilian social movements for the achievement of the right to adequate food. Glob Public Health. 2018; 14: 875–883.
29.
CastroIRR. A extinção do Conselho Nacional de Segurança Alimentar e Nutricional e a agenda de alimentação e nutrição. Cad Saúde Pública. 2019; 35: e00009919.
30.
Brasil. Lei nº 11.346, de 15 de setembro de 2006. Cria o Sistema Nacional de Segurança Alimentar e Nutricional - SISAN com vistas em assegurar o direito humano à alimentação adequada e dá outras providências. 2006. Diário Oficial da União; 18 set.
31.
JaimePCDelmuèDCCCampelloTSilvaDOSantosLMP. A look at the food and nutrition agenda over thirty years of the Unified Health System. Cien Saude Colet. 2018; 23: 1829–1836.
32.
NdlovuTNdlovuS.Are cash transfers the panacea to local involvement in humanitarian decision making?Evidence from world vision projects in Umzingwane, Jamba. 2019; 11: a486.
33.
AndradeLOPellegriniFASolarORígoliFSalazarLMSerratePC, et al. Social determinants of health, universal health coverage, and sustainable development: case studies from Latin American countries. Lancet. 2015; 385: 1343–1351.
34.
WangLWangZMaQFangGYangJ. The development and reform of public health in China from 1949 to 2019. Glob Health. 2019; 15: 45.
35.
DoshmangirLBazyarMMajdzadehRTakianA.So near, so far: four decades of health policy reforms in Iran, achievements and challenges. Arch Iran Med. 2019; 22: 532–605.
36.
HeoHJeongWCheXHChungH.A stakeholder analysis of community-led collaboration to reduce health inequity in a deprived neighbourhood in South Korea. Glob Health Promot. 2018; 14: 1757975918791517.
