Health services, intersectoriality and social control: a comparative study on a conditional income transfer program

Area of Science:

• Public Health
• Socioeconomic Studies
• Health Services Research

Background:

• The Bolsa Família Program (BFP) is a major global conditional cash transfer initiative.
• Understanding BFP's impact on health access and social determinants is crucial for poverty reduction.
• Socioeconomically vulnerable populations often face barriers to essential services.

Purpose of the Study:

• To compare health service access, intersectoral actions, and social control between BFP-eligible and non-eligible families.
• To analyze the influence of BFP enrollment on service utilization patterns in a vulnerable urban population.

Main Methods:

• Cross-sectional study involving a representative sample of 380 families in a Brazilian urban center.
• Statistical analysis including Chi-square tests, Fisher's exact tests, and multiple correspondence analysis.
• Comparison of service access based on BFP eligibility.

Main Results:

• BFP-eligible families reported worse general living conditions but demonstrated significantly greater access to healthcare services (medical care, community health agents, home visits).
• BFP eligibility explained 31% of the variability in service access patterns.
• Both groups exhibited low access to intersectoral actions, and social control was minimal.

Conclusions:

• The Bolsa Família Program effectively increases access to health services, likely linked to conditionalities.
• Limited access to intersectoral actions among BFP participants may hinder breaking intergenerational poverty cycles.
• Further integration of intersectoral strategies is needed to maximize the program's impact on poverty.