Conditional cash transfer program and child mortality: A cross-sectional analysis nested within the 100 Million...

Area of Science:

• Public Health
• Social Epidemiology
• Health Policy

Background:

• Brazil has significantly reduced child mortality in recent decades.
• The Bolsa Família program (BFP) is credited with a portion of this success.
• Understanding BFP's impact on child mortality across different demographics is crucial.

Purpose of the Study:

• To examine the association between Bolsa Família program (BFP) participation and child mortality (1-4 years).
• To investigate how this association varies by maternal race/skin color, gestational age, municipality income, and BFP management quality.

Main Methods:

• Cross-sectional analysis of the 100 Million Brazilian Cohort (over 6.3 million children).
• Data linkage with BFP payroll and Brazilian Mortality Information System.
• Kernel matching and weighted logistic regressions were employed.

Main Results:

• BFP participation was associated with a significant reduction in child mortality (OR=0.83).
• The protective association was stronger for preterm children (OR=0.78), Black children (OR=0.74), and children in the lowest income quintile municipalities (OR=0.72).
• Better BFP management quality also correlated with stronger mortality reduction (OR=0.76).

Conclusions:

• BFP participation is linked to improved child survival rates in Brazil.
• The program's benefits are particularly significant for vulnerable subgroups, including preterm infants and children of Black mothers in low-income areas.
• Findings support BFP's role in enhancing child health and survival, offering insights for policy refinement and targeted interventions.