RESUMO

BACKGROUND: Preterm births increase mortality and morbidity during childhood and later life, which is closely associated with poverty and the quality of prenatal care. Therefore, income redistribution and poverty reduction initiatives may be valuable in preventing this outcome. We assessed whether receipt of the Brazilian conditional cash transfer programme - Bolsa Familia Programme, the largest in the world - reduces the occurrence of preterm births, including their severity categories, and explored how this association differs according to prenatal care and the quality of Bolsa Familia Programme management. METHODS: A retrospective cohort study was performed involving the first live singleton births to mothersenrolled in the 100 Million Brazilian Cohort from 2004 to 2015, who had at least one child before cohort enrollment. Only the first birth during the cohort period was included, but born from 2012 onward. A deterministic linkage with the Bolsa Familia Programme payroll dataset and a similarity linkage with the Brazilian Live Birth Information System were performed. The exposed group consisted of newborns to mothers who received Bolsa Familia from conception to delivery. Our outcomes were infants born with a gestational age < 37 weeks: (i) all preterm births, (ii) moderate-to-late (32-36), (iii) severe (28-31), and (iv) extreme (< 28) preterm births compared to at-term newborns. We combined propensity score-based methods and weighted logistic regressions to compare newborns to mothers who did and did not receive Bolsa Familia, controlling for socioeconomic conditions. We also estimated these effects separately, according to the adequacy of prenatal care and the index of quality of Bolsa Familia Programme management. RESULTS: 1,031,053 infants were analyzed; 65.9% of the mothers were beneficiaries. Bolsa Familia Programme was not associated with all sets of preterm births, moderate-to-late, and severe preterm births, but was associated with a reduction in extreme preterm births (weighted OR: 0.69; 95%CI: 0.63-0.76). This reduction can also be observed among mothers receiving adequate prenatal care (weighted OR: 0.66; 95%CI: 0.59-0.74) and living in better Bolsa Familia management municipalities (weighted OR: 0.56; 95%CI: 0.43-0.74). CONCLUSIONS: An income transfer programme for pregnant women of low-socioeconomic status, conditional to attending prenatal care appointments, has been associated with a reduction in extremely preterm births. These programmes could be essential in achieving Sustainable Development Goals.

Assuntos

Nascimento Prematuro , Recém-Nascido , Gravidez , Criança , Lactente , Feminino , Humanos , Estudos Retrospectivos , Estudos Longitudinais , Brasil/epidemiologia , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/prevenção & controle , Fertilização

RESUMO

This research analyses the Prospera program's impact on poverty and income distribution through a computable general equilibrium model. It concludes that transfers to households have a positive impact on the Mexican economy but hide the real problem-the low wage share-that, in the long term, prevents poverty from worsening but does not reduce the population in poverty or inequality. In a scenario without transfers, neither the population in poverty nor the Gini Index decreases significantly. The results obtained lead to an understanding of some of the causes of the high rates of poverty and inequality in Mexico, which in turn have been perpetuated since the economic crisis of 1995. This allows the design of public policies in line with the structural needs of the economy, which combat the problem from the root that generates it, in order to contribute to the reduction of inequality in accordance with the UN Sustainable Development Goal 10.

Assuntos

Pobreza , Mudança Social , Humanos , México/epidemiologia , Avaliação de Programas e Projetos de Saúde , Pobreza/prevenção & controle , Renda

RESUMO

OBJECTIVES: The aims of this scoping review are to assess the literature investigating the association between cash transfer programs and oral health; and to identify the theoretical frameworks applied to guide this literature. METHODS: A search strategy to identify studies published until December 2020 was applied to a range of databases. Observational and interventional studies that had cash transfer programs as exposure/intervention and oral health as outcome were considered. Dental health services utilization, as well as access to dental health services, were considered secondary outcomes. Cash transfer programs were considered programs based on conditional or unconditional cash transfer carried out as part of national social protection schemes, and interventional studies on the impact of cash transfer on oral health were also considered eligible. Data charting was performed in two steps and a narrative synthesis was conducted. RESULTS: Of 6344 articles identified, four articles were included. These articles investigated three different conditional cash transfer programs, Universal Child Allowance (Argentina), Bolsa Família (Brazil) and Family Rewards (USA). Inconsistencies were identified in findings on the effect of conditional cash transfer programs on the prevalence of dental caries and these differences may be due to the comparison group selected for each study. Concerning dental visits, the results point in different directions, which makes these findings still inconclusive. No explicit theoretical framework was reported in the articles to guide the expected association. CONCLUSION: Although cash transfers play an important role in improving certain health outcomes, there is limited evidence to suggest an association between cash transfers and oral health.

Assuntos

Cárie Dentária , Saúde Bucal , Criança , Humanos , Cárie Dentária/prevenção & controle , Brasil/epidemiologia

RESUMO

This article provides five panel datasets for the projections of the mean replacement ratios of pension income relative to the worker's income. The time dimension is from year 2022 until 2055. The panel groups consider the gender, income and education of the workers. Furthermore, the variables consider different scenarios for the social security system: (1) a baseline with the current policies, (2) an increase of retirement age to 67 years, (3) an increase of the retirement age to 67 years and a 6% increase of the contribution rate, with a rate of 0-3% going to solidarity funds.