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What is the relative impact of primary health care quality and conditional cash transfer program in child mortality?
Vieira-Meyer, Anya Pimentel Gomes Fernandes; de Araújo Dias, Maria Socorro; Vasconcelos, Maristela Ines Osawa; Rouberte, Emilia Soares Chaves; de Almeida, Ana Mattos Brito; de Albuquerque Pinheiro, Themis Xavier; de Lima Saintrain, Maria Vieira; Machado, Maria de Fatima Antero Sousa; Dufault, Suzanne; Reynolds, Sarah Ann; Fernald, Lia.
Afiliação
  • Vieira-Meyer APGF; Family Health Master Program, Fundação Oswaldo Cruz (FIOCRUZ), Fortaleza, Rua São José, S/N, Eusébio, CE, Brazil. anyavieira10@gmail.com.
  • de Araújo Dias MS; Faculty of Dentistry, Centro Universitário Christus (Unichristus), Fortaleza, Brazil. anyavieira10@gmail.com.
  • Vasconcelos MIO; Universidade Vale do Acaraú, Sobral, Brazil.
  • Rouberte ESC; Universidade Vale do Acaraú, Sobral, Brazil.
  • de Almeida AMB; Universidade da Integração Internacional da Lusofonia Afro-brasileira (UNILAB), Redenção, Brazil.
  • de Albuquerque Pinheiro TX; Universidade de Fortaleza (UNIFOR), Fortaleza, Brazil.
  • de Lima Saintrain MV; Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil.
  • Machado MFAS; Public Health Program. Universidade de Fortaleza (UNIFOR), Fortaleza, Brazil.
  • Dufault S; Universidade Regional do Cariri (URCA), Juazeiro do Norte, Brazil.
  • Reynolds SA; Department of Biostatistics, University of California, Berkeley, CA, USA.
  • Fernald L; School of Public Health, University of California, Berkeley, CA, USA.
Can J Public Health ; 110(6): 756-767, 2019 12.
Article em En | MEDLINE | ID: mdl-31359297
OBJECTIVE: Evaluate how coverage and quality of primary health care (PHC) and a conditional cash transfer (CCT) program associate with child mortality in Brazil. METHODS: Multivariate linear regression models and least absolute shrinkage and selection estimator (LASSO) were utilized with the municipal level child mortality rate as the key dependent variable. PHC quality with PHC and CCT coverage were the independent variables. The quality of the Brazilian PHC was assessed using the Brazilian National Program for Access and Quality Improvement in PHC data. PHC and CCT coverage were calculated based on Brazilian official databases. Human developmental index (HDI), municipality size, and country region were used as control variables. A total of 3441 municipalities were evaluated. RESULTS: We found that ESF (Estratégia Saúde da Família) quality variables PLANNING [Family Health Team Planning activities], CITYSUPPORT [municipality support for Family Health Strategy activities], EXAMS [exams offered and priority groups seen by the family health team], and PRENATAL [prenatal care and exams provided by the family health team], as well as HDI, percentage of PHC coverage, percentage of CCT coverage, and population size have significant and negative relationships with 1-year-old child mortality. LASSO regression results confirmed these associations. Quality is an important element of effective social service provision. CONCLUSION: This exploration represents one of the first investigations into the role of PHC system quality, and how it is related to health outcomes, while also considering PHC and conditional cash transfer program coverage. Quality of PHC, measured by work process variables, plays an important role in child mortality. Efforts on PHC quality and coverage, as well as on CCT program coverage, are important to child mortality reduction. Therefore, this is an important finding to other PHC public health services.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Assistência Pública / Qualidade da Assistência à Saúde / Mortalidade da Criança Tipo de estudo: Evaluation_studies / Prognostic_studies Limite: Child / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Can J Public Health Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Atenção Primária à Saúde / Assistência Pública / Qualidade da Assistência à Saúde / Mortalidade da Criança Tipo de estudo: Evaluation_studies / Prognostic_studies Limite: Child / Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Can J Public Health Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Brasil País de publicação: Suíça