What is the relative impact of primary health care quality and conditional cash transfer program in child mortality?
| Autor: | Emilia Soares Chaves Rouberte, Ana Mattos Brito de Almeida, Maristela Inês Osawa Vasconcelos, Lia C. H. Fernald, Sarah Ann Reynolds, Maria Socorro de Araújo Dias, Anya Pimentel Gomes Fernandes Vieira-Meyer, Maria Vieira de Lima Saintrain, Themis Xavier de Albuquerque Pinheiro, Suzanne M. Dufault, Maria de Fátima Antero Sousa Machado |
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| Rok vydání: | 2019 |
| Předmět: |
Child mortality
medicine.medical_specialty Quality management media_common.quotation_subject education Prenatal care Conditional cash transfer program behavioral disciplines and activities 03 medical and health sciences Clinical Research Environmental health Bayesian multivariate linear regression medicine Humans Quality (business) Child Quality of Health Care media_common 030505 public health Variables Primary Health Care Public health Conditional cash transfer Public Health Environmental and Occupational Health Public Assistance General Medicine Health Services Good Health and Well Being Child Mortality Public Health and Health Services Quality of health care Public Health Quantitative Research 0305 other medical science Psychology Brazil Curriculum and Pedagogy Program Evaluation |
| Zdroj: | Canadian journal of public health = Revue canadienne de sante publique, vol 110, iss 6 Can J Public Health |
| ISSN: | 1920-7476 0008-4263 |
| Popis: | 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.17269/s41997-019-00246-9) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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