title: The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998-2010.
abstract: OBJECTIVE
  I examined the combined effects of access to primary care through the Family Health Program (FHP) and conditional cash transfers from the Bolsa Familia Program (BFP) on postneonatal infant mortality (PNIM) in Brazil.
  
  
  METHODS
  I employed longitudinal ecological analysis using panel data from 4583 Brazilian municipalities from 1998 to 2010, totaling 54,253 observations. I estimated fixed-effects ordinary least squares regressions models with PNIM rate as the dependent variable and FHP, BFP, and their interactions as the main independent variables of interest.
  
  
  RESULTS
  The association of higher FHP coverage with lower PNIM became stronger as BFP coverage increased. At the means of all other variables, when BFP coverage was 25%, predicted PNIM was 5.24 (95% confidence interval [CI] = 4.95, 5.53) for FHP coverage = 0% and 3.54 (95% CI = 2.77, 4.31) for FHP coverage = 100%. When BFP coverage was 60%, predicted PNIM was 4.65 (95% CI = 4.36, 4.94) when FHP coverage = 0% and 1.38 (95% CI = 0.88, 1.89) when FHP coverage = 100%.
  
  
  CONCLUSIONS
  The effect of the FHP depends on the expansion of the BFP. For impoverished, underserved populations, combining supply- and demand-side interventions may be necessary to improve health outcomes.
authors.affiliation: Frederico C. Guanais is with the Social Protection and Health Division, Inter-American Development Bank, Washington, DC.
authors.forename: Frederico C
authors.initials: FC
authors.lastname: Guanais
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002947:Cities; D006293:Health Promotion / Q000191:economics* / Q000379:methods; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality / Q000639:trends*; D007231:Infant, Newborn; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D008137:Longitudinal Studies; D015233:Models, Statistical; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*
references.citation: Pediatrics. 1998 Jul;102(1 Pt 1):25-30
references.pmid: 9651409
references.citation: Bull World Health Organ. 2011 Jul 1;89(7):496-503
references.pmid: 21734763
references.citation: Lancet. 2003 Jun 28;361(9376):2226-34
references.pmid: 12842379
references.citation: Lancet. 2003 Jul 26;362(9380):323-7
references.pmid: 12892965
references.citation: Global Health. 2011 Oct 24;7:42
references.pmid: 22023970
references.citation: J Ambul Care Manage. 2009 Apr-Jun;32(2):115-22
references.pmid: 19305223
references.citation: Cad Saude Publica. 2002 Nov-Dec;18(6):1725-36
references.pmid: 12488900
references.citation: JAMA. 2007 Oct 24;298(16):1900-10
references.pmid: 17954541
references.citation: Health Econ. 2010 Sep;19 Suppl:126-58
references.pmid: 20803631
references.citation: PLoS One. 2010 Sep 17;5(9):
references.pmid: 20862298
references.citation: Am J Public Health. 2011 Oct;101(10):1963-70
references.pmid: 21330584
references.citation: Health Aff (Millwood). 2009 Jul-Aug;28(4):1127-35
references.pmid: 19597212
references.citation: Lancet. 2008 Nov 8;372(9650):1661-9
references.pmid: 18994664
references.citation: Pediatrics. 2010 Sep;126(3):e534-40
references.pmid: 20679307
references.citation: Scand J Public Health. 2007;35(3):288-97
references.pmid: 17530551
references.citation: Bull World Health Organ. 2003;81(2):140-5
references.pmid: 12756980
references.citation: Prev Med. 2012 Nov;55 Suppl:S95-S105
references.pmid: 22178043
references.citation: Pediatrics. 2001 Jun;107(6):1335-42
references.pmid: 11389253
references.citation: Health Policy Plan. 2004 Mar;19(2):69-79
references.pmid: 14982885
references.citation: Lancet. 2008 Mar 8;371(9615):828-37
references.pmid: 18328930
references.citation: Lancet. 2009 Dec 12;374(9706):1997-2005
references.pmid: 19892392
references.citation: Soc Sci Med. 2007 Nov;65(10):2070-80
references.pmid: 17689847
references.citation: Lancet. 2011 Jun 11;377(9782):2042-53
references.pmid: 21561659
references.citation: Am J Public Health. 2009 Jan;99(1):87-93
references.pmid: 19008516
references.citation: Lancet. 2003 Jul 19;362(9379):233-41
references.pmid: 12885488
references.citation: Rev Panam Salud Publica. 2009 Dec;26(6):478-84
references.pmid: 20107701
references.citation: J Epidemiol Community Health. 2006 Jan;60(1):13-9
references.pmid: 16361449