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Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program

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  • Romero Rocha
  • Rodrigo R. Soares

Abstract

This paper analyzes the direct and indirect impacts of Brazil's Family Health Program, using municipality level mortality data from the Brazilian Ministry of Health, and individual level data from the Brazilian household survey. We estimate the effects of the program on mortality and on household behavior related to child labor and schooling, employment of adults, and fertility. We find consistent effects of the program on reductions in mortality throughout the age distribution, but mainly at earlier ages. Municipalities in the poorest regions of the country benefit particularly from the program. For these regions, implementation of the program is also robustly associated with increased labor supply of adults, reduced fertility, and increased school enrollment. Evidence suggests that the Family Health Program is a highly cost‐effective tool for improving health in poor areas. Copyright © 2010 John Wiley & Sons, Ltd.

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  • Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
  • Handle: RePEc:wly:hlthec:v:19:y:2010:i:s1:p:126-158
    DOI: 10.1002/hec.1607
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    1. Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
    2. Romero Rocha & Rodrigo R. Soares, 2010. "Evaluating the impact of community‐based health interventions: evidence from Brazil's Family Health Program," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 126-158, September.
    3. Nishijima, Marislei & Sarti, Flavia Mori & Canuto, Otaviano, 2020. "Does the Brazilian policy for oil revenues distribution foster investment in human capital?," Energy Economics, Elsevier, vol. 88(C).
    4. Dias, Mateus & Fontes, Luiz Felipe, 2020. "The Effects of a Large-Scale Mental-Health Reform: Evidence from Brazil," MPRA Paper 104753, University Library of Munich, Germany.
    5. Marcelo Castro & Enlinson Mattos & Fernanda Patriota, 2021. "The effects of health spending on the propagation of infectious diseases," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2323-2344, September.
    6. Mayara Lisboa Bastos & Dick Menzies & Thomas Hone & Kianoush Dehghani & Anete Trajman, 2017. "The impact of the Brazilian family health on selected primary care sensitive conditions: A systematic review," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-14, August.
    7. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    8. Sonia Bhalotra & Letícia Nunes & Rudi Rocha, 2020. "Urgent Care Centers, Hospital Performance and Population Health," Working Papers 10, Instituto de Estudos para Políticas de Saúde.
    9. Cesur, Resul & Gunes, Pinar Mine & Tekin, Erdal & Ulker, Aydogan, 2019. "Socialized Healthcare and Women's Fertility Decisions," IZA Discussion Papers 12186, Institute of Labor Economics (IZA).
    10. Sonia Bhalotra & Rudi Rocha & Rodrigo R. Soares, 2020. "Can Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," Working Papers 03, Instituto de Estudos para Políticas de Saúde.
    11. Thomas, Ranjeeta & Jones, Andrew M & Squire, Lyn, 2010. "Methods for Evaluating Innovative Health Programs (EIHP): A Multi-Country Study," MPRA Paper 29402, University Library of Munich, Germany.
    12. Squire, Lyn & Jones, Andrew M & Thomas, Ranjeeta, 2010. "Evaluating Innovative Health Programs: Lessons for Health Policy," MPRA Paper 29205, University Library of Munich, Germany.
    13. Dimitrovová, Klára & Perelman, Julian & Serrano-Alarcón, Manuel, 2020. "Effect of a national primary care reform on avoidable hospital admissions (2000–2015): A difference-in-difference analysis," Social Science & Medicine, Elsevier, vol. 252(C).
    14. Letícia Xander Russo & Anthony Scott & Peter Sivey & Joilson Dias, 2019. "Primary care physicians and infant mortality: Evidence from Brazil," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-16, May.
    15. Mateus Dias & Luiz Felipe Fontes, 2020. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil," Working Papers 09, Instituto de Estudos para Políticas de Saúde.
    16. Mattos, Enlinson & Mazetto, Debora, 2019. "Assessing the impact of more doctors’ program on healthcare indicators in Brazil," World Development, Elsevier, vol. 123(C), pages 1-1.
    17. Yonatan Dinku & David Fielding & Murat Genç, 2018. "Health shocks and child time allocation decisions by households: evidence from Ethiopia," IZA Journal of Labor Economics, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 7(1), pages 1-23, December.
    18. Mattos, Enlinson & Mazetto, Débora, 2018. "Assessing the impact of More Doctors Program on health care indicators," Textos para discussão 494, FGV EESP - Escola de Economia de São Paulo, Fundação Getulio Vargas (Brazil).
    19. Cesur, Resul & Güne?, P?nar Mine & Tekin, Erdal & Ulker, Aydogan, 2015. "The Value of Socialized Medicine: The Impact of Universal Primary Healthcare Provision on Birth and Mortality Rates in Turkey," IZA Discussion Papers 9329, Institute of Labor Economics (IZA).
    20. Hansoo Ko, 2020. "The effect of outdoor smoking ban: Evidence from Korea," Health Economics, John Wiley & Sons, Ltd., vol. 29(3), pages 278-293, March.
    21. Ehlert, Christoph, 2013. "Did Customers Benefit from the Reorganisation of Customer Management in German Employment Agencies?," Ruhr Economic Papers 462, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    22. Singhal, Sonica & Correa, Rejane & Quiñonez, Carlos, 2013. "The impact of dental treatment on employment outcomes: A systematic review," Health Policy, Elsevier, vol. 109(1), pages 88-96.
    23. Luiz Felipe Campos Fontes & Otavio Canozzi Conceição & Paulo de Andrade Jacinto, 2018. "Evaluating the impact of physicians' provision on primary healthcare: Evidence from Brazil's More Doctors Program," Health Economics, John Wiley & Sons, Ltd., vol. 27(8), pages 1284-1299, August.
    24. Martin Foureaux Koppensteiner & Jesse Matheson, 2016. "Access to Education and Teenage Pregnancy," CINCH Working Paper Series 1604, Universitaet Duisburg-Essen, Competent in Competition and Health, revised Aug 2016.
    25. Vânia Cristina Campelo Barroso Carneiro & Paulo de Tarso Ribeiro de Oliveira & Saul Rassy Carneiro & Marinalva Cardoso Maciel & Janari da Silva Pedroso, 2021. "Evidence of the effect of primary care expansion on hospitalizations: Panel analysis of 143 municipalities in the Brazilian Amazon," PLOS ONE, Public Library of Science, vol. 16(4), pages 1-14, April.

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    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J10 - Labor and Demographic Economics - - Demographic Economics - - - General
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • O54 - Economic Development, Innovation, Technological Change, and Growth - - Economywide Country Studies - - - Latin America; Caribbean

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