IDEAS home Printed from https://ideas.repec.org/p/ese/iserwp/2016-16.html
   My bibliography  Save this paper

Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil

Author

Listed:
  • Bhalotra, Sonia
  • Rocha, Rudi
  • R. Soares, Rodigo

Abstract

We investigate restructuring of the health system in Brazil motivated to operationalize universal health coverage. Using administrative data from multiple sources and an event study approach that exploits the staggered rollout of programmatic changes across municipalities, we find large reductions in maternal, foetal, neonatal and postneonatal mortality, and fertility. We document increased prenatal care visits, hospital births and other maternal and child hospitalization, which suggest that the survival gains were supply-driven. We find no improvement in the quality of births, which may be explained by endogenous shifts in the composition of births towards higher-risk births.

Suggested Citation

  • Bhalotra, Sonia & Rocha, Rudi & R. Soares, Rodigo, 2016. "Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil," ISER Working Paper Series 2016-16, Institute for Social and Economic Research.
  • Handle: RePEc:ese:iserwp:2016-16
    as

    Download full text from publisher

    File URL: https://www.iser.essex.ac.uk/wp-content/uploads/files/working-papers/iser/2016-16.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Douglas Almond & Bhashkar Mazumder, 2013. "Fetal Origins and Parental Responses," Annual Review of Economics, Annual Reviews, vol. 5(1), pages 37-56, May.
    2. Fitzsimons, Emla & Malde, Bansi & Mesnard, Alice & Vera-Hernández, Marcos, 2016. "Nutrition, information and household behavior: Experimental evidence from Malawi," Journal of Development Economics, Elsevier, vol. 122(C), pages 113-126.
    3. 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.
    4. 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.
    5. Conti, Gabriella & Ginja, Rita, 2016. "Health Insurance and Child Health: Evidence from Mexico," IZA Discussion Papers 10122, Institute of Labor Economics (IZA).
    6. Guanais, F.C., 2013. "The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998-2010," American Journal of Public Health, American Public Health Association, vol. 103(11), pages 2000-2006.
    7. Michele Gragnolati & Magnus Lindelow & Bernard Couttolenc, 2013. "Twenty Years of Health System Reform in Brazil : An Assessment of the Sistema Único de Saúde," World Bank Publications - Books, The World Bank Group, number 15801.
    8. Martha J. Bailey & Andrew Goodman-Bacon, 2015. "The War on Poverty's Experiment in Public Medicine: Community Health Centers and the Mortality of Older Americans," American Economic Review, American Economic Association, vol. 105(3), pages 1067-1104, March.
    9. Stefania Albanesi & Claudia Olivetti, 2014. "Maternal health and the baby boom," Quantitative Economics, Econometric Society, vol. 5, pages 225-269, July.
    10. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    11. Pascaline Dupas, 2011. "Health Behavior in Developing Countries," Annual Review of Economics, Annual Reviews, vol. 3(1), pages 425-449, September.
    12. Becker, Gary S & Tomes, Nigel, 1979. "An Equilibrium Theory of the Distribution of Income and Intergenerational Mobility," Journal of Political Economy, University of Chicago Press, vol. 87(6), pages 1153-1189, December.
    13. Rosenzweig, Mark R & Schultz, T Paul, 1989. "Schooling, Information and Nonmarket Productivity: Contraceptive Use and Its Effectiveness," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 30(2), pages 457-477, May.
    14. Cesur, Resul & Gunes, Pinar 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).
    15. Aquino, R. & De Oliveira, N.F. & Barreto, M.L., 2009. "Impact of the Family Health Program on infant mortality in brazilian municipalities," American Journal of Public Health, American Public Health Association, vol. 99(1), pages 87-93.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Elisa M. Maffioli, 2023. "The local health impacts of natural resource booms," Health Economics, John Wiley & Sons, Ltd., vol. 32(2), pages 462-500, February.
    2. Gabriella Conti & Rita Ginja, 2023. "Who Benefits from Free Health Insurance?: Evidence from Mexico," Journal of Human Resources, University of Wisconsin Press, vol. 58(1), pages 146-182.
    3. Sonia Bhalotra & Martin Karlsson & Therese Nilsson & Nina Schwarz, 2022. "Infant Health, Cognitive Performance, and Earnings: Evidence from Inception of the Welfare State in Sweden," The Review of Economics and Statistics, MIT Press, vol. 104(6), pages 1138-1156, November.
    4. Charris, Carlos & Branco, Danyelle & Carrillo, Bladimir, 2024. "Economic shocks and infant health: Evidence from a trade reform in Brazil," Journal of Development Economics, Elsevier, vol. 166(C).

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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).
    2. 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.
    3. Gabriella Conti & Rita Ginja, 2023. "Who Benefits from Free Health Insurance?: Evidence from Mexico," Journal of Human Resources, University of Wisconsin Press, vol. 58(1), pages 146-182.
    4. Aline Bütikofer & Katrine V. Løken & Kjell G. Salvanes, 2019. "Infant Health Care and Long-Term Outcomes," The Review of Economics and Statistics, MIT Press, vol. 101(2), pages 341-354, May.
    5. Bhalotra, Sonia R. & Karlsson, Martin & Nilsson, Therese, 2015. "Infant Health and Longevity: Evidence from a Historical Trial in Sweden," IZA Discussion Papers 8969, Institute of Labor Economics (IZA).
    6. Bhalotra, Sonia & Karlsson, Martin & Nilsson, Therese, 2014. "Life Expectancy and Mother-Baby Interventions. Evidence from A Historical Trial," Ruhr Economic Papers 504, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
    7. Dafeng Xu, 2020. "Free Wheel, Free Will! The Effects of Bikeshare Systems on Urban Commuting Patterns in the U.S," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 664-685, June.
    8. Bhalotra, Sonia R. & Clarke, Damian & Gomes, Joseph & Venkataramani, Atheendar, 2018. "Maternal Mortality and Women's Political Participation," IZA Discussion Papers 11590, Institute of Labor Economics (IZA).
    9. Salvanes, Kjell G & Løken, Katrine, 2018. "Infant Health Care and Long-Term," CEPR Discussion Papers 13064, C.E.P.R. Discussion Papers.
    10. 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.
    11. Sonia Bhalotra & Damian Clarke & Joseph Flavian Gomes & Atheendar Venkataramani, 2023. "Maternal Mortality and Women’s Political Power," Journal of the European Economic Association, European Economic Association, vol. 21(5), pages 2172-2208.
    12. Sonia Bhalotra & Martin Karlsson & Therese Nilsson, 2014. "Life Expectancy and Mother-Baby Interventions. Evidence from A Historical Trial," Ruhr Economic Papers 0504, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    13. Charris, Carlos & Branco, Danyelle & Carrillo, Bladimir, 2024. "Economic shocks and infant health: Evidence from a trade reform in Brazil," Journal of Development Economics, Elsevier, vol. 166(C).
    14. Ferreira-Batista, Natalia N. & Postali, Fernando Antonio Slaibe & Diaz, Maria Dolores Montoya & Teixeira, Adriano Dutra & Moreno-Serra, Rodrigo, 2022. "The Brazilian Family Health Strategy and adult health: Evidence from individual and local data for metropolitan areas," Economics & Human Biology, Elsevier, vol. 46(C).
    15. Cesur, Resul & Tekin, Erdal & Ulker, Aydogan, 2018. "Can natural gas save lives? Evidence from the deployment of a fuel delivery system in a developing country," Journal of Health Economics, Elsevier, vol. 59(C), pages 91-108.
    16. Gunes, Pinar Mine & Tsaneva, Magda, 2022. "The Effect of Brazil's Family Health Program on Cognitive Skills," IZA Discussion Papers 15784, Institute of Labor Economics (IZA).
    17. 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.
    18. Mora-García, Claudio A. & Pesec, Madeline & Prado, Andrea M., 2024. "The effect of primary healthcare on mortality: Evidence from Costa Rica," Journal of Health Economics, Elsevier, vol. 93(C).
    19. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, Maria Deni, 2023. "An Ounce of Prevention for a Pound of Cure: Efficiency of Community-Based Healthcare," IZA Discussion Papers 16350, Institute of Labor Economics (IZA).
    20. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, María Deni, 2024. "An Ounce of Prevention for a Pound of Cure: Basic Health Care and Efficiency in Health Systems," IDB Publications (Working Papers) 13433, Inter-American Development Bank.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:ese:iserwp:2016-16. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Jonathan Nears (email available below). General contact details of provider: https://edirc.repec.org/data/rcessuk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.