Brazil’s austerity measures could increase avoidable child deaths

Austerity policies disproportionately affect the poorest areas of Brazil, researchers have found

Cutbacks to social programmes in Brazil could lead to more avoidable childhood hospitalisations and deaths compared to maintaining current funding.

The findings come from new research, published this week in the journal PLOS Medicine and led by researchers at Imperial College London and Universidade Federal da Bahia in Brazil.

Using statistical models to simulate future outcomes, the researchers found that childhood mortality rates could be 8.6 per cent lower by 2030 if investments in two major social programmes were protected when compared with austerity measures currently being proposed.

The team also found that these austerity policies disproportionately affect the poorest areas of the country.

We urge policy makers in Brazil to protect child health and well-being by reversing proposed austerity measures affecting these important social programmes Professor Christopher Millett School of Public health

Brazil is the eighth largest economy in the world, but since 2015 a deep economic crisis has increased poverty and the government has introduced austerity measures substantially reducing funding for social programmes. .

These include proposed reductions to two major programmes known to reduce childhood mortality: the Bolsa Familia Programme (BFP) and the Estrategia Saude da Familia (ESF) – Brazil’s main poverty-alleviating welfare programme and primary healthcare service.

The BFP was launched in 2003 and in 2016 was estimated to cover 25 per cent of Brazilian families, providing funds to poor families, vulnerable individuals, and pregnant women. The ESF delivers community-based healthcare services to families including vaccination, child healthcare services, treatment of simple conditions, and chronic disease management. Existing evidence demonstrates these programmes have led to large improvements in health – especially for children.

To date, however, there has been little evidence on how the economic crisis, austerity measures, and reducing the coverage of such social programmes, could affect children’s health in middle income countries such as Brazil.

The cost of cutbacks

In the latest paper, researchers developed a statistical model to measure the projected effects of the economic crisis, poverty, as well as the impact of reductions to these two programmes on child health in all 5,507 Brazilian municipalities for the period 2017-2030.

Their simulations revealed that maintaining coverage from social protection programmes led to a child mortality rate up to 8.6 per cent lower in 2030, when comparing to lower coverage under austerity measures.

In addition, their simulations revealed that maintaining coverage of the BFP and ESF reduced avoidable childhood deaths by nearly 20,000 and avoidable childhood hospitalisations were up to 124,000 lower between 2017 and 2030, compared to austerity. They also found that the country’s poorer municipalities would be impacted most.

Professor Christopher Millett, from Imperial’s School of Public health and author of the study, said: “It is clear that these programmes have a hugely beneficial impact on the health of Brazilian children.

“We urge policy makers in Brazil to protect child health and well-being by reversing proposed austerity measures affecting these important social programmes.”

Davide Rasella, from Universidade Federal da Bahia, added: “Our study suggests that reduced coverage of poverty-alleviation and primary care programmes may result in a substantial number of preventable child deaths and hospitalizations in Brazil.

“These austerity measures will disproportionately impact child mortality in the poorest municipalities, halting important progress made in Brazil in reducing inequality in child health outcomes.”

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‘Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: A nationwide microsimulation study’ by PLOS Medicine.

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