Compared with fiscal austerity measures currently being implemented in Brazil, the maintenance of social protection could result in a reduction in childhood mortality by 8.6% in 2030, according to simulations published this week in PLOS Medicine by Davide Rasella of the Universidade Federal da Bahia, Brazil, and colleagues.
Since 2015, a major economic crisis in Brazil has led to increasing poverty and the implementation of austerity measures, including proposed cuts to the Bolsa Familia Programme (BFP) and the Estrategia Saude da Familia (ESF), two major programs with an impact on childhood mortality. Rasella and colleagues developed a microsimulation model, projecting the effects of poverty, BFP, and ESF on child health in all 5,507 Brazilian municipalities for the period 2017-2030.
Compared with reducing the coverage provided by BFP and ESF due to fiscal austerity, the maintenance of their levels of social protection would lead to a child mortality rate 8.6% lower [95% confidence interval: 6.9%-10.2%] in 2030, the study estimated. Avoidable childhood deaths would be approximately 20,000 lower and avoidable childhood hospitalisations up to 124,000 lower between 2017 and 2030 under maintenance of social protection. Under various simulations, which varied the length of the economic crisis and the amount of cuts, childhood mortality was still affected. The research also showed that poorer municipalities would be disproportionately impacted.
"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," the authors say. "These austerity measures will disproportionately impact child mortality in the poorest municipalities, disrupting previous trends of reducing inequality in child health outcomes."