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Washington, DC, United States

Objectives. 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. Copyright © 2015 American Public Health Association. Source

Guanais F.C.,Inter American Development Bank
Revista Panamericana de Salud Publica/Pan American Journal of Public Health | Year: 2013

Objective. To propose a method for the interpolation of yearly local-level covariates of health status that is suitable for panel data analysis of the effect of health services. Methods. The proposed method distributes the yearly rate of growth of covariates at the regional level (e.g., state) from household survey data, and applies it to interpolate yearly data at the local level (e.g., municipality) between two consecutive census surveys. The method was applied to municipal-level socioeconomic covariates of health status in Brazil for every year between 2001 and 2009. The data was tested on a previously validated analysis of the effects of the Family Health Program on post-neonatal infant mortality in Brazil. Results. A total of 895 628 values were generated for 20 socioeconomic predictors of health status. Valid data were obtained for 5 057 municipalities in the Northeast, Southeast, South, and Center-West regions of Brazil, from 2001 to 2009, covering 98.89% of the municipalities in these regions and 90.87% of municipalities in the country. A supplemental annex includes the interpolated data from 2001 to 2009, plus the 2000 and 2010 census data, for all 5 057 municipalities. An application on a fixed-effect regression model suggested that, compared to linear interpolation, the proposed method reduced multi-collinearity and improved the precision of the estimates of the effects of health services. Conclusions. The advantages of the proposed interpolation method suggest that it is a feasible solution for panel data analysis of health services at the local level in Brazil and other countries. Source

Schady N.,Inter American Development Bank
American Journal of Public Health | Year: 2011

Objectives: I estimated the association between parents' education, mothers' vocabulary, and early child cognitive development in a sample of poor children in rural Ecuador. Methods: I used regression analysis to estimate the association between parents' education, mothers' vocabulary, and the vocabulary, memory, and visual integration skills of children at early ages, controlling for possible confounders. The study is based on a longitudinal cohort of children in rural Ecuador (n=2118). Results: The schooling and vocabulary levels of mothers were strong predictors of the cognitive development of young children. Household wealth and child's height, weight, and hemoglobin levels explained only a modest fraction of the observed associations. The vocabulary levels of mothers and children were more strongly correlated among older children in the sample, suggesting that the effects of a richer maternal vocabulary are cumulative. Conclusions: Differences in children's cognitive outcomes start very early, which has important implications for the intergenerational transmission of poverty and inequality. Programs that seek to increase early stimulation for disadvantaged children, perhaps through parenting programs or high-quality center-based care, hold promise. Source

Cavallo E.,Inter American Development Bank | Noy I.,University of Hawaii at Manoa
International Review of Environmental and Resource Economics | Year: 2011

This paper surveys the state of the economic literature examining the aggregate impacts of natural disasters. The paper reviews the main disaster data sources available, discusses the determinants of the direct effects of disasters, and distinguishes between short-and long-run indirect effects. The paper then examines some of the relevant policy questions and follows up with a survey of current projections about the likelihood of future disasters. The paper ends by identifying several significant gaps in the literature. © 2011 E. Cavallo and I. Noy. Source

Martincus C.V.,Inter American Development Bank
Journal of Regional Science | Year: 2010

Does trade policy shape a country's internal economic geography? Empirical evidence on the spatial effects of trade policy in developing countries is limited. This paper contributes to this literature by looking at the experience of Brazil over the 1990s. In particular, an econometric analysis of the determinants of industrial location using data on regional manufacturing employment as well as data on several region and industry characteristics over the period 1990-1998 is performed. Estimation results suggest that trade openness favored location in states closer to the largest neighbor trading partner and that this effect increased through the end of the 1990s. © 2009, Wiley Periodicals, Inc. Source

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