James Macinko
Evaluation of the impact of the Family Health Program on infant mortality in Brazil, 1990-2002
New York University
bobjectiveb use publicly available secondary data assess impact brazils family health program state level infant mortality rates imr 1990s bdesignb longitudinal ecological analysis using panel data secondary sources analyses controlled state level measures access clean water sanitation average income womens literacy fertility physicians nurses per 10 000 population hospital beds per 1000 population additional analyses controlled immunisation coverage tested interactions family health program proportionate mortality diarrhoea acute respiratory infections bsettingb 13 years 19902002 data 27 brazilian states bmain resultsb 1990 2002 imr declined 497 289 per 1000 live births period average family health program coverage increased 0 36 10 increase family health program coverage associated 45 decrease imr controlling health determinants plt001 access clean water hospital beds per 1000 negatively associated imr female illiteracy fertility rates mean income positively associated imr examination interactions family health program coverage diarrhoea deaths suggests programme may reduce imr least partly reductions diarrhoea deaths interactions deaths acute respiratory infections ambiguous bconclusionsb family health program associated reduced imr suggesting important although unique contributor declining infant mortality brazil existing secondary datasets provide important tool evaluation effectiveness health services brazil