Brazil’s austerity measures could increase avoidable child deaths, researchers find

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 on May in the journal PLOS Medicine and led by researchers at Imperial College London, Fiocruz and Universidade Federal da Bahia in Brazil.

Until the publication of the study, 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.

Using statistical models to simulate future outcomes, the projected effects of the economic crisis, poverty, as well as the impact of cuts to two major social programmes on child health in all 5,507 Brazilian municipalities for the period 2017-2030.

The researchers found that childhood mortality rates could be 8.6% lower by 2030 if investments in these 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. 

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 cutting funding for social programmes. . 

These include reductions to two major programmes known to impact childhood mortality: the Bolsa Familia Programme (BFP) and the Estratégia Saúde 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% 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.

The simulations of the study also revealed that maintaining coverage of the BFP and ESF would reduce avoidable childhood deaths by nearly 20,000 and avoidable childhood hospitalisations were up to 124,000 lower between 2017 and 2030, compared to austerity.

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, Fiocruz researcher and Universidade Federal da Bahia professor, 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.”