The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil
Background Evidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to mor...
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BMJ Publishing Group
2019-02-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/4/1/e001029.full |
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| author | Daniel J Carter Rhian Daniel Ana W Torrens Mauro N Sanchez Ethel Leonor N Maciel Patricia Bartholomay Draurio C Barreira Davide Rasella Mauricio L Barreto Laura C Rodrigues Delia Boccia |
| author_facet | Daniel J Carter Rhian Daniel Ana W Torrens Mauro N Sanchez Ethel Leonor N Maciel Patricia Bartholomay Draurio C Barreira Davide Rasella Mauricio L Barreto Laura C Rodrigues Delia Boccia |
| author_sort | Daniel J Carter |
| collection | DOAJ |
| description | Background Evidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to more rigorously evaluate the effect of BFP on TB treatment success rate.Methods Propensity scores were estimated from a complete-case logistic regression using covariates from a linked data set, including the Brazil’s TB notification system (SINAN), linked to the national registry of those in poverty (CadUnico) and the BFP payroll.Results The average effect of treatment on the treated was estimated as the difference in TB treatment success rate between matched groups (ie, the control and exposed patients, n=2167). Patients with TB receiving BFP showed a treatment success rate of 10.58 percentage points higher (95% CI 4.39 to 16.77) than patients with TB not receiving BFP. This association was robust to sensitivity analyses.Conclusions This study further confirms a positive relationship between the provision of conditional cash transfers and TB treatment success rate. Further research is needed to understand how to enhance access to social protection so to optimise public health impact. |
| format | Article |
| id | doaj-art-f23c2c9c82fc4590aeca46089c5f4ab0 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2019-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-f23c2c9c82fc4590aeca46089c5f4ab02024-12-15T03:30:09ZengBMJ Publishing GroupBMJ Global Health2059-79082019-02-014110.1136/bmjgh-2018-001029The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in BrazilDaniel J Carter0Rhian Daniel1Ana W Torrens2Mauro N Sanchez3Ethel Leonor N Maciel4Patricia Bartholomay5Draurio C Barreira6Davide Rasella7Mauricio L Barreto8Laura C Rodrigues9Delia Boccia102 Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK2 Cardiff University, Cardiff, UK3 Tropical Medicine Department, University of Brasília, Brasília, Brazil4 Federal University of Brasília, Brasília, Brazil5 Federal University of Espírito Santo, Vitoria, Brazil6 National Tuberculosis Programme/Ministry of Health, Brasília, Brazil7 National Tuberculosis Programme/Ministry of Health of Brazil, Brasília, Brazil8 Centro de Pesquisas Gonçalo Muniz, Fundação Oswaldo Cruz, Salvador, Brazil1 Public Health Institute, Federal University of Bahia, Salvador, BrazilDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UKFaculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UKBackground Evidence suggests that social protection policies such as Brazil’s Bolsa Família Programme (BFP), a governmental conditional cash transfer, may play a role in tuberculosis (TB) elimination. However, study limitations hamper conclusions. This paper uses a quasi-experimental approach to more rigorously evaluate the effect of BFP on TB treatment success rate.Methods Propensity scores were estimated from a complete-case logistic regression using covariates from a linked data set, including the Brazil’s TB notification system (SINAN), linked to the national registry of those in poverty (CadUnico) and the BFP payroll.Results The average effect of treatment on the treated was estimated as the difference in TB treatment success rate between matched groups (ie, the control and exposed patients, n=2167). Patients with TB receiving BFP showed a treatment success rate of 10.58 percentage points higher (95% CI 4.39 to 16.77) than patients with TB not receiving BFP. This association was robust to sensitivity analyses.Conclusions This study further confirms a positive relationship between the provision of conditional cash transfers and TB treatment success rate. Further research is needed to understand how to enhance access to social protection so to optimise public health impact.https://gh.bmj.com/content/4/1/e001029.full |
| spellingShingle | Daniel J Carter Rhian Daniel Ana W Torrens Mauro N Sanchez Ethel Leonor N Maciel Patricia Bartholomay Draurio C Barreira Davide Rasella Mauricio L Barreto Laura C Rodrigues Delia Boccia The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil BMJ Global Health |
| title | The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil |
| title_full | The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil |
| title_fullStr | The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil |
| title_full_unstemmed | The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil |
| title_short | The impact of a cash transfer programme on tuberculosis treatment success rate: a quasi-experimental study in Brazil |
| title_sort | impact of a cash transfer programme on tuberculosis treatment success rate a quasi experimental study in brazil |
| url | https://gh.bmj.com/content/4/1/e001029.full |
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