Evidence mapPaperPMID 40451230Full record

ArticleThe Lancet. Public health2025

Health effects of the Brazilian Conditional Cash Transfer programme over 20 years and projections to 2030: a retrospective analysis and modelling study.

Daniella Medeiros Cavalcanti, José Alejandro Ordoñez, Andrea Ferreira da Silva, Elisa Landin Basterra, Ana L Moncayo, Carlos Chivardi, Philipp Hessel, Alberto Pietro Sironi, Rômulo Paes de Sousa, Tereza Campello and 2 more

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Article in The Lancet. Public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

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7citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Daniella Medeiros CavalcantiInstitute of Collective Health, Federal University of Bahia, Bahia, Brazil.
José Alejandro OrdoñezInstitute of Collective Health, Federal University of Bahia, Bahia, Brazil; Pontificia Universidad Católica de Chile, Santiago, Chile.
Andrea Ferreira da SilvaInstitute of Collective Health, Federal University of Bahia, Bahia, Brazil.
Elisa Landin BasterraInstituto de Salud Global (ISGlobal), Hospital Clinic-Universitat de Barcelona, Barcelona, Spain.
Ana L MoncayoCentro de Investigación para la Salud en América Latina (CISeAL), Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
Carlos ChivardiCentre for Health Economics, University of York, York, UK.
Philipp HesselAlberto Lleras Camargo School of Government, Universidad de los Andes, Bogotá, Colombia.
Alberto Pietro SironiInstitute of Collective Health, Federal University of Bahia, Bahia, Brazil.
Rômulo Paes de SousaRené Rachou Institute at Fiocruz, Belo Horizonte, Brazil.
Tereza CampelloBrazilian Development Bank (BNDES), Rio de Janeiro, Brazil.
Luis Eugênio SouzaInstitute of Collective Health, Federal University of Bahia, Bahia, Brazil.
Davide RasellaInstitute of Collective Health, Federal University of Bahia, Bahia, Brazil; Instituto de Salud Global (ISGlobal), Hospital Clinic-Universitat de Barcelona, Barcelona, Spain; Institución Catalana de Investigación y Estudios Avanzados (ICREA), Pg Lluís Companys 23, Barcelona, Spain. Electronic address: davide.rasella@isglobal.org.

Funding

Wellcome Trust
6 · The paper itself

Abstract

backgroundIn 2024, Brazil celebrated the 20th anniversary of the Bolsa Família Program (BFP), one of the world's oldest and largest conditional cash transfer (CCT) programmes, covering more than 50 million Brazilians. This study aimed to evaluate the effect of the BFP on overall mortality and hospitalisation rates over the past two decades, and to forecast the potential effects of expanding this programme until 2030.

methodsThis study combined retrospective impact evaluations in Brazil from 2000-19 with microsimulation models up to 2030. First, the effect of the BFP on overall mortality and hospitalisation rates was estimated across different age groups, adjusting for all relevant demographic, socioeconomic, and health-care factors. Fixed-effect multivariable Poisson models were then applied to 3671 municipalities with adequate quality vital statistics data. The three exposure variables of BFP were target coverage, benefits adequacy (average transfer per family), and the interaction of coverage and adequacy. Several sensitivity and triangulation analyses were conducted, including difference-in-difference models with propensity-score matching. Previous longitudinal datasets were then integrated with validated dynamic microsimulation models to project trends up to 2030.

findingsHigh coverage of BFP was associated with a significant reduction in overall age-standardised mortality rates (rate ratio [RR] 0·824 [95% CI 0·807-0·842]). High adequacy of BFP was associated with a reduction in overall age-standardised mortality (0·849 [0·833-0·866]). Our models estimated that the BFP prevented 8 225 390 (95% CI 8 192 730-8 257 014) hospitalisations and 713 083 (702 949-723 310) deaths in 2000-19. Stronger effects were found in BFP high coverage and high adequacy scenario, resulting in large reductions in under-5 mortality (RR 0·67 [95% CI 0·65-0·69]) and hospitalisation of individuals older than 70 years (0·52 [0·50-0·53]). Expanding BFP coverage could avert an additional 8 046 079 (95% CI 8 023 306-8 068 416) hospitalisations and 683 721 (676 494-690 843) deaths by 2030, compared with scenarios of reduced coverage.

interpretationCCT programmes have strongly contributed to the reduction of morbidity and mortality in Brazil, having prevented millions of hospitalisations and deaths in the past two decades. During the current period of polycrisis, the expansion of CCTs in terms of coverage and benefits could prevent a large number of hospitalisations and deaths worldwide, and should be considered a crucial strategy for achieving the UN health-related Sustainable Development Goal 3.

fundingUK Foreign, Commonwealth and Development Office, UK Medical Research Council, and the Wellcome Trust (grant number MC_PC_MR/T023678/1). TRANSLATION: For the Portuguese translation of the summary see Supplementary Materials section.

Indexed as

HospitalizationMortalityAdolescentAdultAgedBrazilChildChild, PreschoolFemaleForecastingHumansInfantInfant, NewbornMaleMiddle AgedProgram Evaluation

Identifiers

PMID40451230
PMCPMC12208920

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.