AVALIAÇÃO DO PROGRAMA BOLSA FAMÍLIA: foco, cobertura e impacto na vacinação de crianças das coortes de nascimento BRISA, Ribeirão Preto/SP e São Luís/MA, Brasil.

Abstract

INTRODUCTION: Childish vaccination has important impact on children health. Although, vaccine coverage are heterogeneous. The Bolsa Familia Program that has vaccination as one of its conditionalities is highlighted It aimed to estimate the percentages of focus and coverage of BFP and analyze the effect of to be a beneficiary of BFP on incomplete vaccine for low-income children, 13 to 35 months, born in 2010, from BRISA birth cohorts, Ribeirão Preto (RP)/SP and São Luís (SL)/MA. METHOD: Starting from RP, of all residents births and from probabilistic sampling of 1/3 of the resident births in SLZ. 3.805 children in RP and 3.308 in SLZ returned at the time of the follow-up (2011 to 2013). Only low-income children eligible to BFP were selected, with final sample of 532 in RP and 1.229 in SLZ. Were used to categorize the variable of exposure receiving benefit of BFP (yes or no), the data from the Single Cadaster for Social Programs and from the cohorts. The variable outcome was Children Vaccine Scheme (CVS), built with the vaccines BCG, DTP, MMR, Hepatitis B, polio, rotavirus and yellow fever. The adjustment variables were economic class , mother’s education, mother’s skin color. We considered as eligible to BFP, children with monthly family income per capta from 140,00 to 280,00 and economic class (EC) D/E. Percentage of focus and coverage of the BFP were estimated. To estimate the effect of being a beneficiary of BFP on incomplete vaccine for low-income children, a theoretical model was done by Directed Acyclic Graph (DAG). A pairing by propensity score and weighting by the inverse of the probability of selection was used in statistical analyzes. RESULTS: Focus of BFP for monthly family income per capta was 33,8% in SLZ and 15,9% in RB; and to EC was 33,7% in SLZ and 15,3% in RP. Coverage of BFP according to monthly family income per capta was 82,1% in SLZ and 71,6% in RP; and to EC was 68,9% in SLZ and 46,8% and RP. The percentage of incompleteness of CVS was 37,4% in SLZ and 15,2% in RP. Considering monthly family income per capta up to R$280,00, being beneficiary of BFP had no effect on CVS, according to: weighting by the inverse of the probability of selection (SLZ – coefficient: -0,01; CI 95%: - 0,07 to 0,04; p: 0,725 and RP –coefficient: 0,04; CI 95%: - 0,02 to 0,10; p: 0,244). CONCLUSION: Coverage percentages were higher than those of focus that were low. The receipt of the benefit of BFP had no influence on children vaccination incompleteness, which may indicate that this conditionality is not being properly monitored.