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Master's Dissertation
DOI
https://doi.org/10.11606/D.12.2013.tde-12022014-162901
Document
Author
Full name
Laura Soledad Cutruffo Comparini
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2013
Supervisor
Committee
Rangel, Marcos de Almeida (President)
Madeira, Ricardo de Abreu
Ponczek, Vladimir Pinheiro
Title in Portuguese
Investimento público em saúde pré-natal: inferência causal e canais de impacto
Keywords in Portuguese
Desenvolvimento econômico
Investimentos
Microeconomia
Políticas públicas
Abstract in Portuguese
Este estudo busca entender a importância de políticas voltadas para o pré-natal no Brasil, bem como verificar se uma delas, o Programa Rede de Proteção à Mãe Paulistana, tem alcançado seus principais objetivos. Para tanto, utilizamos o método de diferenças em diferenças aplicado à base formada pela Declaração de Nascidos Vivos, disponibilizada pela Fundação Seade, e pelo Censo Demográfico de 2000, elaborado pelo IBGE. Os resultados parecem indicar que o programa aumentou o número de consultas pré-natal, bem como a incidência de partos hospitalares. Encontramos também evidências de redução da prematuridade, aliada a uma queda no índice APGAR 1, referente ao primeiro minuto de vida do recém-nascido, que parecem estar relacionados à melhora do acompanhamento gestacional. O índice APGAR 5, referente ao quinto minuto de vida do recém-nascido, foi positivamente impactado, o que parece indicar que os bebês que tiveram a oportunidade de serem beneficiados pelo programa passaram a se adaptam melhor ao ambiente extra-uterino quando comparado aos que não tiveram essa oportunidade. Finalmente, a distância até o local onde são realizadas as consultas de pré-natal também se mostrou relevante no sentido de permitir um melhor acompanhamento gestacional, o que pode estar associado a um aumento da probabilidade de que o bebê nasça com vida.
Title in English
Public policy targeted at prenatal health: channels of impact and causal inference
Keywords in English
Economic development
Investments
Microeconomics
Public policies
Abstract in English
This study seeks to understand the importance of prenatal care policies in Brazil, and also verify if one of them, the "Rede de Proteção à Mãe Paulistana" program, has achieved its main targets. We used the method of difference in differences applied to the Live Births Statement, provided by Fundação SEADE, together with the Demographic Census of 2000, released by the IBGE, data. The results indicate that the program might actually have increased the number of prenatal appointments, as well as the incidence of hospital births. We also found evidence of a reduction in prematurity, along with a drop in APGAR 1 score, measured in the first minute of life of the newborn, which seem to be related to the improvement of pregnancy monitoring. The program have also positively affected the APGAR 5 score, measured in the fifth minute of life of the newborn, which seems to indicate that babies born of mothers that had the chance to participate in the program have adapted better to the extra uterine environment when compared to the ones that did not have that opportunity. Finally, we found evidence that the distance to the spot where prenatal appointments take place is also important to allow better pregnancy monitoring, which may be associated with an increased likelihood that the baby is born alive.
 
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Publishing Date
2014-02-18
 
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