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Rapid decline in childhood undernutrition in Brazil and the role of policies reducing inequality Eduardo A. F. Nilson Food and Nutrition Coordination Ministry of Health of Brazil
Decline in childhood undernutrition according to national inquiries in Brazil (children < 5 years old) ,[object Object],Sources: National population surveys (ENDEF, PNSN and PNDS)
Major causes of the decline in child undernutrition in Brazil through the last three decades 1975-1989: ,[object Object]
Moderate increase in family income.1989-1996: ,[object Object]
Better access to basic health care (National Health System - SUS): universalization of health care.
Expansion of public water supply.1996-2007: ,[object Object],[object Object]
But there are still differences in undernutrition rates ,[object Object],(for children under 5 years old) Sources: DHS 2006 (PNDS), 1st National Inquiry of Health and Nutrition on Indigenous Populations, Nutritional Call of Quilombola Populations 2006, Food and Nutrition Surveillance System (Ministry of Health of Brazil)
And overweight and obesity are increasing… Sources: National Study on Family Expenditure (ENDEF), National Health and Nutrition Survey (PNSN) and Family Budget Survey (POF)
… equally Sources: National Study on Family Expenditure (ENDEF), National Health and Nutrition Survey (PNSN) and Family Budget Survey (POF)
Causes ofthe decline in undernutrition in thelastdecade Source: Monteiro et al, 2009. Causes for the decline in child undernutrition in Brazil, 1996-2007.
Underlying determinants Purchasing power of Brazilian families: ,[object Object]
Economic growth and reduction in unemployment rates.
Systematic increases in the official minimum wage.
Cash transfer programs and social security.Population with less than US$ PPC 1.25/day (%)) Source: Institute for Applied Economic Research (IPEA)
Underlying determinants Cash transfer programs in Brazil: ,[object Object]
2003 - unification of CCTs – BolsaFamília Program.Average annual growth in household per capita income per day (US$ PPC) by tenths of income distribution Source: Institute for Applied Economic Research (IPEA)
Underlying determinants BolsaFamília Program: ,[object Object]
2010: 12.5 million beneficiary families.
Conditionalities oriented to guarantee universal rights (health and education) – over 99% of families fulfill the health conditionalities and over 97% of children and adolescents attend at least 85% of  school classes.
Registration can also be used for intersectoral policies and to target the most vulnerable families for other complementary programs: adult alphabetizing, school reinforcement, professional education, familiar agriculture, microcredit.,[object Object]

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Rapid Decline in Childhood Undernutrition in Brazil and the Role of Policies Reducing Inequality

  • 1. Rapid decline in childhood undernutrition in Brazil and the role of policies reducing inequality Eduardo A. F. Nilson Food and Nutrition Coordination Ministry of Health of Brazil
  • 2.
  • 3.
  • 4.
  • 5. Better access to basic health care (National Health System - SUS): universalization of health care.
  • 6.
  • 7.
  • 8. And overweight and obesity are increasing… Sources: National Study on Family Expenditure (ENDEF), National Health and Nutrition Survey (PNSN) and Family Budget Survey (POF)
  • 9. … equally Sources: National Study on Family Expenditure (ENDEF), National Health and Nutrition Survey (PNSN) and Family Budget Survey (POF)
  • 10. Causes ofthe decline in undernutrition in thelastdecade Source: Monteiro et al, 2009. Causes for the decline in child undernutrition in Brazil, 1996-2007.
  • 11.
  • 12. Economic growth and reduction in unemployment rates.
  • 13. Systematic increases in the official minimum wage.
  • 14. Cash transfer programs and social security.Population with less than US$ PPC 1.25/day (%)) Source: Institute for Applied Economic Research (IPEA)
  • 15.
  • 16. 2003 - unification of CCTs – BolsaFamília Program.Average annual growth in household per capita income per day (US$ PPC) by tenths of income distribution Source: Institute for Applied Economic Research (IPEA)
  • 17.
  • 18. 2010: 12.5 million beneficiary families.
  • 19. Conditionalities oriented to guarantee universal rights (health and education) – over 99% of families fulfill the health conditionalities and over 97% of children and adolescents attend at least 85% of school classes.
  • 20.
  • 21. Policies designed to ensure universal access to primary education and to improve the quality of schools.Source: Demography and Health Surveys (PNDS)
  • 22.
  • 23. Universal and integral health care: to guarantee the Constitutional right for health.
  • 24. Decentralization of management and funding (specially primary health care): municipalization and more equity in budget distribution.
  • 25.
  • 26. Family Health Teams and Community Health Agents.
  • 27. Dec. 2009: 30.3 thousand Family Health Teams in 5251 municipalities (population coverage of 96 million people -50,7% of Brazil’s population) – mostly low-income families.Population covered by Family Health Teams, Brazil. Source: Ministry of Health of Brazil
  • 28.
  • 29. Vitamin A Supplementation Program (2003)
  • 31.
  • 32.
  • 33. Lesser children per family (1996: 4.0 / 2006: 3.4 people per family)
  • 36.
  • 37.
  • 38. 90% decrease in the mortality rate by diarrhea.
  • 39. 60% decline in overall infant mortality (1990-2008)
  • 40. 10% increase in Family Health coverage corresponded to a 4.6% reduction in infant mortality (1994-2002).Infant mortality, Brazil Source: Mortality Information System, Ministry of Health of Brazil
  • 41.
  • 42. Change of agenda: assistancial policies give place to universal, rights-oriented policies.
  • 43. Critical effect of policies which promote income redistribution and policies of universal access to education, health, water supply and sanitation services.
  • 44. If Brazil maintains the present decline rate (6.3% per year) in the next decade, stunting will no longer represent a public health problem.
  • 45.