Table 1.
Description of the quantitative papers and quantitative results of mixed papers, on the impact of the BFP according with the seven themes and subthemes (N = 64) (the number within the table represent the study's reference)
| Themes | Age range of participants | Sample data source | Results | Conclusions | |
|---|---|---|---|---|---|
| Primary data | Secondary data | ||||
| Poverty (n = 25) | |||||
| Food consumption (n = 7) | Adults | - | 14a, 30 |
One study found that the consumption of food from families beneficiaries of the BFP was higher than among families not benefited by the Program (30). Studies found that BFP provided the diversification of food from the basic basket (2, 47), and improved the probability of consumption of foods derived from milk (14). One study showed that before entering the BFP, 50.3% of the participants faced severe food insecurity, and this number went down to 36.8% in five years (9) One study indicated that the BFP had a neutral impact to the consumption of healthier foods (2). Only one study showed that BFP investment was associated with increased child malnutrition amongst the poorest subsample of municipality’s population (31) |
Five studies indicated an improvement in the quantity and quality of food intake, and one of them showed no improvement (neutral) on the consumption of healthy food. One study showed that BFP increased child malnutrition |
| All ages | 9cd | 47 | |||
| NPb | - | 2, 31c | |||
| Macroeconomic variables and household income (n = 9) | School age | - | 15c | Studies indicated that the expansion of the BFP was associated with the reduction of economic inequality (1, 15) and changes in macroeconomic variables (28), with greater impact on non-metropolitan and poorly industrialized municipalities (77). One study found that BFP increased protein production across Brazil: and its rates tend to be greater in north-eastern states (31). A study showed that Brazil has made progress toward Millennium Development Goals: (i) evidenced satisfactory performance and contribution of the Program to reduce poverty and promote human development; (ii) Beneficiaries’ income increased in 2006, 2009 and 2012 (11). There was a positive effect of BFP on the reduction in a poverty indicator (Foster index) for the Brazilian states (7). Similarly, a study with national data from the IBGE indicated the contribution of the BFP to break the “cycle of poverty” (65). BFP was positively associated with increase in wages and complementary incomes (21). However, a study showed that the Program did not produce statistically significant effects on income inequality rates (7) | Eight out of the nine studies demonstrated positive impacts either on income of families or macroeconomic variables. Otherwise, one study did not identify (neutral) impacts on income inequality rates |
| All ages | - | 11c, 77 | |||
| NPb | - | 1, 7, 21c, 28, 31c, 65 | |||
| Social inclusion (n = 5) | Adults | 63, 79d, 92d | 76 | Three studies have identified a positive impact of the BFP on the purchase of products, such as consumption of goods and services of a private nature (63), housing (76) and expansion of inclusion in socialization spaces, such as schools, health centers and commerce (79). One study showed that the BFP contributed to the autonomy of beneficiaries, allowing to overcome important forms of social deprivation (92). One study identified that a small proportion of adult participants were able to return to school and increase their educational qualifications (neutral) (9) | Four studies showed positive impacts of BFP on the social inclusion of beneficiaries. One study identified neutral effect |
| All ages | 9cd | - | |||
| Food quality (n = 4) | School age | - | 89 | One study identified that the BFP increased the intake of energy and macronutrients and decreased the intake of calcium and vitamin A, D, E and C of beneficiary adolescents. Adult beneficiaries from the Southeast increased the intake of fibers, iron and selenium, and those in the Northeast decreased the intake of energy, lipids, among others (88). One study identified that BFP was effective in increasing the quality of the diet of families, mainly improving the variety and reducing the consumption of fat and sodium (20). It was found that the proportion of children and adolescents with low weight was lower in beneficiary families than in non-beneficiary families in the Northeast region (89). It was also found that BFP beneficiaries had lower consumption of processed and ultra-processed foods compared to non-beneficiaries (90) | All four studies showed a positive impact of the BFP on the quality of feeding of children and young beneficiaries |
| All ages | - | 88, 90 | |||
| NPb | 20 | - | |||
| Health (n = 23) | |||||
| Utilization of health services (n = 1) | All ages | 9cd | This single study showed that after receiving BFP, families have been able to access healthcare services on a more regular basis. Particularly women who were systematically excluded – black women, poorly educated and from the less developed regions of the country –, after their participation in the BFP, increased access to prenatal care and could count with a greater availability of public healthcare network (9) | Positive changes were observed in healthcare access, particularly amongst vulnerable population | |
| Child health (n = 4) | Preschoolers | 81 | 6, 39, 85 | One study found that the BFP increased the chances of children visiting the health center and improved their behavior and social relationships (81). Two articles demonstrated that the BFP did not affect the immunization rate of children (6, 85). One study found that the Program was associated with a reduction in the z-score of length and weight for age of beneficiaries (39) | The BFP increased the chances of children visiting the health center, as well as their psychosocial health (one article), and two articles demonstrated neutral effects of BFP on immunization rate. One paper showed that BFP did not improve the immunization rate. There was a negative impact of reduction in children growth (one article) |
| Infectious diseases (n = 8) | School age | - | 25, 58 | One study found that the incidence of tuberculosis decreased in municipalities with high BFP coverage (57), and three studies showed that the BFP had a positive impact on the cure rates of tuberculosis patients (12, 60, 73). Three studies identified a reduction in the rates of new leprosy cases (25, 58, 66), and a fourth study identified increased treatment and cure of this disease (67) | The eight articles pointed out positive impacts in the fight against tuberculosis and leprosy |
| Adults | 73, 60 | - | |||
| All ages | - | 67 | |||
| NPb | - | 12, 57, 66 | |||
| Mortality (n = 10) | Preschoolers | - | 11c, 31c, 35, 72, 82, 83, 84 | One study showed that BFP spending mitigated harmful health effects, especially among vulnerable populations (37). Another study showed that a greater reduction in the risk of death occurred among those receiving the BFP benefit compared to those who did not receive (38). It was found that the increase in BFP coverage resulted in a reduction in the mortality rate due to tuberculosis (29). Six studies found that the mortality rate of children under 5 years of age decreased as BFP coverage increased (11, 35, 72, 82, 83, 84). One study showed that BFP was associated with increased infant mortality (31) | Nine articles indicated positive effects on mortality rates in children and adults, in contrast with only one study |
| Adults | - | 37, 38 | |||
| NPb | - | 29 | |||
| Education (n = 12) | |||||
| School enrolment, approval and dropout (n = 5) | School age | 27 | 5, 10, 34, 86 | It was found that the BFP contributed to reduce the chances of school dropout and increased rates of year approval (5, 10), and one study identified this impact on the sample of girls living in rural areas, with the greatest effect on adolescents (15 to 17 years old versus 6 to 14 years old) (27). A study showed that at grades 1–8, the Program provided an increase in the number of students enrolled, lowered dropout rates, and raised grade promotion rates (34). One study identified a significant and negative impact of BFP in performance of schools in Portuguese proficiency by Prova Brasil between 2005 to 2007 and in Mathematics for the year 2007 (86) | Four studies indicated contribution to permanence among children and adolescents, but one study identified a negative impact of BFP in Mathematics and Portuguese performance |
| School attendance (n = 7) | School age | 31c, 50 | 8c, 15c, 19c, 56, 74 | Four studies showed that children and adolescents receiving the BFP had a higher school attendance compared to those who did not receive the benefit (15, 50, 56, 74), also when this estimative were compared amongst a same group of adolescents before and after receiving BFP (19). It was found that BFP is positively associated with primary and secondary school attendance (31); and that there were positive and significant effects on girls’ school attendance (8) | All the studies showed a positive impact on the school attendance of children and adolescents |
| Employability (n = 10) | |||||
| Participation in the labor market (n = 7) | All ages | 9cd | 19c | Four studies showed a statistically significant association between the receipt of the BFP and the increase in participation in the labor market (9, 21, 91, 94). It was found a growth in the proportion of beneficiaries with formal jobs, which went from 9.8% in 2004 to 12.5% in 2007 (9) and influence on the choice of young people to study and work at the same time (19). Otherwise, two studies showed that BFP did not increase labor force participation among adults (8, 19) | Five studies indicated that the BFP was associated with increased participation of young people and adults in the labor market, in contrast to two other studies that indicated neutrality |
| Adults | - | 8c, 94 | |||
| NPb | - | 21c, 91 | |||
| Working hours (n = 3) | All ages | - | 19c | A study identified that the working hours of the beneficiaries decreased, allowing better quality at work (22). One study showed that poor heads of households who have land tenure had an increase in their chances of executing agricultural work (59). It was found that BFP did not increase the number of working hours among mothers and fathers (19) | Two studies showed that the BFP positively influenced the quality of work. One study showed neutral effect |
| Adults | - | 59 | |||
| NPb | - | 22 | |||
| Gender equality (n = 4) | |||||
| Gender roles, stereotypes (n = 1) | NPb | - | 62 | One study identified that the BFP increased domestic care time for women and reduction for men (62) | This study indicated the reinforcement of traditional gender roles |
| Violence against woman (n = 2) | Adults | 41cd | 51 | A study with data extracted from the 2009 National Household Sample Survey indicated that the BFP increased domestic violence (51). Another study identified that the BFP had no influence on feminicide rates (41) | BFP did not have effect on feminicide and can increase domestic violence |
| Women’s empowerment (n = 1) | Adults | 41cd | - | One article showed that BFP was associated with an increase in separations, and, to a greater extent, separations of couples with children (41) | BFP increased divorce |
| Teenage pregnancy (n = 3) | |||||
| Pregnancy rate (n = 3) | Adults | - | 17, 61, 87 | One study identified that the BFP reduced teen pregnancy rates among poor women living in urban areas, bringing them closer to the Brazilian average (61), and other study showed that teenage pregnancy rates among BFP beneficiaries were significantly lower than those of non-beneficiary adolescents (87). Otherwise, one study showed that beneficiaries of BFP were more likely to generate the second child compared to non-beneficiaries (17) | Two of the three studies indicated an impact on reducing teenage pregnancy, while the third indicated an increase in fertility |
| Violence (n = 3) | |||||
| Homicide and other crimes (n = 2) | School age | - | 18 | Studies identified the Program’s impact on reducing crime rates (18) and in the rates of hospitalizations for violence (not specified what type) (42). It was found that the rates of homicide were negatively associated with the duration of BFP coverage (42) | BFP reduced crime, hospitalizations for violence rates, and homicide |
| NPb | - | 42 | |||
| Suicide (n = 1) | NPb | - | 4 | One study found that as BFP coverage increased, suicide rates decreased in several municipalities in different regions of the country (4) | The BFP led to a decrease in suicide rates |
aAll the references are presented on the supplementary chart 2; NPb = not presented; c These studies are in more than one category and/or subcategory; d Mixed methods study