Programa Criança Feliz: an Evaluation of the Impact on Maternal and Child Mortality and Nutrition

Abstract Background Intervention programs for pregnant women and children in early childhood are known for their effectiveness and contribution to child health and development. To promote these indicators, the Programa Criança Feliz (PCF) started to monitor families in 2017 in Brazil. The present study aims to measure the impact of the PCF on the mortality and nutrition indicators of children and pregnant women in Brazilian municipalities benefited. Methods The identification strategy is based on two characteristics of the program: 1) the gradual adhesion of the municipalities, and 2) the specific characteristics that the municipality needs to have to be able to adhere. This leads to the use of the instrumented differences-in-differences (what is here referred to as a DDIV) method. Results The results indicate that the municipalities that are part of the PCF have lower rates of maternal deaths and, children from zero to six months have a higher adequate weight and a lower proportion of thinness. The results remain robust to variations in control groups, are monotonic concerning the time of exposure to treatment, and are higher in the north and northeast regions of the country. Conclusions This has important implications, because when the children are born with an adequate weight, the probability is that it will develop fewer diseases and that it will be a healthier child. Considering that health costs with newborns are high, healthier children generate less expenses for the public system. This makes preventive actions, such as the PCF case, highly cost-effective.