TY - JOUR
T1 - Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador
T2 - A scoping review
AU - Social and, Environmental Determinants of Health Inequalities (SEDHI)
AU - on behalf of the Global Health Research Unit
AU - Pescarini, Julia M.
AU - Moncayo, Ana L.
AU - Guimarães, Joanna M.N.
AU - Dias, Francine S.
AU - Ruiz, Ronald
AU - da Silva, Samuel A.G.
AU - Casais, Gustavo
AU - Shimonovich, Michal
AU - Wells, Valerie
AU - Campbell, Mhairi
AU - Barreto, Mauricio L.
AU - Vittal Katikireddi, S.
AU - Matta, Gustavo
AU - Craig, Peter
N1 - Publisher Copyright:
© 2025 Pescarini et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2025/10
Y1 - 2025/10
N2 - We conducted a scoping review to investigate planned (intentional) and unplanned (not intentional) effects of social protection on socioeconomic determinants of health (SDH) and health inequalities among children, adolescents, elders and people with disabilities, and their caregivers. We reviewed seven programs in (i) Brazil (Programa Bolsa Familia (BFP) and Beneficio de Prestacao Continuada (BPC)), and (ii) Ecuador (Bono de Desarrolo Humano (BDH), Bono 1000 días, Pensión Mis Mejores Años/Pensión para Adultos Mayores, Pensión Toda una Vida/Pensión para personas con discapacidad and Bono Joaquín Gallegos Lara). We searched PubMed, EMBASE, LILACS, Scopus, Econlit, PsycINFO, Global Health, Global Index Medicus and grey literature for studies evaluating program implementation and effects on health outcomes or SDH from 1990 to 2023. We extracted data from 114 studies (84 on BFP, 17 on BDH and 13 on BPC). No studies were identified for the remaining programs. In Brazil, we found substantial evidence of BFP planned effects on children’s health and some SDH but little evidence on its unplanned effects in adults and caregivers. Evidence effects of BPC on health outcomes were scarce, with only one study in elders and none among people with disabilities. In Ecuador, we found evidence only for BDH, with some studies on planned health effects and few on SDH and its unplanned effects. Very few studies used longitudinal data, quasi-experimental designs, or comparison groups of eligible non-recipients. Finally, we found large variations coverage and implementation of programs. In summary, our review highlights the lack of evidence on the overall impacts of social protection in Ecuador, particularly those targeting older adults and people with disabilities. In Brazil, further research is needed on unplanned health effects of the BFP and on the impacts of social protection targeting elders and people with disabilities.
AB - We conducted a scoping review to investigate planned (intentional) and unplanned (not intentional) effects of social protection on socioeconomic determinants of health (SDH) and health inequalities among children, adolescents, elders and people with disabilities, and their caregivers. We reviewed seven programs in (i) Brazil (Programa Bolsa Familia (BFP) and Beneficio de Prestacao Continuada (BPC)), and (ii) Ecuador (Bono de Desarrolo Humano (BDH), Bono 1000 días, Pensión Mis Mejores Años/Pensión para Adultos Mayores, Pensión Toda una Vida/Pensión para personas con discapacidad and Bono Joaquín Gallegos Lara). We searched PubMed, EMBASE, LILACS, Scopus, Econlit, PsycINFO, Global Health, Global Index Medicus and grey literature for studies evaluating program implementation and effects on health outcomes or SDH from 1990 to 2023. We extracted data from 114 studies (84 on BFP, 17 on BDH and 13 on BPC). No studies were identified for the remaining programs. In Brazil, we found substantial evidence of BFP planned effects on children’s health and some SDH but little evidence on its unplanned effects in adults and caregivers. Evidence effects of BPC on health outcomes were scarce, with only one study in elders and none among people with disabilities. In Ecuador, we found evidence only for BDH, with some studies on planned health effects and few on SDH and its unplanned effects. Very few studies used longitudinal data, quasi-experimental designs, or comparison groups of eligible non-recipients. Finally, we found large variations coverage and implementation of programs. In summary, our review highlights the lack of evidence on the overall impacts of social protection in Ecuador, particularly those targeting older adults and people with disabilities. In Brazil, further research is needed on unplanned health effects of the BFP and on the impacts of social protection targeting elders and people with disabilities.
UR - https://www.scopus.com/pages/publications/105020311544
U2 - 10.1371/journal.pgph.0005281
DO - 10.1371/journal.pgph.0005281
M3 - Artículo
AN - SCOPUS:105020311544
SN - 2767-3375
VL - 5
JO - PLOS Global Public Health
JF - PLOS Global Public Health
IS - 10 October
M1 - e0005281
ER -