Impact of Rapid Expansion of the Estratégia de Saúde da Familia in Rio de Janeiro: Mixed Methods Evaluation


The project will be conducted by a multi-disciplinary team of researchers and policy makers from Brazil, UK and USA, including doctors, health planners, mathematical modellers, and social scientists. It involves quantitative analyses of a unique database that has linked information from patients' medical records (both primary care and hospitalisation records), data on eligibility for state welfare benefits, and deaths in the city. This component of the project will examine whether public investment in ESF in Rio de Janeiro has produced better health outcomes, including a lower likelihood of being admitted to hospital for chronic conditions and a lower risk of death during infancy. It will examine whether individuals dually enrolled in the ESF and a major conditional cash transfer programme derive health benefits above those obtained from each programme in isolation. The project will also explore whether certain groups of patients, including from different race/ethnic groups, benefit more from the ESF than others. We will observe practices in health clinics and undertake interviews with health managers, clinicians, and patients to understand success in the implementation process and barriers to programme expansion. We will undertake mathematical modelling to estimate the potential benefits from further expansion of the programme in the city and whether comparable benefits may accrue if the ESF is expanded in other major Brazilian cities. Dr Christopher Joseph Millett is the principal investigator and the Imperial College London is the lead research organisation..


Funding Source

Medical Research Council - London

Project Period


This site is registered on as a development site.