This paper estimates the impact of exposure to infectious diseases during pregnancy on health outcomes at birth. By linking administrative data on births, mortality and mandatory notification of infectious diseases, we are able to assess whether a mother residing in the municipality of Rio de Janeiro was exposed to dengue fever, syphilis or tuberculosis in the nine months prior to birth. Our main empirical strategy consists in estimating linear fixed effects models controlling for neighborhood-specific and city-level trends, as well as mother characteristics and socioeconomic variables in the region of residence. We further complement our analysis with the estimation of semi-parametric survival functions. Consistent with previous evidence in the medical literature, we find that exposure to Dengue fever during pregnancy leads to an increase in preterm birth. As for syphilis, we find that exposure during pregnancy leads to higher infant mortality and lower birth weight; it also increases the odds of fetal death. Exposure to tuberculosis leads to lower birth weight and a higher likelihood of preterm birth. We assess the heterogeneity of our estimates with respect to access to primary health care by exploiting the arguably exogenous expansion of Family Health Clinics (Clínicas da Família) in Rio over the years 2001-2016. We find that primary health care is able to mitigate some, though by no means all, adverse effects of exposure to infectious diseases during pregnancy. Interestingly, there appears to be a “postponement” effect in exposure to syphilis: access to primary health care decreases the effect of exposure on fetal death, though it increases the positive impact on infant mortality. 

Seasonal infectious diseases, such as dengue, have been causing great losses in many countries around the world in terms of deaths, quality of life, and economic burden. In Brazil, this is relevant not only in large cities such as Rio de Janeiro and São Paulo but, according to the Ministry of Health, in another 500 cities throughout the country. Predicting the occurrence of diseases, such as dengue bursts, can be a valuable instrument for public health management as health officials can better prepare and redirect resources to the affected areas. In this paper, we present an explainable machine learning model to forecast the number of dengue occurrences in a large metropolis, Rio de Janeiro. We focus on explainable models, which provide health authorities with the reasons for outbreak predictions, allowing them to plan their actions accordingly. We trained a gradient boosting decision tree algorithm (CatBoost) with data from the National System of Information on Notifiable Diseases (SINAN), weather data, and socio-demographic data from The Brazilian Institute of Geoaraphy and Statistics (IBGE).

In 30 years, the Unified Health System  (SUS, for Sistema Único de Saúde) has managed to significantly increase life expectancy at birth and reduce infant mortality, hospitalizations, as well as racial inequality in deaths and immunizations. This success is largely attributed to the Family Health Strategy (FHS), which has become one of the most successful to date. We estimate that a 100% coverage of the FHS can be achieved with approximately 25.6 thousand new teams, which would require up to 236.9 thousand healthcare professionals, including doctors, nurses, technicians, assistants, and community health agents, at a cost of R$ 22.9 billion per year.

This article has the objective to study patterns of interaction between the Executive and the Legislative branches of government, in the City of São Paulo, between the promulgation of the City Council bylaw (1991) and the legislative period ended in 2016. We seek to observe if there are pattern differences’ between the municipal level and the Federal level through the usage of the coalition’s presidentialism model. We use data from all laws presented according to its presenter to work with the concepts of “dominance” and “success” at the municipal level. The main findings are described as: I -the percentage of laws presented and voted inside each legislature period is high; II -the majority of the laws presented came from the Legislative branch; III -The Executive branch has greater success in its propositions even though this power underperforms what is seen at the Federal Level; IV -The Municipal Executive branch tax of dominance is low in comparison to the dominance presented by the Federal Executive, suggesting a greater share of power between powers in the Municipal level.