Políticas intersetoriais de saúde e educação reduzem a taxa de gravidez e infecções sexualmente transmissíveis dos adolescentes? Evidências para o Brasil.

Abstract

Policies focused on health promotion and prevention are in the spotlight due to the epidemic of sexually transmitted infections (STIs) and cases of teenage pregnancy. From this perspective, the School Health Program (PSE) is an intersectoral policy between the fields of education and health that aims to carry out actions for the promotion, prevention, and provision of basic health care in the school setting; for this purpose, there are 12 target actions that must be achieved, among which is the promotion and prevention of students’ sexual health. It is noted that there is a gap in the national literature regarding this topic, with only one study having evaluated the program’s impact on young people’s sexual health. Therefore, the objective of this work is to assess the impact of the implementation of the PSE on cases of sexually transmitted infections and teenage pregnancy in Brazilian municipalities from 2013 to 2019. The econometric model used was the Differences-in-Differences (DiD) method over multiple time periods, taking into account that the treated municipalities joined the program in different years. Descriptive statistics indicated that municipalities that adopted the PSE had a higher average number of HIV, Syphilis, and AIDS cases than those that did not implement the program, and it was observed that there was a decrease in the pregnancy rate and hepatitis cases after its implementation. Although the parallel trends test and event study indicated that the parallel trends assumption was not violated and that there was no impact in the pre-treatment period, the estimates of the empirical model indicate that the Average Treatment Effect on the Treated (ATT) was null. The same result was observed for the aggregated group estimates, indicating that the implementation of the PSE had no effect on the variables of interest. A heterogeneous effects analysis by demographic region was carried out, and the estimates also show that the program had no impact at the regional level.