Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review

Julia M. Pescarini; Ana L. Moncayo; Joanna M.N. Guimarães; Francine S. Dias; Ronald Ruiz; Samuel A.G. da Silva; Gustavo Casais; Michal Shimonovich; Valerie Wells; Mhairi Campbell; Mauricio L. Barreto; S. Vittal Katikireddi; Gustavo Matta; Peter Craig

doi:10.1371/journal.pgph.0005281

Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review

Julia M. Pescarini^*
, Ana L. Moncayo^*
, Joanna M.N. Guimarães
, Francine S. Dias
, Ronald Ruiz
, Samuel A.G. da Silva
, Gustavo Casais
, Michal Shimonovich
, Valerie Wells
, Mhairi Campbell
, Mauricio L. Barreto
, S. Vittal Katikireddi
, Gustavo Matta
, Peter Craig

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

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.

Original language	English
Article number	e0005281
Journal	PLOS Global Public Health
Volume	5
Issue number	10
DOIs	https://doi.org/10.1371/journal.pgph.0005281 https://doi.org/10.1371/journal.pgph.0005281
State	Published - 29 Oct 2025

Bibliographical note

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.

Funding

Funding: “This research was funded by the NIHR (project reference) using UK international

Funders	Funder number
National Institute for Health Research	NIHR134801

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 1 No Poverty
SDG 10 Reduced Inequalities

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SCOPUS

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Cite this

Pescarini, J. M., Moncayo, A. L., Guimarães, J. M. N., Dias, F. S., Ruiz, R., da Silva, S. A. G., Casais, G., Shimonovich, M., Wells, V., Campbell, M., Barreto, M. L., Vittal Katikireddi, S., Matta, G., & Craig, P. (2025). Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review. PLOS Global Public Health, 5(10), Article e0005281. https://doi.org/10.1371/journal.pgph.0005281, https://doi.org/10.1371/journal.pgph.0005281

@article{4de6a5d6fe3e4bc2afe772ae8563a756,

title = "Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review",

abstract = "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 d{\'i}as, Pensi{\'o}n Mis Mejores A{\~n}os/Pensi{\'o}n para Adultos Mayores, Pensi{\'o}n Toda una Vida/Pensi{\'o}n para personas con discapacidad and Bono Joaqu{\'i}n 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{\textquoteright}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.",

author = "Pescarini, \{Julia M.\} and Moncayo, \{Ana L.\} and Guimar{\~a}es, \{Joanna M.N.\} and Dias, \{Francine S.\} and Ronald Ruiz and \{da Silva\}, \{Samuel A.G.\} and Gustavo Casais and Michal Shimonovich and Valerie Wells and Mhairi Campbell and Barreto, \{Mauricio L.\} and \{Vittal Katikireddi\}, S. and Gustavo Matta and Peter Craig",

note = "Publisher Copyright: {\textcopyright} 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.",

year = "2025",

month = oct,

day = "29",

doi = "10.1371/journal.pgph.0005281",

language = "English",

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Pescarini, JM, Moncayo, AL, Guimarães, JMN, Dias, FS, Ruiz, R, da Silva, SAG, Casais, G, Shimonovich, M, Wells, V, Campbell, M, Barreto, ML, Vittal Katikireddi, S, Matta, G & Craig, P 2025, 'Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review', PLOS Global Public Health, vol. 5, no. 10, e0005281. https://doi.org/10.1371/journal.pgph.0005281, https://doi.org/10.1371/journal.pgph.0005281

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 - 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 - 2025/10/29

Y1 - 2025/10/29

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.

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ER -

Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review

Abstract

Bibliographical note

Funding

UN SDGs

Indexed Database

Publication Quartile

Access to Document

Other files and links

UNIDAD NIHR EN DETERMINANTES SOCIALES Y AMBIENTALES DE LAS DESIGUALDADES EN SALUD (NIHR GLOBAL HEALTH RESEARCH UNIT ON SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH INEQUALITIES)

Cite this

Implementation and effects of social protection programs for children, older adults, and people with disabilities in Brazil and Ecuador: A scoping review

Abstract

Bibliographical note

Funding

UN SDGs

Indexed Database

Publication Quartile

Access to Document

Other files and links

Projects

UNIDAD NIHR EN DETERMINANTES SOCIALES Y AMBIENTALES DE LAS DESIGUALDADES EN SALUD (NIHR GLOBAL HEALTH RESEARCH UNIT ON SOCIAL AND ENVIRONMENTAL DETERMINANTS OF HEALTH INEQUALITIES)

Cite this