O ideal de efetivação da Constituição Federal nos tempos atuais é a concretização dos direitos sociais nela estampados. No entanto, garantir direitos sociais, essenciais para a consolidação de uma igualdade material, capaz de diminuir as discrepâncias sociais, pode corroborar para uma política de troca de favores e aprofundar as raízes clientelistas do voto, dependendo da forma como as políticas públicas são colocadas em prática. O presente estudo visa a analisar a relação entre a implementação de direitos sociais e o exercício de direitos políticos, considerando as políticas de redistribuição de renda desenvolvidas nos últimos governos, principalmente o Programa Bolsa Família. O objetivo é verificar se há algum clientelismo por parte dos governantes ao estabelecer tais políticas, uma vez que podem eles se valer da desigualdade econômica, da vulnerabilidade cívica e da fragilidade das instituições democráticas do país como instrumentos para forjar sua imagem à semelhança de um pai, protetor de uma sociedade carecedora de direitos básicos. E isso pode acabar por institucionalizar um modelo sutil de clientelismo que descaracteriza os indivíduos como atores capazes de escolher as políticas que melhor implementam seus interesses, impedindo o livre exercício do direito ao voto. Por isso, mesmo a concretização de direitos sociais também deve levar em conta que um modelo de democracia inclui ainda a viabilização de um autogoverno dos cidadãos, razão pela qual parece fundamental que, ao gozar de direitos sociais, os sujeitos percebam a sua participação e ingerência na escolha das políticas públicas. O desafio proposto é utilizar o referencial teórico-metodológico do continuum para, ao longo do espectro formado entre o clientelismo e a cidadania, tentar propor alguns parâmetros para aproximar ao máximo as políticas públicas de concretização de direitos sociais de um ideal de cidadania. / The ideal of effectiveness of the Brazilian Federal Constitution nowadays is the assurance of the social rights it frames. However, in order to ensure social rights that are essential to the consolidation of material equality, capable of reducing social discrepancies, it may corroborate a policy of exchange of favors and deepen the roots of vote clientelism, depending on how public policies are put into practice. The present study aims at analyzing the relationship between the implementation of social rights and the exercise of political rights, considering conditional cash transfer programs developed in recent government mandates, specifically the Bolsa Família. The aim is to verify whether there are any clientelistic relationships by governors when setting up said policies, since they can benefit from economic inequality, civic vulnerability and of the fragility of the democratic institutions of the country as instruments to forge their image as the image of a father, protector of society lacking basic rights. This may end up institutionalizing a subtle model of pervasive patronage that decharacterize individuals as players capable of choosing policies that best implement their interests by preventing the free exercise voting rights. Thus, even the solidification of social rights shall acknowledge that the ideal concept of democracy also includes the furtherance of self-government by citizens, which is why it seems essential that they perceive their participation and interference in the choice of social public policies. The challenge proposed is to use the theoretical and methodological framework of the continuum between clientelism and citizenship to try to propose certain parameters to approximate, to the maximum extent possible, public policies for social rights awareness of an ideal of citizenship.

Submitted by Tiago Bonomo (tiagobonomo@gmail.com) on 2018-07-17T17:34:29Z No. of bitstreams: 1 Tiago Bonomo - Impacts of Bolsa Familia Program on Infant Health.pdf: 1947491 bytes, checksum: 7336d2e5c14d12500d3129884a3a18e4 (MD5) / Approved for entry into archive by GILSON ROCHA MIRANDA (gilson.miranda@fgv.br) on 2018-07-19T19:38:06Z (GMT) No. of bitstreams: 1 Tiago Bonomo - Impacts of Bolsa Familia Program on Infant Health.pdf: 1947491 bytes, checksum: 7336d2e5c14d12500d3129884a3a18e4 (MD5) / Made available in DSpace on 2018-07-25T12:49:50Z (GMT). No. of bitstreams: 1 Tiago Bonomo - Impacts of Bolsa Familia Program on Infant Health.pdf: 1947491 bytes, checksum: 7336d2e5c14d12500d3129884a3a18e4 (MD5) Previous issue date: 2018-03-26 / The objective of this dissertation is to evaluate the impacts of the introduction of a cash transfer for pregnant women in the design of the Bolsa Família Program (BFP) on infant health. In particular, I focus on the effects on birth weight and on the incidence of low birth weight, but I also assess the impacts on pregnancy outcomes such as the incidence of preterm births and prenatal care. The new benefit consists of nine monthly transfers which start to be paid when the woman is identified as pregnant by the health management system of the BFP, regardless of the stage of pregnancy at the moment of the identification. The empiracal strategy explores the fact that when the transfer was implemented eligible women at different stages of pregnancy were exposed to different income shocks before giving birth. Using administrative data from the BFP and from the Brazilian Ministry of Health, I create links between benficiary women and their children's natality outcomes. The main results show that the transfer had a positive impact on birth weight and reduced significantly the likelihood of low birth weight. I also find that higher exposures to the transfer during pregnancy reduced the incidence of preterm births. While I don't find significant impacts on the number of prenatal visits, the results show that the transfer reduced the likelihood of delayed prenatal care.

No description available.

Made available in DSpace on 2011-05-04T12:36:17Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O Programa Bolsa Família (PBF) foi criado em outubro de 2003, a partir da unificação de quatro programas federais de transferência de renda (Bolsa Escola, Bolsa Alimentação, Cartão Alimentação e Vale Gás), sendo destinado a famílias pobres e extremamente pobres, no qual o critério de inclusão é a renda per capita. O Programa articula a transferência de renda a condicionalidades da saúde e educação, que são responsabilidades que toda família deve cumprir para se manter no Programa. A exigência dessas contrapartidas tem provocado um intenso debate no campo das políticas públicas. De um lado, pesquisadores e gestores compreendem a estratégia como oportunidade de melhorar o acesso aos serviços públicos. Por outro lado, há a abordagem de que os direitos sociais, incluindo o acesso aos serviços de saúde, são incondicionais. O presente trabalho analisa o processo de implementação do Programa Bolsa Família na região de Manguinhos, no que se refere ao acompanhamento das ações de saúde previstas para a população beneficiária, identificando os limites e as potencialidades no cumprimento das chamadas condicionalidades , em um contexto local marcado por precária infra-estrutura urbana e dificuldades no acesso aos equipamentos públicos. O período desta pesquisa foi de março de 2007 a dezembro de 2008 e a metodologia utilizada foi o estudo de caso, com a análise de documentos oficiais do PBF, entrevistas com gestores e profissionais que atuam nas diversas secretarias (saúde, educação e assistência social) e grupos focais com famílias beneficiárias. Essa experiência revelou fragilidades institucionais como: pouca qualificação dos profissionais, ausência de incentivos, falta de recursos humanos, ênfase na questão burocrática e oferta insuficiente de ações e serviços de saúde. Contudo, um aspecto positivo observado foi a busca de maior integração dos beneficiários às demais ações e iniciativas sociais locais. / The Bolsa Família Program (BFP) was created in October 2003, from the unification of four federal cash transfer programs (Bolsa Escola, Bolsa Alimentação, Cartão Alimentação e Vale Gás), destined to poor and extremely poor families, in which the inclusion criterion is the per capita income. The Program articulates the income transfer with conditionalities of health and education, which are responsibilities that all families must accomplish to continue in the Program. The exigency of these counterparties has been causing an intense debate in the public politics area. On the one hand, researchers and managers understand the strategic as an opportunity to improve the public services access. On the other hand, there’s the approach that the social rights, including the health services access, are unconditional. The present paper analyses the implementation process of the Bolsa Família Program in the Manguinhos region, concerned to the attendance of the health actions, destined to the beneficiaries, by identifying the limits and the potentials in the accomplishment of what is called “conditionalities”, in a local context marked from a precarious urban infrastructure and difficulties in the public equipments access. The period of this search was from March 2007 to December 2008 and the methodology was the case study, with the analysis of BFP official documents, interviews with managers and professionals that work in the different secretariats (health, education and social assistance) and focal groups with beneficiaries. This experience showed institutional fragilities, like: not much qualification of professionals, absence of incentives and of human resources, emphasis in the bureaucratic question and insufficient offer of actions and health services. Nevertheless, a positive aspect observed was the search of higher integration between beneficiaries and the other actions and local social initiatives.

Made available in DSpace on 2011-05-04T12:36:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / O Programa Bolsa Família, criado em outubro de 2003, propõe a articulação do benefício monetário à implementação de programas complementares, com o objetivo oficial de promover o desenvolvimento de capital humano e de fomentar o processo de autonomização das famílias beneficiárias. O objetivo deste estudo foi analisar a implementação dos programas complementares a nível local, identificando as potencialidades e os entraves deste processo em Manguinhos, região localizada na Zona Norte do município do Rio de Janeiro. Foi realizado um estudo de caso, utilizando como instrumentos de levantamento de dados consultas documentais, grupos focais com beneficiários do Programa, além de entrevistas semi-estruturadas com atores governamentais, não-governamentais e beneficiários do Programa. Foram também coletados dados secundários que pudessem contribuir para a análise sócio-demográfica de Manguinhos. Os principais programas que configuram ações complementares voltadas à capacitação profissional e ampliação das possibilidades de inserção social de jovens são o Plano Setorial de Qualificação e Inserção Profissional (PlanSeQ), o Programa de Mobilização da Indústria Nacional de Petróleo e Gás Natural (PROMINP) e o Programa Nacional de Inclusão de Jovens (PROJOVEM). No entanto, o desenho, a cobertura e a avaliação destas iniciativas mostram-se frágeis na região. As famílias desconhecem a oferta de cursos de qualificação profissional voltados aos beneficiários e afirmam que as oportunidades de trabalho que surgem não são vinculadas ao Bolsa Família. Os gestores reconhecem a debilidade das ações e destacam que os cursos do PlanSeQ não se adéquam à demanda local, ainda que pensados como estratégia de qualificação profissional voltada às obras do Programa de Aceleração do Crescimento e à vocação turística da cidade do Rio de Janeiro. Considerando que a perspectiva de inclusão social defendida pelo Programa Bolsa Família está atrelada ao acesso às políticas de promoção da saúde, de segurança alimentar e nutricional, de educação e de trabalho, a oferta e o acompanhamento destas ações pelas esferas governamentais e organizações civis constituem um eixo essencial para a efetividade do combate à pobreza e à fome, contribuindo para as chamadas portas de saída do Programa Bolsa Família. / The Bolsa Família or “Family Grant” Program, created in October 2003, proposes the articulation of monetary benefit to the implementation of complementary programs with the official aim of promoting human capital development and encourage the process of empowering the beneficiary family. The objective of this study was to analyse the implementation of complementary programs at the local level, identifying the potentialities and obstacles of this process in Manguinhos, region located in the northern zone of Rio de Janeiro. A case study was conducted, using as instruments for data collection document review, focus groups with beneficiaries of the program, and semi-structured interviews with governmental, nongovernmental stakeholders and beneficiaries of the Program. We also collected secondary data that could contribute to the socio-demographic analysis of Manguinhos. The main complementary programs targeting professional training and expansion of possibilities for social inclusion are Plano Setorial de Qualificação e Inserção Profissional (PlanSeQ), Programa de Mobilização da Indústria Nacional de Petróleo e Gás Natural (PROMINP) and Programa Nacional de Inclusão de Jovens (PROJOVEM). However, the design, coverage, and evaluation of these initiatives have been precarious in the area. Families are unaware of the supply of vocational training courses and claim that the area’s new work opportunities are unrelated to Bolsa Família. The program administrators admit to the activities’ weakness and emphasize that the courses offered under PlanSeQ are not adapted to the local demand, even though they were conceived as a vocational training strategy aimed at filling construction jobs in the Growth Acceleration Program (GAP) and the tourist industry in Rio de Janeiro. Considering that the social inclusion perspective defended by the Bolsa Família Program is tied to access to policies for health promotion, food and nutrition security, education, and work, the supply and follow-up of these activities by government agencies and civil society organizations are an essential thrust for the effectiveness of the fight against poverty and hunger, aimed at contributing to the “exit routes” or “graduation” from the Bolsa Família Program.

Submitted by Iuri Pitta (iuripitta@gmail.com) on 2018-07-07T16:48:37Z No. of bitstreams: 1 Dissertação Iuri Pitta - PDF Final 2.pdf: 1480195 bytes, checksum: e120301e40e33e8fa3ae8d04f2f8c55d (MD5) / Approved for entry into archive by Pamela Beltran Tonsa (pamela.tonsa@fgv.br) on 2018-07-10T13:37:01Z (GMT) No. of bitstreams: 1 Dissertação Iuri Pitta - PDF Final 2.pdf: 1480195 bytes, checksum: e120301e40e33e8fa3ae8d04f2f8c55d (MD5) / Approved for entry into archive by Suzane Guimarães (suzane.guimaraes@fgv.br) on 2018-07-10T14:39:07Z (GMT) No. of bitstreams: 1 Dissertação Iuri Pitta - PDF Final 2.pdf: 1480195 bytes, checksum: e120301e40e33e8fa3ae8d04f2f8c55d (MD5) / Made available in DSpace on 2018-07-10T14:39:07Z (GMT). No. of bitstreams: 1 Dissertação Iuri Pitta - PDF Final 2.pdf: 1480195 bytes, checksum: e120301e40e33e8fa3ae8d04f2f8c55d (MD5) Previous issue date: 2018-06-22 / O Programa Bolsa Família (PBF) tornou-se uma das políticas públicas mais estudadas e debatidas no Brasil tanto por seus resultados como carro-chefe da rede de proteção social quanto pelos efeitos políticos a ele atribuídos. Criado por Medida Provisória em outubro de 2003, o Programa tem um desenho institucional singular que envolve uma dinâmica de relações intergovernamentais mais complexa do que a dicotomia centralização versus descentralização, fruto da própria trajetória dos programas de transferência de renda condicionada no país. Ainda que as principais decisões e regulações se concentrem no nível federal, o Bolsa Família prevê aos governos locais papel determinante na gestão dessa política pública. Ademais, a instituição do Índice de Gestão Descentralizada fez surgir um importante instrumento de indução para o bom funcionamento do Programa, reduzindo eventuais práticas clientelísticas ou discricionárias na execução dessa política pública. Nesse contexto federativo e institucional, nosso intuito com esta pesquisa é mostrar como a qualidade da gestão local do Bolsa Família afeta os efeitos do Programa nas eleições municipais, e dessa forma suprir uma lacuna existente na literatura, cuja produção deu maior atenção às disputas presidenciais. Com base em dados relativos aos mandatos entre 2009 e 2012 e à votação ocorrida neste ano e tendo como lentes teóricas o neoinstitucionalismo e a escolha racional na arena político-eleitoral, desenhamos uma pesquisa de métodos mistos, estratégia metodológica que vem ganhando espaço nos campos da ciência política e da administração pública, para investigar as associações entre o desempenho da gestão local do PBF e o sucesso eleitoral dos incumbentes municipais. Diferentemente do observado nas disputas presidenciais, em que candidatos incumbentes tendem a uma melhor performance eleitoral conforme aumenta o número de beneficiados pelo programa de transferência de renda, no nível local esse incremento apresentou efeito negativo. Em contrapartida, a melhoria na qualidade da gestão foi um fator de elevação das chances de sucesso eleitoral dos prefeitos que buscaram um segundo mandato nas eleições municipais de 2012, indicativo de que o Programa Bolsa Família tem sido bem-sucedido também em seu desenho institucional. / Bolsa Família Program has become one of the most studied and debated public policies in Brazil both for its results as the flagship of the social protection network and for the political effects attributed to it. Created by Provisional Measure in October 2003, the Program has a unique institutional design that involves a dynamic of intergovernmental relations more complex than the dichotomy centralization versus decentralization, a consequence of the trajectory of the conditioned income transfer programs in the country. Although the main decisions and regulations are focused at the federal level, Bolsa Familia provides local governments with a decisive role in the management of this public policy. In addition, the institution of the Decentralized Management Index (Índice de Gestão Descentralizada) has created an important induction tool for the proper functioning of the Program, reducing possible clientelist or discretionary practices in the execution of this public policy. In this federative and institutional context, our intention with this research is to show how the quality of the local management of Bolsa Família affects the effects of the Program in municipal elections, and fill a gap in the literature, whose production has given greater attention to presidential elections. Based on data related to the period between 2009 and 2012 and by the theoretical lenses of new institutionalism and rational choice in the politicalelectoral arena, we designed a mixed methods research to investigate the associations between the performance of local management of the Program and the electoral success of municipal incumbents. This is a methodological strategy that has been gaining ground in the fields of political science and public administration. Unlike the presidential elections, in which incumbent candidates tend to perform better as the number of beneficiaries of the income transfer program increases, at the local level such increase had a negative effect. On the other hand, the improvement in the quality of the management was a factor of improvement of the chances of electoral success of mayors who sought a second term in the municipal elections of 2012, an indicative that Bolsa Família Program has also been successful in its institutional design.

Résumé Le taux de mortalité infantile est un indicateur de santé des populations et de l'efficacité des systèmes de santé. Il est également capable d'estimer l'ampleur des inégalités sociales et en matière de santé entre populations. Au cours des 30 dernières années, le Brésil a enregistré des réductions significatives des taux de mortalité infantile. Entre 1990 et 2017, le taux de mortalité des moins de cinq ans est passé de 53,7 décès pour mille naissances vivantes à 15,6. Une réduction de 71% sur la période. La moyenne nationale de réduction était de 6% par an dans les années 90, passant à 4,8% dans les années 2000 et à 3,2% par an entre 2011 et 2015. De nombreux facteurs ont été signalés comme la cause de ces améliorations. Malgré la mise en œuvre de politiques sociales et de santé qui ont eu un impact positif sur la santé des populations brésiliennes au cours des dernières décennies, depuis 2009 le pays a connu une lente diminution de la baisse de la mortalité infantile qui est restée à des niveaux élevés, enregistrant de grandes disparités régionales. Après une crise économique qui a évolué vers une période troublée de crise politique, le pays a enregistré en 2016 une augmentation de la mortalité infantile chez les moins d'un an et de cinq ans, qui est passé de 12,43 à 12,72 décès pour mille naissances vivantes et de 14,28 décès à 14,89 décès pour mille naissances vivantes, respectivement. Ces éléments attirent l'attention sur l'impact possible des déterminants sociaux de la santé sur les taux de mortalité infantile au Brésil après la mise en œuvre de ces politiques sociales et de santé. Cette anomalie observée dans la tendance de la mortalité infantile, combinée aux disparités régionales et à une lente diminution de la baisse des taux de mortalité infantile est préoccupante. Elle soulève des questions sur l'impact de ces politiques sociales et de santé, sur la capacité du pays à maintenir une réduction du taux de mortalité infantile à long terme, et sa capacité à rejoindre les taux des pays développés, ainsi quels sont les déterminants de la mortalité infantile au Brésil après la mise en œuvre de ces politiques publiques? L'objectif premier de cette thèse était d'identifier les déterminants de la mortalité infantile au Brésil après la mise en œuvre du programme Stratégie Santé Famille et du Programme Bolsa Família afin de formuler des hypothèses plausibles, relatives au ralentissement du taux de mortalité chez les moins d’un an et de cinq ans, aux disparités régionales et à l’anomalie observée dans la tendance à la baisse du taux de mortalité infantile au Brésil. Pour atteindre cet objectif, nous avons effectué trois études: 1) un examen de la portée qui visait à identifier et à résumer les déterminants de la mortalité infantile au Brésil sous l'influence de ces programmes, en vue de formuler des hypothèses relativement à l’évolution récente des taux de mortalité infantile au Brésil et d’identifier les lacunes, en termes de recherche, concernant les déterminants de la mortalité infantile dans le pays; 2) une analyse descriptive rétrospective, dans une optique de santé publique et des inégalités en matière de santé, en adoptant le cadre analytique proposé par la Commission de l'OMS sur les déterminants sociaux de la santé, en utilisant les données du taux de mortalité chez les enfants de moins d'un an et des possibles déterminants de la mortalité infantile au Brésil selon les conclusions de notre examen de la portée (article 1); 3) une proposition de méthodologie pour faire face aux défis liés au développement d'un modèle de données de panel en utilisant des données agrégées des 26 états brésiliens et des différentes sous-régions, selon le « Conceptual Model of Health Capability » , afin d'inférer des associations possibles entre nos variables indépendantes et les taux de mortalité infantile au Brésil et pour vérifier l'hypothèse soulevée dans l'examen de cadrage sur les récents changements des indicateurs de mortalité infantile du pays. Les résultats globaux de ces études ont démontré qu'à la lumière du « Conceptual Model of Health Capability » et des déterminants sociaux de la santé, les disparités régionales liées aux inégalités, notamment aux niveaux du revenu, de l'éducation, de l'emploi, du taux de fécondité, de l'accès et de la qualité des services de santé, expliquent les inégalités en termes de taux de mortalité infantile, en particulier dans les macro-régions du nord et du nord-est du pays, ce qui freine probablement la baisse du taux de mortalité infantile. Ces inégalités expliqueraient à la fois la lenteur de la réduction du taux de mortalité infantile et sa tendance à demeurer à des niveaux relativement élevés. Les résultats ont également montré que les variations de ces facteurs, pour des raisons liées à la crise économique et politique, ont probablement perturbé la tendance à la baisse des taux de mortalité infantile. À cet égard, les résultats suggèrent qu'une forte réduction du taux d'emploi, observée entre 2014 et 2015 entre autres facteurs, pourrait avoir eu un impact différé sur le TMI en 2016. Les résultats ont également permis d’établir une association entre l'emploi et différents indicateurs de mortalité infantile, le taux d'emploi pouvant avoir un impact sur la mortalité infantile jusqu'à trois ans. Enfin, les études ont démontré qu'il existe un seuil de revenu des ménages, qui agit comme facteur de protection contre la mortalité infantile, en dessous duquel plus la proportion de ménages est élevée, plus le risque d'augmentation de la mortalité infantile est élevé. / Abstract The infant mortality rate is an indicator of population health and the effectiveness of health systems that is also capable of estimating the extent of social and health inequalities between populations. Over the last 30 years, Brazil has recorded significant reductions in child mortality rates. Between 1990 and 2017, the under-five mortality rate dropped from 53.7 to 15.6 deaths per thousand live births, a 71% reduction over the period. The national reduction average was 6% per year in the 1990s, decreasing to 4.8% in the 2000s and to 3.2% per year between 2011 and 2015, and many factors have been reported as the cause of these improvements. Even after the implementation of health and social policies that positively affected the health of the populations in Brazil in the last decades, since 2009 the country has experienced a slow decrease in the decline in infant mortality that remained at high levels, registering great regional disparities. After an economic crisis that evolved into a troubled period of political crisis, in 2016 the country recorded increases in under-one-year infant mortality and under-five-year infant mortality rates, that raised from 12.43 deaths to 12.72 deaths per thousand live births and from 14.28 deaths to 14.89 deaths per thousand live births, respectively. These facts call attention to the possible impact of social determinants of health on infant mortality rates in Brazil after the implementation of these health and social policies. This anomaly in the trend of child mortality, particularly when combined with regional disparities and a slow decrease in the decline in infant mortality rates is of great concern and raise questions about what is the extent of these health and social policies on the country’s ability to maintain a longer-term decline in the infant mortality rate, is it capable of placing this rate at the level of developed countries and what are the determinants of infant mortality in Brazil after the implementation of these public policies. The overarching goal of this thesis was to identify the determinants of infant mortality in Brazil after the implementation of the Family Health Strategy and the Bolsa Família programs in order to raise plausible hypotheses for the slowdown, the regional disparities, and the anomaly observed in the trend of declines in the infant mortality rate in Brazil. To attain this objective, we conducted three research papers: 1. a scoping review that aimed at identifying and summarizing the determinants of infant mortality in Brazil under the influence of Family Health Strategy and Bolsa Família programs, with a view of raising hypothesis for the recent changes in the infant mortality rates in Brazil and identifying gaps in terms of research concerning the determinants of infant mortality in the country, 2. a descriptive retrospective analysis according to the perspective of Public Health and health inequalities by adopting the analytical framework proposed by the World Health Organization’s Commission on Social Determinants of Health, using data from under-one-year old infant mortality rate and from possible determinants of infant mortality in Brazil according to the findings of our scoping review (article 1), and 3. a methodological proposal in order to overcome the challenges to developing a panel data model using aggregated data from the 26 Brazilian states and different subregions according to the Conceptual Model of Health Capability, with a view of inferring possible associations between our independent variables and infant mortality rates in Brazil, aiming at reviewing the hypothesis raised in the scoping review about the recent changes in the country's infant mortality indicators. The global results of these studies demonstrated that in the light of the Conceptual Model of Health Capability and the social determinants of health, regional disparities related to inequalities in factors such as income, education, employment, fertility rate, access, and quality of health services, account for inequalities in infant mortality rates, especially in the north and Northeast macro-regions of the country, which likely hamper further reductions of infant mortality. Those inequalities would explain both the slowdown in the reduction and the tendency of the infant mortality rate to remain at relatively high levels. Results also demonstrated that variations in those factors for reasons relating to the economic and political crisis, likely have interrupted the secular trend of declining infant mortality rates. In this regard, results suggest that a sharp reduction in employment rate observed between 2014 and 2015, among other factors, may have had a delayed impact on infant mortality rates in 2016. The results also identified an association between employment and different infant mortality indicators, with employment rate possibly impacting child mortality up to three years. Finally, the studies have shown that a household income threshold acts as a protective factor against child mortality, the bigger the proportion of households below this income bracket, the greater the risk of an increase in child mortality.

Les politiques actives du marché du travail (PAMT) sont considérées de plus en plus comme nécessaires pour renforcer le lien entre protection sociale et création de sources de revenu plus durables dans l’objectif d’améliorer la qualité de l’emploi mais aussi, de façon plus générale, les conditions de vie. En conséquence, ces mesures jouent un rôle essentiel aujourd’hui dans les programmes de politique publique de la plupart des économies avancées et voient leur importance augmenter fortement dans les pays émergents et dans les pays en développement, où elles ne sont pas encore aussi bien établies. Il reste toutefois encore beaucoup à apprendre sur l’impact de ces mesures, en particulier sur le rôle des caractéristiques de leur mise en œuvre. Cette thèse entend contribuer à ce débat en étudiant l’efficacité des PAMT et le rôle des systèmes de mise en œuvre pour ce qui est de leur impact à la fois dans les pays développés et dans les pays émergents et en développement.Le premier chapitre examine sous un angle macroéconomique l’efficacité des PAMT à améliorer les résultats sur le marché du travail au sein des pays de l’OCDE, en particulier pour les travailleurs peu qualifiés. Il est capital de saisir de façon empirique l’effet net global des PAMT sur l’ensemble du marché du travail, car ces politiques entraînent souvent des phénomènes de substitution, de déplacement et d’autres conséquences indirectes. Les deux chapitres suivants cherchent à déterminer si les PAMT doivent être encore étendues dans les pays émergents et en développement. Pour ce faire, les effets au niveau individuel de deux types de PAMT en Amérique latine sont étudiés, en s’appuyant sur la présence de règles d’attribution intéressantes et de données de qualité au niveau individuel. Ainsi, le deuxième chapitre s’intéresse plus particulièrement aux conséquences à moyen et long terme d’un programme de workfare péruvien, l’une des mesures d’activation les moins étudiées, bien que fréquemment mise en œuvre dans la région, afin d’évaluer la durabilité de ses effets. Le troisième chapitre s’intéresse à l’introduction d’un ensemble complet de PAMT en Argentine, dans le but d’aider les bénéficiaires éligibles d’un programme de transfert de fonds sous conditions à trouver des sources de revenus plus stables. Dans les deux cas, l’accent est mis sur les effets sur la qualité de l’emploi et sur la manière dont la mise en œuvre des mesures conditionne leur impact.Ces travaux montrent que les PAMT sont utiles mais à condition qu’elles s’accompagnent d’une conception et d’une mise en œuvre appropriées. Les résultats confirment l’importance de ces facteurs pour ce qui est de l’efficacité des mesures tant dans les pays de l’OCDE que dans ceux d’Amérique latine étudiés. L’ampleur des effets dépend du type de mesure étudiée et de la catégorie de bénéficiaires visée. / Today, active labor market policies (ALMPs) are increasingly seen as a necessary tool to strengthen the link between social protection and the creation of more sustainable sources of income with a view to increasing work quality but also improving living conditions more broadly. As a result, the role of ALMPs in policy agendas remains high in most advanced economies and has increased dramatically in emerging and developing countries, where ALMPs are still less established. Despite this, there is still a lot to be learned regarding the impact of these policies, particularly with regards to the role of implementation characteristics. My dissertation aims to contribute to this debate by looking at the effectiveness of ALMPs and the role of delivery systems in shaping their impact in both, developed and emerging and developing countries.It starts by examining the effectiveness of ALMPs in OECD countries in improving labor market outcomes, especially for low-skilled individuals, from a macroeconomic perspective (Chapter 1). Capturing empirically the overall net effect of ALMPs on the wide labor market is of upmost importance, since the role of ALMPs frequently involves substitution, displacement and other indirect effects. Then, the following two chapters aim to assess whether ALMPs should be leveraged further in emerging and developing countries, by investigating the individual-level effects of two different types of ALMPs in Latin America, exploiting the availability of interesting assignment rules and good-quality individual-level data. Chapter 2 focuses on the medium- to long-term effects of a Peruvian workfare program, one of the least studied ALMPs in the region albeit commonly implemented, to assess the sustainability of these type of programs’ effects. Chapter 3 then looks at the provision of a comprehensive package of ALMPs in Argentina, implemented to support eligible beneficiaries of a conditional cash transfer program in finding more stable income opportunities. In both cases, the focus is placed on the effects on work quality and on the role of design and implementation in shaping the effects.My research suggests that ALMPs are relevant but mostly through appropriate design and implementation aspects. The results confirm the importance of these factors in ensuring effectiveness both in OECD and the Latin American countries assessed. The size of effects depends on the type of policy assessed and on the beneficiary group.