In 2020, the Brazilian federal government launched the “Prevent Brazil” program to incentivize cities to improve their performance across 7 health care indicators, including prenatal dental care. Our study examines the impact of this policy on the use of oral health care among pregnant women in Brazil. We used a series of cross-sectional data from the Brazilian Public Health System from 2018 to 2023. We linked publicly available data from the Brazilian Ministry of Health and the Brazilian Institute of Geography and Statistics. Our outcome was the proportion of pregnant women receiving prenatal care who had at least 1 dental visit during the past year. Covariates included city-level socioeconomic (income and literacy), demographic (gender, race, and urban areas), and workforce variables (number of dentists working in the public health system per city/year). We estimated the impact of the policy on prenatal dental visits nationwide and stratified by geographic region using interrupted time-series analysis. Our analyses included 99.9% of all Brazilian cities ( n = 5,562). The use of oral health care among pregnant women increased from 15% in 2018 to 69% in 2023. Adjusted estimates show that, after initiation of the Prevent Brazil, dental care use among pregnant women increased nationally at a rate of 4.6 percentage points per 4-mo period (95% confidence interval [CI] 4.5; 4.7). The policy’s largest impact was in the North and Northeast regions, which have the lowest socioeconomic profiles (adjusted time-series rate 5.7 [95% CI 5.3; 6.1] and 5.2 [5.0; 5.4] percent points, respectively). Our findings support the positive impact of the Prevent Brazil policy on prenatal dental care in Brazil. The policy was associated with a countrywide improvement in prenatal dental care use, with a greater impact in socioeconomically disadvantaged regions.

中文翻译：

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巴西激励政策出台后产前牙科护理使用情况的变化


2020年，巴西联邦政府启动了“预防巴西”计划，激励城市提高包括产前牙科保健在内的7项医疗保健指标的表现。我们的研究探讨了该政策对巴西孕妇使用口腔保健的影响。我们使用了 2018 年至 2023 年巴西公共卫生系统的一系列横截面数据。我们链接了巴西卫生部和巴西地理与统计研究所的公开数据。我们的结果是接受产前护理的孕妇在过去一年中至少看过一次牙科的比例。协变量包括城市级社会经济（收入和识字率）、人口统计（性别、种族和城市地区）和劳动力变量（每个城市/每年在公共卫生系统工作的牙医数量）。我们使用间断时间序列分析估计了该政策对全国产前牙科就诊的影响，并按地理区域进行分层。我们的分析涵盖了 99.9% 的巴西城市 (n = 5,562)。孕妇口腔保健的使用率从 2018 年的 15% 增加到 2023 年的 69%。调整后的估计显示，巴西预防计划启动后，全国孕妇口腔保健的使用率以每 4 人 4.6 个百分点的速度增加-mo 周期（95% 置信区间 [CI] 4.5；4.7）。该政策影响最大的是社会经济状况最低的北部和东北地区（调整后的时间序列比率分别为 5.7 [95% CI 5.3; 6.1] 和 5.2 [5.0; 5.4] 个百分点）。我们的研究结果支持“预防巴西”政策对巴西产前牙科护理的积极影响。 该政策与全国范围内产前牙科护理使用的改善有关，对社会经济弱势地区的影响更大。