Navigation Links
Brazil's health care system vastly expands coverage, but universality, equity remain elusive
Date:5/10/2011

Two decades after Brazil's constitution recognized health as a citizen's right and a duty of the state, the country has vastly expanded health care coverage, improved the population's health, and reduced many health inequalities, but universal and equitable coverage remains elusive, experts from four major Brazilian universities and New York University have concluded.

According to their analysisone of six articles published in the medical journal The Lancet as a special series on health in Brazilwhile federal expenditures have nearly quadrupled over the past 10 years, the health sectors' share in the federal budget has not grown, resulting in constraints on health care financing, infrastructure, and human resources.

The paper's co-authors were: Jairnilson Paim of the Federal University of Bahia; Claudia Travassos of Center for Communication, Scientific Information and Technology at the Oswaldo Cuz Foundation; Celia Almeida of the National School of Public Health, Oswaldo Cruz Foundation; Ligia Bahia of the Federal University of Rio de Janeiro; and James Macinko, an associate professor at New York University's Steinhardt School of Culture, Education, and Human Development.

After more than 20 years of a military dictatorship, Brazil created its present constitution in 1988, which included health as a right of citizenship. Health care reform in Brazil, then, occurred under unique circumstances--simultaneously with the process of democratization and spear-headed by health professionals along with civil society movements and organizations.

To meet this constitutional guarantee, the country established the Unified Health System, or Sistema nico de Sade (SUS), which was based on the principles of universality, equity, integrality, and social participation. The SUS, which serves more than 192 million citizens, is supplemented by private insurers, which cover about 25 percent of Brazilians.

Overall, the Brazilian health system is made up of a complex network of complementary and competitive service providers and purchasers, forming a publicprivate mix that is financed mainly by private funds.

During the past two decades, the researchers noted, the SUS has undergone significant changes. Among these were granting municipalities greater responsibility for health service management, along with the flexibility and means which to bring about social participation in health policy making and accountability.

In the Lancet study, the researchers found vastly increased access to health care for a substantial proportion of the Brazilian population. In 2009 alone, the SUS financed about 12 million hospitalizations, delivered nearly 100 million ambulatory care procedures per month, and reached universal coverage of vaccination and prenatal care. It also expanded the supply of related human resources and technology, including enhanced production to meet most of the country's pharmaceutical needs.

But the researchers also observed that "the SUS is a health system under continual development that is still struggling to enable universal and equitable coverage."

"As the private sector's market share increases, interaction between the public and private sectors are creating contradictions and unfair competition, leading to conflicting ideologies and goalsnotably, universal access vs. market segmentation," they wrote. "All of this has a negative effect on the equity of health-care access and outcomes."

Further complicating the nation's goal of universal coverage are constraints on federal funding. While federal expenditures have increased nearly four times over the past 10 years, they added, the health sectors' share in the federal budget has not grown, producing constraints on financing, infrastructure, and human resources.

"The development of the Brazilian health system reflects the uneven process of social, economic, and political development within the country," the researchers wrote. "Ultimately, to overcome the challenges that Brazil's health system faces, a revised financial structure and a thorough reassessment of public-private relations will be needed. Therefore, the greatest challenge facing the SUS is political. Such issues as financing, composition of the publicprivate mix, and the persistent inequities cannot be solved in the technical sphere only."


'/>"/>

Contact: James Devitt
james.devitt@nyu.edu
212-998-6808
New York University
Source:Eurekalert

Related medicine news :

1. FDA could analyze public health consequences of its decisions better
2. Chemicals May Raise Health Risks for Nail Salon Workers
3. Online Gaming With Real-World Friends Is Healthier: Study
4. IU-Regenstrief programs targeted to alleviate shortage of health IT workforce
5. Many Dialysis Patients Short on Health Literacy
6. New UTHealth trial aimed at helping pregnant women stop smoking
7. Grant funds next phase in bringing healthier sorghum closer to underserved communities
8. INFORMS health care conference highlights increased role of math modeling in health systems
9. Nonprofit health organizations increase health literacy through social media
10. US must strengthen efforts to restrict chemicals that threaten health, say researchers
11. Family Meals Keep Kids Slimmer, Healthier, Study Finds
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/21/2017)... ... April 21, 2017 , ... Young Asset Protection, an insurance ... throughout the greater Pittsburgh metropolitan region, is joining forces with the local chapter ... differently-abled children. , Variety the Children’s Charity is a national organization dedicated to ...
(Date:4/21/2017)... ... April 21, 2017 , ... The Hong Kong Polytechnic University (PolyU) launched ... among higher education institutions in Hong Kong to support teaching, learning and research. It ... and quantity of facilities in Hong Kong. , With an area of 620 ...
(Date:4/21/2017)... , ... April 21, 2017 , ... ... held the much anticipated Regional Primary Care Spring Symposium on April 1, 2017 ... local medical community, offering physicians and healthcare providers an opportunity to learn about ...
(Date:4/21/2017)... , ... April 21, 2017 , ... Westside Dental ... personalized dental care since 1985. After thirty-two years, Dr. Latner has become one of ... help my numerous clients over the years with all their dental needs,” said Dr. ...
(Date:4/21/2017)... ... April 21, 2017 , ... ... reveals good news for older shoulder replacement patients; post-operative recovery just might be ... two groups of patients presenting with osteoarthritis following surgery: 262 patients under 65 ...
Breaking Medicine News(10 mins):
(Date:4/20/2017)... DUBLIN , April 20, 2017 ... the "Global Biosimilar Pipeline and Market Prospects: Addressing ... report to their offering. ... "Global Biosimilar Pipeline and Market ... by Design" provides an in-depth assessment of the current ...
(Date:4/20/2017)... 20, 2017  AbbVie (NYSE: ABBV), a global ... of chronic hepatitis C virus (HCV) infected patients ... and compensated cirrhosis (Child-Pugh A) achieved sustained virologic ... with its investigational, pan-genotypic regimen of glecaprevir/pibrentasvir (G/P). ... following 12 weeks of G/P treatment without ribavirin. ...
(Date:4/19/2017)... Medical Corporation (TSX: CRH) (NYSE MKT: CRHM) (the "Company"), announces that it ... 2017 at the Sheraton Hotel in Toronto, Ontario ... the Company is scheduled to present on Tuesday, May 2 at ... Chairman of the Board, Tony Holler will also attend ... For more details ...
Breaking Medicine Technology: