Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
8
result(s) for
"Health care reform Brazil History 21st century."
Sort by:
Twenty years of health system reform in brazil
It has been more than 20 years since Brazil's 1988 Constitution formally established the Unified Health System (Sistema Unico de Saude, SUS). Building on reforms that started in the 1980s, the SUS represented a significant break with the past, establishing health care as a fundamental right and duty of the state and initiating a process of fundamentally transforming Brazil's health system to achieve this goal. This report aims to answer two main questions. First is have the SUS reforms transformed the health system as envisaged 20 years ago? Second, have the reforms led to improvements with regard to access to services, financial protection, and health outcomes? In addressing these questions, the report revisits ground covered in previous assessments, but also brings to bear additional or more recent data and places Brazil's health system in an international context. The report shows that the health system reforms can be credited with significant achievements. The report points to some promising directions for health system reforms that will allow Brazil to continue building on the achievements made to date. Although it is possible to reach some broad conclusions, there are many gaps and caveats in the story. A secondary aim of the report is to consider how some of these gaps can be filled through improved monitoring of health system performance and future research. The introduction presents a short review of the history of the SUS, describes the core principles that underpinned the reform, and offers a brief description of the evaluation framework used in the report. Chapter two presents findings on the extent to which the SUS reforms have transformed the health system, focusing on delivery, financing, and governance. Chapter three asks whether the reforms have resulted in improved outcomes with regard to access to services, financial protection, quality, health outcomes, and efficiency. The concluding chapter presents the main findings of the study, discusses some policy directions for addressing the current shortcomings, and identifies areas for further research.
eBook
From Alma-Ata to Astana: the path of Primary Health Care in Portugal, 1978-2018 and the genesis of Family Medicine
Throughout the twentieth century, the profound changes that have taken place in Medicine can only be wholly explained if observed from a historical perspective, for they have always occurred in response to external influences, some scientific and technological, others of a social nature. Modern Family Medicine is one of the many new disciplines that have developed during medical history, and we critically discuss the last 40 years of primary health care in Portugal, which started in 1971, long before the Alma-Ata Declaration (1978). Along the way, in 2005, the Primary Health Care Reform emerges in Portugal, along with the new family health facilities, which until September 2019, attended about 94 % of Portuguese citizens, i.e., 9,5 million people. At the end of this course, in solidarity and voluntarily, this Reform inspired another one in Brazil, in Rio de Janeiro, in 2009. Finally, we present the challenges pointed out in the 2018 Astana Declaration, among them, the issue of the workforce in primary health care as an essential factor for the performance and sustainability of health systems.
Journal Article
Impact of Elizabeth Fee’s Ideas and Scholarship for Brazil and the Global South
Innovative perspectives in the history of science blossomed after the 1962 publication of Thomas Kuhn's classic The Structure of Scientific Revolutions,1 opening the path for approaches that eschew a linear view of scientific and social progress. Elizabeth Fee's invaluable contributions can be framed as part of this drive to renew the construction of scientific knowledge as a reflection and form of interaction with the larger societal context and foster a hopeful vision of its role in the future of health and social policies. By engaging in dialogue with historians and, more important, with broader audiences such as politicians, public health practitioners, and leaders, Fee placed research and the historical imagination at the service of our contemporary fight for the right to health and social justice.
Journal Article
The current scenario of emergency care policies in Brazil
Background
The regulation of emergency care has featured prominently in Brazil’s federal health agenda since the 2000s. The aim of this study was to review up to the present day the implementation of the National Emergency Care Policy.
Methods
The methods employed were documental review, analysis of official data and 11 interviews conducted with federal, state and local managers. The results were analyzed using Giddens’ Structuration Theory, relating the cognitive abilities of the agents to their action strategies, in view of the structural dimensions, rules and resources provided by the federal administration.
Results
Federal policy for emergency care in Brazil can be divided into three stages: from 1998 to 2003, the initial regulation; from 2004 to 2008, the expansion of the Mobile Emergency Medical Services (SAMU, in Brazil); and from 2009 onwards, the implementation of stationary pre-hospital care facilities, known as Emergency Care Units (UPA). The structuration elements identified for the emergency care policy were the public health system guidelines, legislation, standards and federal financing. Significant restrictions were found such as lack of hospital beds and intensive care treatment, gaps in the information system for producing evidence for management, ineffective Management Committees, as well as a low degree of commitment among physicians to the services.
Conclusion
Considering the financial constraints imposed on the SUS (Brazilian Unified Health System), emergency care was identified as a political priority with financial support. The individual actions by emergency care workers and governmental agents typified the first period of the policy, structuring the basis and producing changes in the circumstances of action. Federal strategies can be equated to the rules and resources provided to support the implementation process of the policy.
Journal Article
A public health physician named Walter Leser
A brief review of the career of the public health physician Walter Sidney Pereira Leser, who died in 2004 aged 94. Self-taught, from his 1933 doctoral thesis he became a country reference in the field of statistics and epidemiology, with dozens of studies and supervisions. In the clinical field he is one of the founders of Fleury Laboratory, and participates in the creation of CREMESP. As an academic, Leser was a professor at the Escola de Sociologia e Política de São Paulo, Escola Paulista de Medicina e Faculdade de Farmácia e Odontologia da USP. Also, Leser introduced objective tests in the college entrance examination, and led the creation of CESCEM and Carlos Chagas Foundation. In the Escola Paulista de Medicina he created the first Preventive Medicine Department of the country. As a public official, he was secretary of the State Department of Health of São Paulo between 1967 and 1971 and between 1975 and 1979, responsible for extensive reforms and innovations. Among the most remembered, the creation of sanitary medical career. Throughout this legacy, he lent his name to the \"Medal of Honor and Merit Public Health Management\" of the State of São Paulo.
Journal Article
The history of a movement: Saúde em Debate magazine and Brazilian health reform
This article traces significant moments in the history of the magazine Saúde em Debate - sourcing references and information from documents, historical studies, editions of the magazine, academic work and interviews with physicians and writers who contributed to its creation. In its 39 years of existence, although there may have been variations in the magazine's editorial policy, its role as a means for exchange of ideas and debate on critical health thinking, and making a contribution by in some way intervening in the Brazilian political process, has not changed. The magazine established itself with a firm reputation as a vehicle of scientific communication especially in the areas of health policy and management, expanding the scope of subjects over time. Among the challenges it has faced, as well as that of financial sustenance, has been its role as an instrument for dissemination of Latin American thinking in the field of health.
Journal Article
Giovanni Berlinguer: socialist, sanitarian, and humanist!
This article highlights important aspects of the biography of Giovanni Berlinguer that led him to become a prominent scientist and political activist. His works were marked by a strong socialist conviction and deep humanism. His contribution to health in Brazil ranged from a vast academic output in the field of public health to an active involvement in the Brazilian Health Movement. His later publications addressing everyday bioethics reveal the common thread that runs through his entire works: the use of science to demonstrate the social determinants of health; the fight against unjust inequality; the defense of life against exploitation; and the struggle to prevent the commoditization of life, the human body, and health care.
Journal Article