Challenges for ensuring availability and accessibility toin health care services under Brazil's Unified Health System (SUS)
Cien Saude Colet. 2017 Apr;22(4):1165-1180.
doi: 10.1590/1413-81232017224.31382016.
[Article in
Portuguese,
English]
Affiliations
- 1 Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa. R. da Junqueira 100. 1349-008 Lisboa Portugal. paula.cavalcante@ihmt.unl.pt.
- 2 Departamento de Odontologia Social, Faculdade de Odontologia, Universidade de São Paulo. São Paulo SP Brasil.
- 3 Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro. Rio de Janeiro RJ Brasil.
Abstract
Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas. This review focused on eight interventions in the last 30 years, whose mainly aim was to correct the maldistribution of physicians in the SUS such as Rondon Project, Interiorization of Health Work Program, Medical Specialists Training Program, PHC Program and More Doctors Program. The discussion focuses on the factors that influence the outcome of these interventions.
MeSH terms
-
Brazil
-
Delivery of Health Care / organization & administration*
-
Health Personnel / statistics & numerical data
-
Health Policy
-
Health Services Accessibility*
-
Health Workforce / statistics & numerical data
-
Humans
-
National Health Programs / organization & administration*
-
Physicians / statistics & numerical data
-
Physicians / supply & distribution
-
Primary Health Care / organization & administration
-
Socioeconomic Factors