scholarly journals Regional support in the health regions of Rio de Janeiro state: a strategy for strengthening SUS

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L M Cabral ◽  
A M Peres ◽  
P H Rodrigues ◽  
M Caldas ◽  
M Magalhães ◽  
...  
Keyword(s):  
Health Services ◽  
Health System ◽  
Rio De Janeiro ◽  
Municipal Government ◽  
Regional Governance ◽  
The State ◽  
Federal State ◽  
National Council ◽  
Health Departments ◽  
Municipal Health

Abstract Brazil is one of the few countries in the world with more than 200 million inhabitants that has a universal public health system. In its 30 years of existence, the Unified Health System (SUS) has brought many advances to the Brazilian society. However, it still faces challenges to ensure health services in quantity and quality to the entire population. Federal, state and municipal government levels share the responsibility for its management and financing. In this governance scheme, it is the Municipal Health Secretariats (MHS) of the 5,596 Brazilian municipalities that are primarily responsible for providing and managing health services. Given the importance of this responsibility, Councils of Municipal Health Departments (COSEMS) and the National Council of Municipal Health Departments (CONASEMS) were created in 1986. Their role is to promote the articulation and negotiation of their interests with the federal and state levels. In Rio de Janeiro, a team of specialized professionals has been providing support for COSEMS-RJ since 2012. The team carries out activities in the nine regions of the state, which has 92 municipalities and more than 16 million inhabitants, the 3rd largest population in Brazil. Its activities are maintained by CONASEMS, the Ministry of Health and the State University of Rio de Janeiro (UERJ). The objetive of this report is to present the experience of the expert team of COSEMS RJ as a strategy for strengthening regional governance and intergovernmental relations. Providing specialized technical support for MHS has improved local management of SUS and has allowed for the establishment of regionalized health care networks in Rio de Janeiro. Key messages The project improves the participation of municipal managers and teams in regional spaces. It strengthens their capacity for intergovernamental decision-making and regionalization of the health system. The project qualifies the municipal management for fundraising, knowledge building, policy implementing and monitoring, as well as participatory planning.

scholarly journals The Quest to Extend Health Services to Vulnerable Substance Users in Rio de Janeiro, Brazil in the Context of an Unfolding Economic Crisis

2016 ◽  
Vol 47 (3) ◽  
pp. 477-488 ◽  
Author(s):  
Noa Krawczyk ◽  
Deanna Kerrigan ◽  
Francisco Inácio Bastos
Keyword(s):  
Health Services ◽  
Health System ◽  
Economic Crisis ◽  
Rio De Janeiro ◽  
Crack Cocaine ◽  
Access To Health Services ◽  
Government Programs ◽  
Substance Users ◽  
Unified Health System ◽  
Harsh Criticism

Calls to address crack-cocaine use in Brazil among homeless and street-frequenting populations who are in urgent need of health services have questioned the capacity of the Brazilian Unified Health System to attend to the nation’s most marginalized citizens. In recent years, Brazil has launched several actions to escalate care for substance users, yet many obstacles hindering accessibility and effectiveness of services remain. Paradoxically, these actions have been implemented in the context of a growing economic crisis, and expanding services for a population of poor and stigmatized substance users while cutting other government programs tends to elicit harsh criticism from citizens. In consequence of such prospects, this commentary aims to discuss barriers marginalized substance users face in accessing health services that are at risk of worsening with government cutbacks. Using Rio de Janeiro as an example, we explore two primary issues: the resource-strained, under-staffed and decentralized nature of the Brazilian Unified Health System and the pervading stigma that bars vulnerable citizens from official structures and services. Abandoning initiated government efforts to increase access to health services would risk maintaining vulnerable citizens at the margins of public structures, inhibiting the opportunity to offer this population humane and urgently needed treatment and care.

scholarly journals Integration in health: cooperation at triple international border Amazon

2020 ◽  
Vol 54 ◽  
pp. 5
Author(s):  
Giane Zupellari dos Santos-Melo ◽  
Selma Regina de Andrade ◽  
Betina Hörner Schlindwein Meirelles ◽  
Angela Maria Blatt Ortiga
Keyword(s):  
State Government ◽  
Municipal Government ◽  
The State ◽  
Local Health ◽  
Municipal Governments ◽  
Direct Observations ◽  
Health Council ◽  
International Border ◽  
Health Cooperation ◽  
Municipal Health

OBJECTIVE: To describe the scope and limitations of the main strategies of cooperation in health, adopted between 2005 and 2017, in the context of the triple border Brazil, Colombia and Peru. METHOD: Single, explanatory, qualitative, integrated case study carried out in 2017, in the context of the triple Amazon border, Brazil, Colombia and Peru, in the city of Tabatinga, state of Amazonas, Brazil. Our sources of evidence were: documentary data; interviews with health managers of the State Health Secretariats of Amazonas and Municipal Health of Tabatinga, Municipal Health Council of Tabatinga and Consulate of Peru in Colombia; and direct observations in four health services of Tabatinga. Data were organized with MaxQDA12® software. RESULTS: Data analyzed showed that, during the study period, the Brazilian federal government made several health cooperation agreements with both Peru and Colombia and that the state government of Amazonas undertook strategies to improve the health conditions of the dwellers of Tabatinga and the region of Alto Solimões, which indirectly reached the populations of neighboring countries, supporting the interrelationships between the countries of the region. Regarding the municipal government, we verified the existence of health integration agreements, established informally, to minimize the adversities of the local health. CONCLUSION: The cooperation strategies in health adopted in the triple Amazon border have different purposes, benefits and limitations. It is noteworthy that the existence of cooperation agreements between the federal governments of Brazil, Colombia and Peru and the presence of informal cooperation agreements between the municipal governments of Tabatinga (Brazil), Leticia (Colombia) and Santa Rosa (Peru). The limitations of this study are the lack of knowledge of local managers about the cooperation agreements established between federal governments and the lack of legitimacy of the informal agreements established by the Tabatinga government.

scholarly journals Evaluation of informative materials on leishmaniasis distributed in Brazil: criteria and basis for the production and improvement of health education materials

2003 ◽  
Vol 19 (2) ◽  
pp. 561-569 ◽  
Author(s):  
Zélia Maria Profeta da Luz ◽  
Denise Nacif Pimenta ◽  
Ana Rabello ◽  
Virgínia Schall
Keyword(s):  
Health Education ◽  
Health Services ◽  
Health Departments ◽  
Educational Materials ◽  
Quality Of Information ◽  
Pan American ◽  
Health Education Materials ◽  
Health Organization ◽  
Municipal Health

Based on categories related to structure, content, language, and illustrations, the present study provides an evaluation of the quality of educational materials on leishmaniasis available to health services in Brazil. The 18 publications evaluated consisted of four handbooks, four guided studies, four booklets, and six leaflets. Of the total publications assessed, nine were produced by the Brazilian National Health Foundation (FUNASA), five by State and Municipal Health Departments jointly with FUNASA, and one by the Pan-American Health Organization. The evaluations were also performed by three professionals: a physician specialized in leishmaniasis, a parasitologist, and an information/communications expert. The publications failed to specify key items such as target public, objective, and bibliography. The illustrations, especially in the booklets and leaflets, failed to clarify the text, portrayed biased concepts, and omitted credits and scale. According to this study, informative materials on leishmaniasis distributed in Brazil present major limitations which jeopardize the quality of information they contain.

scholarly journals Divided we fall: clinicians and academic psychiatrists need to stand together

2017 ◽  
Vol 25 (5) ◽  
pp. 437-439
Author(s):  
Stephen Allison ◽  
Tarun Bastiampillai ◽  
Malcolm Battersby
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health System ◽  
Mental Health System ◽  
State Mental Health ◽  
The State ◽  
Services Research ◽  
Academic Units ◽  
State Mental

Objective: Psychiatry faces urgent problems requiring united action. These problems affect academic psychiatrists in the universities, and clinicians in publicly funded mental health services. Academic units are isolated and endangered, finding it difficult to recruit. They could benefit from closer relationships with public mental health services, in terms of recruitment, shared teaching and clinical research. However, mental health services are preoccupied with their own problems, particularly in relation to acute clinical demand. How can we stand together to improve academic units and clinical psychiatry? Conclusions: Clinicians and academic psychiatrists can stand together on important matters, but it takes initiatives from local leaders to overcome the structural barriers between health services and the universities. An example is given of united action by clinicians and academic psychiatrists to address a crisis within a state mental health system. First, psychiatrists undertook independent health services research that compared the state system with those in other Australian and international jurisdictions. The comparative data was used to generate solutions, which were presented at every level from ministerial offices through to service managers. Finally, psychiatrists took up joint academic and clinical leadership roles in the university and the mental health system. This united research-led approach turned around the crisis in the state mental health system.

scholarly journals Impacts of a delayed and slow-paced vaccination on cases and deaths during the COVID-19 pandemic: a modelling study

2021 ◽  
Author(s):  
Gustavo Libotte ◽  
Lucas Anjos ◽  
Regina Célia Cerqueira de Almeida ◽  
Sandra Mara Malta ◽  
Roberto Medronho
Keyword(s):  
Rio De Janeiro ◽  
Technological Development ◽  
Gaussian Process Regression ◽  
Vaccination Rate ◽  
The State ◽  
National Council ◽  
Vaccination Rates ◽  
Whole Process ◽  
Credible Intervals ◽  
Modelling Study

Abstract Background: In Brazil, vaccination has always been cutting across party political and ideological lines, which have delayed its start and brought the whole process into disrepute. Such divergences put the immunisation of the population in the background and create additional hurdles beyond the pandemic, mistrust and scepticism over vaccines.Methods: We conduct a mathematical modelling study to analyse the impacts of late vaccination and with slowly increasing coverage, as well as how harmful it would be if part of the population refused to get vaccinated or missed the second dose. We analyse data from confirmed cases, deaths caused by COVID-19, and vaccination in the state of Rio de Janeiro in the period between March 10, 2020, and October 27, 2021. The classical SIR model is extended to consider the effect of vaccination (efficacy, interval between doses, and vaccination rate) and data sets are regularised using Gaussian Process Regression. The model parameter distributions are estimated using Bayesian inference, aiming to obtain credible intervals in the simulations.Findings: We estimate that if the start of vaccination had been 30 days earlier, combined with efforts to drive vaccination rates up, 31,657 (25,801–35,117) deaths could have been averted. Our results also indicate that the slow pace of vaccination and the low demand for the second dose could cause a resurgence of cases as early as 2022.Interpretation: The government's inaction and lack of a strategic plan to fight the pandemic meant that vaccination started late, leading to thousands of deaths that could have been prevented. Even when reaching the expected vaccination coverage for the first dose, it is still challenging to increase adherence to the second dose and maintain a high vaccination rate to avoid new outbreaks.Funding: Carlos Chagas Filho Foundation for Supporting Research in the State of Rio de Janeiro (FAPERJ) and Brazilian National Council for Scientific and Technological Development (CNPq).

scholarly journals A Photographic Astrometric Telescope for Brazil

1986 ◽  
Vol 109 ◽  
pp. 229-230
Author(s):  
L. E. da S. Machado
Keyword(s):  
Rio De Janeiro ◽  
Municipal Government ◽  
Sao Paulo ◽  
The State ◽  
São Paulo ◽  
State University ◽  
Joint Operation ◽  
Catholic University ◽  
Astronomical Station

This paper describes a short focus Astrometric Telescope (D=40cm; F=200cm) at the astronomical station of Campinas, in the State of Sao Paulo, which is a joint operation including the Federal University of Rio de Janeiro, the State University of Campinas, the Catholic University of Campinas and the Municipal Government of Campinas City.

The Financing Health System Problem in Algeria

2016 ◽  
Vol 3 (7) ◽  
pp. 48
Author(s):  
Ali Dehmene Mohammed
Keyword(s):  
Health Services ◽  
Private Sector ◽  
Health System ◽  
Health Sector ◽  
The State ◽  
Social Changes ◽  
The Public ◽  
Demand For Health ◽  
Great Development

The health sector in Algeria witnesses a great development, especially during the last two decades of the last century to coincide with the economic and social changes of the country. But despite the enormity of what the state spends on this sensitive sector in order to meet the growing demand for health services provided by the public or private sector, which, however, take advantage of these services was still below the required level where the sector remains vulnerable to various problems

scholarly journals Study of underreporting of cases of meningitis during a Covid-19 pandemic in the state of São Paulo

2021 ◽  
Author(s):  
Paloma Fernandes de Oliveira ◽  
Matheus Gomes Diniz e Silva ◽  
Daniel Rocha Diniz Teles ◽  
Sabrina de Freitas Barros Soares ◽  
Antônio Fernando Soares Menezes Segundo
Keyword(s):  
Health Services ◽  
Health System ◽  
Sao Paulo ◽  
The State ◽  
World Health ◽  
São Paulo ◽  
Significant Drop ◽  
Knowing That ◽  
The World ◽  
Health Organization

Introduction: In 2020, the World Health Organization declared the COVID-19 pandemic, which brought an overload on the health system. This also impacted the care of other diseases such as meningitis. Meningitis is classified into infectious and non-infectious meningitis, and its prognosis changes with the etiology. Objective: To assess notifications of meningitis in São Paulo compared to the country before and during the COVID-19 pandemic. Methods: An analytical epidemiological study was carried out, from the DATASUS platform, of meningitis notifications, from 2016 to September 2020 in the state of São Paulo in comparison to the country. Results: In 2020 there was a drop in meningitis notifications in São Paulo regarding the average of cases between 2016-2019, where 1,837 cases were reported in 2020, while the average of 2016-2019 was 6,800 notifications, a decrease of approximately 27%. What was also observed in the country, where in 2020, 4,718 cases were reported compared to the 2016- 2019 average of 16,603 cases, a drop of 28.4%. There was a slight increase in the mortality from meningitis in the state from 6% to 7%. Conclusions: Knowing that there was a significant drop in notifications of cases of meningitis in the state of São Paulo and in the country, we can suspect a correlation with the coronavirus pandemic. Therefore, there are some possibilities for this phenomenon: the population with meningitis, for fear of becoming infected, did not seek health services or the overload of health services to monitor patients with COVID-19 led to underreporting of meningitis cases.

scholarly journals Financial Condition and Government Accounts: An Analysis in the Municipalities of the State of Rio de Janeiro (2009 to 2015)

2020 ◽  
Vol 16 ◽  
pp. 60-76
Author(s):  
Marco Henrique da Silva ◽  
Olavo Venturim Caldas
Keyword(s):  
Rio De Janeiro ◽  
Municipal Government ◽  
Political Influence ◽  
The State ◽  
External Control ◽  
Government Accountability ◽  
Financial Health ◽  
Financial Condition ◽  
Prior Opinion ◽  
Chartered Accountants

This research sought to analyze whether the opinion of government accountability of the municipalities of Rio de Janeiro by the Court of Accounts of the State of Rio de Janeiro (TCE-RJ), in the period from 2009 to 2015, considers the financial condition of these municipalities. The financial condition was measured based on the methodology created by the Canadian Institute Chartered Accountants and adapted to the reality of the Brazilian institutional and regulatory environment. Factor analysis was used to select and group the determinants of municipal financial health and the logistic regression analysis to assess whether the result of the opinion of the municipal accounts by the TCE-RJ considered the municipal financial condition. The results were conclusive in relation to the analysis of the accountability of municipal government accounts considering the financial condition factor that deals with the collection, as well as the opinion of the TCE-RJ indicated that it is related to the technical analysis of external control. It was not possible to conclude whether there is political influence from the governor in issuing the prior opinion of the plenary.

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