scholarly journals Testing COVID-19 in Brazil: fragmented efforts and challenges to expand diagnostic capacity at the Brazilian Unified National Health System

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Koichi Kameda ◽  
Mady Malheiros Barbeitas ◽  
Rosângela Caetano ◽  
Ilana Löwy ◽  
Ana Claudia Dias de Oliveira ◽  
...  

Abstract: Since the first recorded case of COVID-19 on February 26, 2020, Brazil has seen an exponential growth in the number of cases and deaths. The national testing approach has been insufficient to correctly use this tool in the support of containing the epidemic in the country. In this communication, we discuss efforts and challenges to scale-up COVID-19 testing at the Brazilian Unified National Health System (SUS). This communication presents the initial results of the research project created to investigate the political, industrial, technological, and regulatory aspects that may affect the diagnostic and testing capacity for COVID-19 in Brazil. The paper draws on the review of academic literature, media publication, and collection of public data on tests purchase and regulation. It enlists initiatives to enhance PCR testing, national production and development of technologies, as well as regulatory measures to fast-track new tests. Our analysis indicates some points of reflection. Firstly, the lack of a consistent national strategy to fight COVID-19 exarcebated supply problems of diagnostic components. If the country was eventually able to circumvent this situation, it still faces a more structural dependency on the importation of diagnostic components. Secondly, the discontinued funding and distribution of tests may have implied health policy fragmentation and the growing importance of local governments and non-state actors to fighting the epidemics within SUS. Finally, initiatives established since the second semester of 2020 have expanded the testing capacity at SUS. However, it has not been sufficient to control the progress of the epidemic in the country.

Author(s):  
Samuel Oluwasogo Dada ◽  
Olawale Ayomikun Oniya ◽  
Oluwatobi James Hussain

Background: The study investigated the knowledge of Nigerian youths on COVID-19 and their perception about COVID-19, National health system and socio-political right.Methods: A descriptive study designed was adopted using an online survey method. Google form was used to elicit responses from 225 Nigerian youths across the six geo-political zones of Nigeria. A 12-point knowledge scale was used to assess knowledge, while a 12-point perception scale was used to determine respondents’ perception. Descriptive statistics was used for data analysis.Results: The respondents’ mean age was 28.2±6.1 years. Majority (58.0%) were from the Southern part of Nigeria while 42.0% were from the Northern part of Nigeria. Also, 63.0% of the respondents had at least a first degree and majority (60.4%) were female. Almost all (87.2%) the respondent had good knowledge on the novel COVID-19, with mean knowledge score of 9.5±2.6. About one-third (31.6%) of the respondent reported the Nigeria health system is too weak and they desired to leave the country, 84.9% believed the federal Government of Nigeria is not doing enough in handling the COVID-19 and 45.5% felt Nigeria is not a safe place during a pandemic.Conclusions: The general perception of Nigerian’s youth about the health system and Government handling of the COVID-19 was poor. A good knowledge of COVID-19 was documented. There is therefore the need for Government to scale up and strengthen the health system capacity to handle health emergencies such as the COVID-19.


Author(s):  
S. S. Budarin ◽  
N. V. Yurgel

The article examines the experience of the national audit office of the United Kingdom in conducting an audit of the effectiveness of budget funds aimed at providing medicines to English citizens. The reasons for the sharp increase in budget expenditures for providing the population with reproduced medicines in 2017—2018 are described in detail.The article analyzes the shortcomings of the system of regulation of drug pricing procedures and the resulting risks to the budget of the national health system in United Kingdom.It is concluded that the effectiveness audit has allowed us to identify not only the reasons for significant overspending of the NHS budget to provide the population with medicines, but also to assess the actions of organizations authorized by the UK Government to address issues of regulation of the pharmaceutical market.


2009 ◽  
pp. 55-62
Author(s):  
Fabrizio Rizzi

- This article recounts the doubts and fears of an experienced analyst who is now an apprentice acrobat. He is forced to keep himself tiredly balanced between psychological and physical limits imposed by age, restrictions introduced by the National Health System and categories of patients who have precedence over others. He cannot receive all of the patients who ask for him and even those who he does receive will have to be discharged in the short term. Explaining to them, with intellectual honesty, that the community service has rules that limit his wishes as well. What can this be if not acrobatics? In the end it means combining the contradictory but perhaps also the most real aspects of life itself. [KEY WORDS: desires, personal and environmental limits, truth of the therapist]


Author(s):  
Robin Gauld

The English NHS is of significance among health policy observers around the globe for various reasons. The NHS is particularly noteworthy for the fact that, for many, it represents the high-income world’s best attempt to have built and maintained a ‘national’ health system with a focus on universal access to care that is free at point of service. The NHS has been in transition for several years. Many commentators have highlighted the role and influence of US market ideals in this transition, with various UK governments clearly pushing this agenda. However, is often useful to look to countries more closely comparable to England, such as New Zealand, for comparison with a view to improvement. This chapter takes such an approach in looking at the NHS from abroad. It draws upon the case of NZ which, in many ways, is very similar to England when it comes to health policy and the healthcare system. In doing so, it aims to provide a critique of the NHS reforms and demonstrate that there are alternatives to the policies and structures being pursued for the English NHS by the Coalition government.


2017 ◽  
Vol 135 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Rômulo Araújo Fernandes ◽  
Kyle Robinson Lynch ◽  
Eduardo Kokubun ◽  
...  

ABSTRACT CONTEXT AND OBJECTIVE: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.


2013 ◽  
Vol 16 (3) ◽  
pp. 622-632
Author(s):  
Katia Cristina Bassichetto ◽  
Denise Pimentel Bergamaschi ◽  
Deivis Elton Schlickmann Frainer ◽  
Vania Regina Salles Garcia ◽  
Edina Aparecida Tramarin Trovões

The nutritional status of people living with HIV/AIDS (PLWHA) is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H), height for age (H/A), body mass index for age (BMI/A) and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66). In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001). The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group.


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