Análise da política nacional de saúde integral de lésbicas, gays, bissexuais, travestis e transexuais no âmbito do sistema único de saúde / Analysis of the national comprehensive health policy for lesbians, gays, bisexuals, transvestites and transsexuals within the scope of the unified health system

Abstract Introduction Social participation is one of the guidelines of the Brazilian health system. Health councils are collegiate instances of participation established by Law 8.142/90. The most recent legal regulation for council organization and functioning was established through Resolution 453/2021. The institution of health councils has a permanent and deliberative nature to act in the formulation, deliberation and control of health policy implementation, including in economic and financial aspects. Objective To evaluate the compliance of health councils with the directives for the establishment, restructuring and operation of the councils from Brazil, based on Resolution 453/2012. Methods An exploratory, descriptive study that used the Health Council Monitoring System as a data source. Qualitative variables were selected to identify the characteristics related to the councils’ establishment (legal instruments for establishment), the strategies adopted for restructuring (budget allocation, existence of an executive secretariat, provision of a dedicated office) and the characteristics of the health councils’ operation (frequency of regular meetings, existence of a board of directors, the election of the board of directors). Results The study analyzed three groups of characteristics related to the constitution, strategies adopted for restructuring and the functioning of the councils. Regarding the constitution of the councils, the findings revealed that the vast majority was constituted in accordance with the legislation and, therefore, is in compliance with Resolution 453/2021. In the second group of characteristics that describe the restructuring of councils, the study found that less than half of registered councils are in compliance with the standard. And, finally, in the third group of characteristics, it was found that the boards have adopted different frequencies for regular meetings and approximately 50% of the boards studied have a board of directors. Conclusions The councils still do not meet the minimum conditions necessary to fulfil their role in the Unified Health System (SUS), as stipulated in Resolution 453/2021. This situation requires monitoring by public oversight agencies. Despite the increase in popular participation with the creation of the health councils, this study demonstrated that most councils still do not meet the minimum conditions for monitoring public health policy. The improvement of the Health Councils Monitoring System (SIACS) to become an instrument for monitoring the councils, with the definition of goals and results, may contribute to the organization of the councils and, therefore, to the realization of social participation in Brazil.

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Satisfação de usuários com aparelhos de amplificação sonora individual concedidos pelo Sistema Único de Saúde: revisão integrativa

Audiology - Communication Research ◽

10.1590/2317-6431-2020-2296 ◽

2020 ◽

Vol 25 ◽

Author(s):

Rodrigo Oliveira da Fonsêca ◽

Monique Ramos Paschoal Dutra ◽

Maria Ângela Fernandes Ferreira

Keyword(s):

Public Health ◽

Hearing Loss ◽

Health Policy ◽

Patient Satisfaction ◽

Health System ◽

Hearing Aids ◽

Public Health Policy ◽

Unified Health System

RESUMO Objetivo Identificar a satisfação de usuários com os aparelhos de amplificação sonora individual (AASI) concedidos pelo Sistema Único de Saúde (SUS). Estratégia de pesquisa Trata-se de uma revisão integrativa da literatura, realizada nas bases de dados LILACS, SciELO, PubMed e Scopus, empregando os descritores hearing loss, public health policy, Unified Health System, public health, patient satisfaction e hearing aids. Critérios de seleção Foram selecionados artigos publicados a partir de 2004, sem restrição quanto ao idioma, envolvendo usuários adaptados pelo SUS. Excluíram-se publicações repetidas, resenhas, artigos de opinião, editoriais, teses e dissertações. Resultados Foram localizados 1011 estudos, dos quais, 24 foram incluídos. As pesquisas veicularam-se a partir de 2007, com predomínio na região Sudeste, por meio de abordagens quantitativas e, em grande parte, com amostras limitadas, compreendendo adultos e idosos. Os questionários de autoavaliação foram os recursos utilizados para avaliar a satisfação. Conclusão A maioria dos usuários revelou elevada satisfação com os AASI concedidos pelo SUS.

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SISTEMA ÚNICO DE SAÚDE (SUS): POLÍTICA DE SAÚDE COLETIVA

Revista de Direitos Humanos e Efetividade ◽

10.26668/indexlawjournals/2526-0022/2017.v3i2.2344 ◽

2017 ◽

Vol 3 (2) ◽

pp. 35

Author(s):

Eneida Orbage de Britto Taquary ◽

Isadora Orbage de Britto Taquary

Keyword(s):

Public Health ◽

Health Policy ◽

Health System ◽

Economic Resources ◽

Health Policies ◽

Public Health Policies ◽

Social Law ◽

Unified Health System ◽

De Se ◽

Constitutional Jurisprudence

A problemática se refere à necessidade de se conhecer os critérios para otimizar os protocolos na saúde pública, de forma a obedecer os princípios do Sistema Único de Saúde (SUS). A hipótese levantada se refere à otimização dos recursos econômicos no SUS e os critérios utilizados para observância de um protocolo. Objetiva identificar as características e princípios do SUS e conhecer a política de saúde baseada em evidências. A metodologia será baseada em revisão bibliográfica e na jurisprudência constitucional, de forma a alcançar como resultado a identificação da saúde como direito coletivo e social. The problem refers to the need to know the criteria to optimize protocols in public health, in order to obey the principles of the Unified Health System (SUS). The hypothesis raised refers to the optimization of the economic resources in the SUS and the criteria used to observe a protocol. It aims to identify the characteristics and principles of SUS and to know the health policy based on evidence. The methodology will be based on literature review and constitutional jurisprudence, in order to achieve as a result the identification of health as a collective and social right. Unified Health System. Health Unic System; Public health policies in Brazil; Collective and social law

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Living, collective and political organisms for construction of the attributes of the National Oral Health Policy

RGO - Revista Gaúcha de Odontologia ◽

10.1590/1981-8637202100302020033 ◽

2021 ◽

Vol 69 ◽

Author(s):

Alexandre Fávero BULGARELLI

Keyword(s):

Public Health ◽

Health Policy ◽

Oral Health ◽

Social Policy ◽

Health System ◽

Health Professionals ◽

Health Policies ◽

Public Health Policies ◽

Unified Health System ◽

Oral Health Policy

ABSTRACT The last few decades have witnessed a growth in the value of dentists as health professionals as they act as protagonists in the construction of public health policies. This change comes from powerful and representative dentists in the Unified Health System (acronym in Portuguese is SUS). This short theoretical essay aims to bring the reader closer to the attributes necessary for the building of a social policy and draws a parallel with the National Oral Health Policy (acronym in Portuguese is PNSB). Issues such as context-oriented health policy and the National Oral Health Policy associated with the attributes of a social policy are presented in a narrative and reflective manner. In this process, the exercise of citizenship is demonstrated, emphasizing the importance of the collective role and policy of dentist surgeons in the stages of health policies in Brazil

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Retrospective study of the distribution of doctors in municipalities of extreme poverty in Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.323 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

B L O Luizeti ◽

E M M Massuda ◽

L F G Garcia

Keyword(s):

Public Health ◽

Health System ◽

Cross Sectional Study ◽

Cross Sectional ◽

Extreme Poverty ◽

The Public ◽

The North ◽

Unified Health System ◽

Shortage Of Doctors ◽

Demographic Distribution

Abstract In view of the national scenario of scarcity of material and human resources in public health in Brazil, the survey verified the demographics of doctors who attend the Unified Health System (SUS) in municipalities of extreme poverty. An observational, analytical and cross-sectional study was carried out, based on secondary quantitative data from the Department of Informatics of the SUS using the TABNET of December 2019. The care networks variable was restricted to infer the number of physicians who attend the SUS in extreme poverty municipalities in Brazil. Municipalities of extreme poverty are those that at least 20% of the population have a household income of up to 145 reais per capita monthly. In Brazil, there are 1526 municipalities in extreme poverty, 27.4% of the country's total municipalities. 14,907 doctors linked to SUS work in this condition, 3.19% of the total of these professionals in Brazil. There is still disproportion between regions: North concentrates 11.2% of the municipalities in extreme poverty and 8.61% of the total number of doctors; Northeast, with 61.33% of these municipalities, for 61.5% of doctors; Southeast, with 15.46% of the municipalities in this condition, has 20.6% of doctors; South concentrates 10.87% of the municipalities under discussion with 5.61% of doctors and the Midwest, with 4.87% of these municipalities, has 3.54% of doctors. Between 2009 and 2018, there was a 39% increase in the number of doctors in these locations, however, for 2019, there was a decrease of 3.89%. The medical demographic distribution in Brazil is uneven, especially in the North. There is also the vulnerability of this population in view of the observed reduction in the number of professionals between 2018 and 2019 in municipalities of extreme poverty, for political reasons. It is evident the need to restructure the health system to guarantee access to health for this population, through the attraction and fixation of doctors in needy regions in Brazil. Key messages Shortage of doctors in extreme poverty municipalities reinforces the health vulnerability of the population in Brazil. The uneven medical demography in Brazil requires restructuring in the public health system.

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

International Journal of Health Services ◽

10.1177/0020731416679351 ◽

2016 ◽

Vol 47 (3) ◽

pp. 477-488 ◽

Cited By ~ 4

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.

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Changes in contraception use among Brazilian women after childbirth, 2006-2013

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.981 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Felisbino-Mendes ◽

B Barrozo Siqueira

Keyword(s):

Health System ◽

Secondary Data ◽

Reproductive Age ◽

Cross Sectional ◽

Regional Inequalities ◽

Unified Health System ◽

Contraception Use ◽

High Prevalence ◽

Modern Methods ◽

Low Prevalence

Abstract Introduction There are gaps in knowledge regarding the neglected and vulnerable subgroups of FP actions in Brazil, such as postpartum women and women in general, regardless of their marital status. Objective To assess changes in the prevalence of use and in the contraceptive pattern of Brazilian women up to two years after pregnancy, between 2006 and 2013. Methods Cross-sectional, descriptive and analytical study which used secondary data from national surveys. We studied Brazilian women with up to 2 years postpartum, of reproductive age, sexually active, non-pregnant and menstruating, and compared them with all the other women. We estimated the prevalence of use, contraception pattern of contraception and ranking of modern methods. Percentual change in indicators between the years was evaluated by calculating the difference between estimates. Results 85% of Brazilian women used CM, remaining stable in 2006 and 2013, with a high prevalence of modern methods use. An increase in the use of CM was observed among those with up to six months postpartum (71.0% to 89.0%). Pills and condoms accounted for about 60% of modern methods used in the postpartum period in both surveys. There was an increase in dual protection (2.9% to 10.1%) and contraceptive insecurity (1.6% to 5.7%) and a reduction in sterilization (16.2% to 13.4%) and traditional methods (2.1% to 1.4%). Conclusions Even with the maintenance of a high prevalence of use of CM and with the increase in contraception among women with up to six months postpartum, regional inequalities in access to CM and low prevalence of the use of other methods made available by the Unified Health System (SUS) persist, pointing out the maintenance of the insufficient care, failures in the means to regulate fertility and that public policies still hinder to guarantee the sexual and reproductive rights of the most vulnerable population. Key messages Regional inequalities in access to contraceptive methods and low prevalence of other methods made available by the Unified Health System (SUS) persist. There was an increase in contraception use among women with up to six months postpartum in Brazil.

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29.F. Workshop: The Health Systems and Policy Monitor network: reforms and health system changes in the spotlight

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1337 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

◽

Keyword(s):

Health Policy ◽

Knowledge Transfer ◽

Health System ◽

Health Systems ◽

Comparative Research ◽

World Health ◽

State Of Health ◽

Wide Range ◽

Cross Country ◽

The Eu

Abstract The European Observatory established the Health Systems and Policy Monitor (HSPM) network in 2008, bringing together an international group of high-profile institutions from Europe and beyond with high academic standing in health systems and policy analysis. An important step was taken in 2011, when the Bertelsmann Health Policy Monitor, a 20-country-project with already significant overlap with the current HSPM network, merged with the Observatory's network of national lead institutions. Today, the network includes 40 institutions from 31 countries, with members participating in a wide range of activities and collaborations, such as writing the Observatory's flagship health system reports (HiTs), keeping the health policy community up-to-date on health system developments via the HSPM web platform, and contributing their expertise to reports, studies and knowledge transfer exercises co-ordinated by the Observatory for a variety of audiences, including ministries of health and international organisations such as the World Health Organization and the European Commission. In addition, network members participate in an annual meeting, hosted in a different member country every year, coming together over two days to exchange knowledge and experiences about the various health system reforms happening in their countries. The aim of these meetings is to present, discuss and start comparative research collaborations of the members that can inform policymaking. As part of a collaboration with the journal Health Policy, researchers of the HSPM network have published more than 100 articles on cross-country comparisons of policies or on ongoing nation health reforms in a special section - the Health Reform Monitor - of the journal. This workshop aims to provide the audience with an overview of the network and its expanding range of activities. An introductory presentation will briefly introduce the origins of the network and discuss its current line of work. The second presentation will provide an overview of reform trends that are routinely collected during the annual meetings as part of the “reform roundup”. The third presentation will give an example of how the network has contributed to the European Commission's State of Health in the EU initiative, by performing a 'rapid response” that informed the companion report to the State of Health in the EU country health profiles 2019. The fourth presentation is a typical example of the kind of collaborative work that the network is undertaking, i.e. involving multiple countries on a topic of shared interest. The workshop will conclude with a debate with the audience about the conceptual and methodological challenges as well as opportunities and future directions of cross-country comparative research and the HSPM network in particular. Key messages The Health Systems and Policy Monitor Network provides detailed descriptions of health systems and provides up to date information on reforms and changes that are particularly policy relevant. The Health Systems and Policy Monitor Network increasingly engages in comparative health systems research and knowledge transfer activities.

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