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Title: The Brazilian health system: history, advances, and challenges
Authors: Paim, Jairnilson Silva
Travassos, Claudia Maria de Rezende
Almeida, Celia Maria de
Bahia, Ligia
Macinko, James
Affilliation: Universidade Federal da Bahia. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Universidade de Nova York. Nova York, NY, EUA.
Abstract: Brazil is a country of continental dimensions with widespread regional and social inequalities. In this report, we examine the historical development and components of the Brazilian health system, focusing on the reform process during the past 40 years, including the creation of the Unified Health System. A defining characteristic of the contemporary health sector reform in Brazil is that it was driven by civil society rather than by governments, political parties, or international organisations. The advent of the Unified Health System increased access to health care for a substantial proportion of the Brazilian population, at a time when the system was becoming increasingly privatised. Much is still to be done if universal health care is to be achieved. Over the past 20 years, there have been other advances, including investments in human resources, science and technology, and primary care, and a substantial decentralisation process, widespread social participation, and growing public awareness of a right to health care. If the Brazilian health system is to overcome the challenges with which it is presently faced, strengthened political support is needed so that financing can be restructured and the roles of both the public and private sector can be redefined.
keywords: Saúde no Brasil
História da Saúde no Brasil
DeCS: Brasil
Sistemas de Saúde
Reforma dos Serviços de Saúde
Serviços de Saúde
Issue Date: 2011
Publisher: Elsevier
Related document:
Citation: PAIM, Jairnilson et al. The Brazilian health system: history, advances, and challenges. The Lancet, v. 377, n. 9779, p. 1778-1797, 2011.
DOI: 10.1016/S0140-6736(11)60054-8
ISSN: 0099-5355
Copyright: restricted access
Appears in Collections:ENSP - Artigos de Periódicos
ICICT - Artigos de Periódicos

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