Brazil’s unified health system: the first 30 years and prospects for the future

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dc.contributor.authorCastro, Marcia C.
dc.contributor.authorMassuda, Adriano
dc.contributor.authorAlmeida, Gisele
dc.contributor.authorNAERCIO AQUINO MENEZES FILHO
dc.contributor.authorAndrade, Monica Viegas
dc.contributor.authorNoronha, Kenya Valéria Micaela de Souza
dc.contributor.authorRocha, Rudi
dc.contributor.authorMacinko, James
dc.contributor.authorHone, Thomas
dc.contributor.authorTasca, Renato
dc.contributor.authorGiovanella, Ligia
dc.contributor.authorMalik, Ana Maria
dc.contributor.authorWerneck, Heitor
dc.contributor.authorFachini, Luiz Augusto
dc.contributor.authorAtun, Rifat
dc.coverage.paisNão Informadopt_BR
dc.creatorCastro, Marcia C.
dc.creatorMassuda, Adriano
dc.creatorAlmeida, Gisele
dc.creatorAndrade, Monica Viegas
dc.creatorNoronha, Kenya Valéria Micaela de Souza
dc.creatorRocha, Rudi
dc.creatorMacinko, James
dc.creatorHone, Thomas
dc.creatorTasca, Renato
dc.creatorGiovanella, Ligia
dc.creatorMalik, Ana Maria
dc.creatorWerneck, Heitor
dc.creatorFachini, Luiz Augusto
dc.creatorAtun, Rifat
dc.date.accessioned2022-10-31T18:07:51Z
dc.date.available2022-10-31T18:07:51Z
dc.date.issued2019
dc.description.otherIn 1988, the Brazilian Constitution defined health as a universal right and a state responsibility. Progress towards universal health coverage in Brazil has been achieved through a unified health system (Sistema Único de Saúde [SUS]), created in 1990. With successes and setbacks in the implementation of health programmes and the organisation of its health system, Brazil has achieved nearly universal access to health-care services for the population. The trajectory of the development and expansion of the SUS offers valuable lessons on how to scale universal health coverage in a highly unequal country with relatively low resources allocated to health-care services by the government compared with that in middle-income and high-income countries. Analysis of the past 30 years since the inception of the SUS shows that innovations extend beyond the development of new models of care and highlights the importance of establishing political, legal, organisational, and management-related structures, with clearly defined roles for both the federal and local governments in the governance, planning, financing, and provision of health-care services. The expansion of the SUS has allowed Brazil to rapidly address the changing health needs of the population, with dramatic upscaling of health service coverage in just three decades. However, despite its successes, analysis of future scenarios suggests the urgent need to address lingering geographical inequalities, insufficient funding, and suboptimal private sector–public sector collaboration. Fiscal policies implemented in 2016 ushered in austerity measures that, alongside the new environmental, educational, and health policies of the Brazilian government, could reverse the hard-earned achievements of the SUS and threaten its sustainability and ability to fulfil its constitutional mandate of providing health care for all.pt_BR
dc.format.extentp. 345-356pt_BR
dc.format.mediumDigitalpt_BR
dc.identifier.doihttp://dx.doi.org/10.1016/ Spt_BR
dc.identifier.urihttps://repositorio.insper.edu.br/handle/11224/4579
dc.identifier.volume394pt_BR
dc.language.isoInglêspt_BR
dc.publisherNão informadopt_BR
dc.relation.ispartofHealth Policypt_BR
dc.rights.licenseO INSPER E ESTE REPOSITÓRIO NÃO DETÊM OS DIREITOS DE USO E REPRODUÇÃO DOS CONTEÚDOS AQUI REGISTRADOS. É RESPONSABILIDADE DOS USUÁRIOS INDIVIDUAIS VERIFICAR OS USOS PERMITIDOS NA FONTE ORIGINAL, RESPEITANDO-SE OS DIREITOS DE AUTOR OU EDITOR.pt_BR
dc.subject.keywordsNão informadopt_BR
dc.titleBrazil’s unified health system: the first 30 years and prospects for the futurept_BR
dc.typejournal article
dspace.entity.typePublication
local.subject.cnpqCiências Sociais Aplicadaspt_BR
local.typeArtigo Científicopt_BR
relation.isAuthorOfPublicationf6aa41b4-c778-4302-9674-af120c85cc97
relation.isAuthorOfPublication.latestForDiscoveryf6aa41b4-c778-4302-9674-af120c85cc97

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