Access to quality and affordable healthcare for all is a social ideal that many countries aspire to attain with varying degrees of success. While many developed countries have more or less achieved universal healthcare, many more other countries are struggling to provide their citizens with quality health services. Brazil is one of the emerging global economies, with a population of over 190 million people. With such a big population and such a large area of approximately 8.5 million km2 and glaring regional and social inequalities,the country's aspiration towards universal healthcare has been a journey full of ups and downs.
The advent of democratic politics in 1988 ushered in hope for a new social system that would guarantee equity in access to the country's resources and lead to significant social gains such as equal access to quality healthcare. While the 1988 constitution granted all citizens the right to affordable and universal healthcare, research has shown that there exists an evidential correlation between differences in income levels and frequency of doctor visits, which points to a strong association between income disparities and access to healthcare. Universal healthcare has not been rolled out uniformly across all social groups.
[...] However, the system has seen the country attain some significant milestones such as reduction of child mortality rates from a high of 114 to 1000 live births in 1970 to 19.3 per 1000 live births in 2007.7 Other milestones included the reduction in fertility rates from 5.8 in 1970 to 1.9 in 2008 and a 40% jump in life expectancy at birth to 72.8 years in 2008. While these achievements are not very high in the standards of more advanced economies, they are remarkable for a country transitioning from Third World to developed status. In comparison to regional neighbors, these statistics are also far more significant for the quality of life of the average Brazilian. Should challenges concerning universality of access for SUS, long term sustainability etc are addressed, it can be a model healthcare system to be emulated in the region and globally. [...]
[...] A CRITIQUE OF THE UNIFIED HEALTH SYSTEM (SUS) IN BRAZIL Is Universal Healthcare in Brazil Really Universal? A Critical Analysis Introduction and Background Access to quality and affordable healthcare for all is a social ideal that many countries aspire to attain with varying degrees of success. While many developed countries have more or less achieved universal healthcare, many more other countries are struggling to provide their citizens with quality health services. Brazil is one of the emerging global economies, with a population of over 190 million people. [...]
[...] In addition, some municipalities had high concentrations of medical schools which attracted students. After graduation, these trained professionals tended to cluster around such municipalities. Moreover, poorer municipalities were shunned for lack of social amenities and medical facilities. To reverse this trend, the government introduced a program where medical staff in such poor municipalities 23 Sampaio, “Healthcare Reform,” 359- were better remunerated as steps were taken to increase capcity. should endeavor to increase the federal annual contribution to the health sector to ensure quality. [...]
[...] Government funding of the health sector has been on a decline in the past decades. According to Sampaio, federal contributions to the health kitty have been on a steady decline since the 1980s: the government spent 75% of all public expenditure on health, in 1987 it was in 2000 it came down to Guanais and Macinko, “Health Effects,” and then 45% in 2007.23 With inadequate and inconsistent financing of the public healthcare program, problems of quality, and by extension access, will continue to plague policymakers and threaten the sustainability of the programs. [...]
[...] This study explores the literature surrounding healthcare provision in Brazil and makes a critical analysis of the underlying issues. It argues that, despite the Unified Health System or Sistema Unico de Saude (SUS) having been operational in the country for over 25 years, it has made little progress in uniformly deepening access to quality and affordable healthcare to all members of the population. It highlights the following challenges as standing in the way of making SUS a truly universal health coverage: 1. [...]
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