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brazil: achievements and challenges to the health system

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brazil: achievements and challenges to the health system

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    1. Brazil: achievements and challenges to the health system Camila Giugliani Denise Nascimento Porto Alegre, Brazil IPHU Short Course – Savar – November 2007

    7. Sistema Único de Saúde (National Health System) Equity Comprehensiveness Universality Descentralization Social participation (social control)

    12. Family Health Program 1994 – National level – Incorporated the PACS and became a full team program Based on a philosophy that “prioritises actions of promotion, protection and recovering of the health of individuals and families, from the newborn to the elderly, healthy or ill, on an integral and continuous basis”. Follows the principles stated on the SUS (NHS). In the beginning (1994), objective was to provide access to the more vulnerable, by prioritising the implementation of family health teams in vulnerable areas throughout the country. Actually, the PSF became a more comprehensive strategy, with the objective of reorganizing health practices, based on a comprehensive understanding of the health-disease process.

    13. Family Health Strategy “Strategy of reorientation of the assistance model, ... by the implementation of multiprofessional teams in health facilities... In charge of the care of a defined number of families, in a limited geographical area. The teams perform actions of health promotion, prevention, recovering, rehabilitation of the more frequent illnesses, and in the maintenance of the health of this community....” “Reorganize the system (SUS) towards a network with strong organisational basis oriened to primary health care….” Ministry of Health, 2005.

    14. Family Health Strategy teams Minimal team: 1 physician 1 nurse 2 nurse assistants 4-6 community health workers every ~ 2 minimal teams – 1 oral health team (dentist and dental assistant)

    17. Some supportive evidence Evaluation of the impact of the Family Health Program on infant mortality in Brazil, 1990–2002 From 1990 to 2002 IMR declined from 49.7 to 28.9 per 1000 live births. During the same period average Family Health Program coverage increased from 0% to 36%. A 10% increase in Family Health Program coverage was associated with a 4.5% decrease in IMR, controlling for all other health determinants (p<0.01).

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