Sistema Único de Saúde: 30 anos de avanços e desafios

Abstract

In 2018, Brazil's Unified National Health System (SUS) is celebrating 30 years since it was implemented following promulgation of the 1988 Federal Constitution. To highlight the date's importance, the July issue of CSP features a Debate section with expert authors on the subject.In three decades, the SUS has made strides in numerous health policies, several of which have been acknowledged by the World Health Organization as successful experiences that can be shared with other countries.The Family Health Program was initially limited to a few municipalities of Brazil but has since expanded nationwide, covering 60% of the country's population, with positive results like the reduction of infant mortality 1 and cardiovascular diseases 2 . The National Immunization Program, dating to the 1970s 3 , has expanded vaccination coverage in infants (under one year) and incorporated new vaccines targeted to specific population groups, such as the HPV (human papilloma virus) vaccine for adolescents and the influenza vaccine for the elderly. HIV/AIDS prevention and treatment has seen improved access to antiretroviral therapy, resulting in increased survival of persons living with HIV and AIDS 4 , as well as a decrease in incidence thanks to the extremely low viral load in individuals with the virus who receive treatment.Studies have also documented the scope and effectiveness of Brazil's tobacco control policy 5 , which reduced the proportion of smokers from 29% to 12% in men and from 19% to 8% in women from 1990 to 2015. More recently, the country's active surveillance system allowed detecting an increase in the number of cases of microcephaly, raising the hypothesis of a causal association with congenital Zika virus infection, with important spinoffs for the deployment of a coordinated strategy to control the epidemic at the international and national levels 6 .In these and other successful cases, the SUS has helped establish a technical and institutional base for key health polices, anchored mainly in groups and organizations from the health sector, within the country's constitutional framework (guaranteeing the right to health) and in specific legislation, in public funding (although insufficient), and in the expansion of inputs, actions, and services. Still, these strides have been offset by difficulties

Percurso assistencial de pacientes convivendo com câncer de pulmão

“…Assumir isso é importante para corrigir rumos 43 . Cabe apontar ainda que o contexto atual de crise política, com constantes ameaças de desmonte do Estado e de direitos sociais constitucionais, prejudica o combate a desigualdades 44 .…”

Avaliação do acesso à Saúde da Mulher na Região Nordeste do Brasil em tempos de pandemia da COVID-19

“…. IntroduçãoDesde a promulgação da Constituição Federal de 1988, o Brasil obteve avanços consideráveis na área da saúde(Lima et al, 2018). Nos últimos 30 anos, com a expansão da rede pública e, principalmente, das Unidades de Atenção Básica, houve uma ampliação do acesso às consultas médicas e uma diminuição das internações hospitalares(Souza et al, 2019;Viacava et al, 2018).…”

Therapeutic itineraries of children with the early loss of primary teeth: A qualitative phenomenological study

“…In Brazil, implementing a National Universal Health System (SUS) and the National Oral Health Policy has brought advances in terms of Brazilians' needs and rights to health (Paim et al, 2011;Lima, Carvalho & Coeli, 2018;Pucca Júnior et al, 2009). This policy prioritized a health care model organized by lines of care (i.e., child, adolescent, adult, and elderly), involved all levels of complexity and the definition of reference and counter-reference system.…”