Problemas e estratégias de gestão do SUS: a vulnerabilidade dos municípios de pequeno porte

Pinafo, Elisangela; Nunes, Elisabete de Fátima Polo de Almeida; Carvalho, Brí­gida Gimenez; Mendonça, Fernanda de Freitas; Domingos, Carolina Milena; Silva, Camila Ribeiro

doi:10.1590/1413-81232020255.34332019

Cited by 15 publications

(12 citation statements)

References 15 publications

(19 reference statements)

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“…This scenario is particularly worrying for the small municipalities that were, for the most part, more vulnerable, especially in relation to health infrastructure and financial resources (68). A large portion of these ones reported few ICU beds, few or no respirators and a reduced number of health professionals, leading to a high lethality of the disease, since the basic care conditions of the most serious cases of COVID-19 are not guaranteed (45).…”

Section: Discussionmentioning

confidence: 99%

“…However, the reality of the state of Minas Gerais does not meet this proposal, as the assessment demonstrated several discontinuities and inequalities in all indicators of the state. Alarmingly, the small municipalities are isolated in the middle of the pandemic, without support from the medium-sized and large municipalities and without enough resources to improve their own health infrastructure (66,68). Municipalities listed to offer this support face the overcrowding of beds and the lack of respirators (25).…”

Section: Discussionmentioning

confidence: 99%

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A Vulnerability Analysis for the Management of and Response to the COVID-19 Epidemic in the Second Most Populous State in Brazil

Campos

Aratani

Cabral

et al. 2021

Front. Public Health

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The COVID-19 pandemic has the potential to affect all individuals, however in a heterogeneous way. In this sense, identifying specificities of each location is essential to minimize the damage caused by the disease. Therefore, the aim of this research was to assess the vulnerability of 853 municipalities in the second most populous state in Brazil, Minas Gerais (MG), in order to direct public policies. An epidemiological study was carried out based on Multi-Criteria Decision Analysis (MCDA) using indicators with some relation to the process of illness and death caused by COVID-19. The indicators were selected by a literature search and categorized into: demographic, social, economic, health infrastructure, population at risk and epidemiological. The variables were collected in Brazilian government databases at the municipal level and evaluated according to MCDA, through the Program to Support Decision Making based on Indicators (PRADIN). Based on this approach, the study performed simulations by category of indicators and a general simulation that allowed to divide the municipalities into groups of 1–5, with 1 being the least vulnerable and 5 being the most vulnerable. The groupings of municipalities were exposed in their respective mesoregions of MG in a thematic map, using the software Tabwin 32. The results revealed that the mesoregion of Norte de Minas stands out with more than 40% of its municipalities belonging to group 5, according to economic, social and health infrastructure indicators. Similarly, the Jequitinhonha mesoregion exhibited almost 60% of the municipalities in this group for economic and health infrastructure indicators. For demographic and epidemiological criteria, the Metropolitana de Belo Horizonte was the most vulnerable mesoregion, with 42.9 and 26.7% of the municipalities in group 5, respectively. Considering the presence of a population at risk, Zona da Mata reported 42.3% of the municipalities in the most vulnerable group. In the joint analysis of data, the Jequitinhonha, Vale do Mucuri and Vale do Rio Doce mesoregions were the most vulnerable in the state of MG. Thus, through the outlined profile, the present study proved how socioeconomic diversity affects the vulnerability of the municipalities to face COVID-19 outbreak, highlighting the need for interventions directed to each reality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Vulnerability Analysis for the Management of and Response to the COVID-19 Epidemic in the Second Most Populous State in Brazil

Campos

Aratani

Cabral

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…This scenario is particularly worrying for the small municipalities that were, for the most part, more vulnerable, especially in relation to health infrastructure and financial resources (64). A large portion of these ones reported few ICU beds, few or no respirators and a reduced number of health professionals, hence leading to a high lethality of the disease, since the basic care conditions of the most serious cases of COVID-19 are not guaranteed (41).…”

Section: Discussionmentioning

confidence: 99%

“…However, the reality of the state of Minas Gerais does not meet this proposal, as the assessment demonstrated several discontinuities and inequalities in all indicators of the state. Alarmingly, the small municipalities are isolated in the middle of the pandemic, without support from the medium-sized and large municipalities and without enough resources to improve their own health infrastructure (62, 64). Municipalities listed to offer this support face the overcrowding of beds and the lack of respirators (25).…”

Section: Discussionmentioning

confidence: 99%

A vulnerability analysis for the management of and response to the COVID-19 epidemic in the second most populous state in Brazil

Campos

Aratani

Cabral

et al. 2020

Preprint

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The COVID-19 pandemic has the potential to affect all individuals, however in a heterogeneous way. In this sense, identifying specificities of each location is essential to minimize the damage caused by the disease. Therefore, the aim of this research was to assess the vulnerability of the 853 municipalities in the second most populous state in Brazil, Minas Gerais (MG), in order to direct public policies. Then, an epidemiological study was carried out based on Multi-Criteria Decision Analysis (MCDA) using indicators with some relation to the process of illness and death caused by COVID-19. The indicators were selected by a literature review and categorized into: demographic, social, economic, health infrastructure, population at risk and epidemiological. The variables were collected in Brazilian government databases at the municipal level and evaluated according to MCDA, through the Program to Support Decision Making based on indicators (PRADIN). Based on this approach, the study performed simulations by category of indicators and a general simulation that allowed to divide the municipalities into groups of 1 to 5, with 1 being the least vulnerable and 5 being the most vulnerable. The groupings of municipalities were exposed in their respective mesoregions of MG in a thematic map, using the software Tabwin 32. The results revealed that the mesoregion of Norte de Minas stands out with more than 40% of its municipalities belonging to group 5, according to economic, social and health infrastructure indicators. Similarly, the Jequitinhonha mesoregion exhibited almost 60% of the municipalities in this group for economic and health infrastructure indicators. For demographic and epidemiological criteria, the Metropolitana de Belo Horizonte mesoregion is the most vulnerable, with 42.9% and 26.7% of the municipalities in group 5, respectively. Considering the presence of a population at risk, Zona da Mata reported 42.3% of the municipalities in the most vulnerable group. In the joint analysis of data, the Jequitinhonha, Vale do Mucuri and Vale do Rio Doce mesoregions were the most vulnerable in the state of MG. Thus, through the outlined profile, the present study proved how socioeconomic diversity affects the vulnerability of the municipalities to face COVID-19 outbreak, highlighting the need for interventions directed to each reality.

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“…È indiscutibile che il decentramento è contro l'asimmetria finanziaria e gestionale dei livelli di governo, nell'organizzazione e nella gestione della rete di servizi eterogenea e non istituzionalmente integrata con impatti derivanti dall'emergere di vari sistemi locali e isolati di servizi sanitari, nonché nella frammentazione e disorganizzazione dei servizi messi a disposizione della comunità (LEVCOVITZ et al, 2001;SANTOS et al, 2015). Un altro punto importante causato dal decentramento discusso dagli autori è legato al distanziamento delle agenzie governative responsabili del finanziamento della salute (PINAFO et al, 2020).…”

Section: Risultatiunclassified

Commissione intermanager regionale: spazio locale di intesa e articolazione interfederale?

Santos¹,

Cota²

2021

Revista Científica Multidisciplinar Núcleo do Conhecimento

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La Commissione Intergestione Regionale (CIR) configura lo spazio per l’accordo, l’articolazione, la cooperazione e il rafforzamento della regione sanitaria. Lo scopo di questo studio è stato quello di riflettere sulle disposizioni normative che sono alla base della costruzione della commissione come luogo di consolidamento della gestione regionale attenuando i conflitti interfederativi. Avendo come guida la domanda: in che modo le Commissioni Regionali di Intergestione forniscono spazi locali di accordo e articolazione interfederativa? Studio qualitativo, basato su ricerche documentarie, basato sull’analisi delle delibere delle Commissioni Regionali Di Intergestione di Alagoas, corrispondenti al periodo dal 2017 al 2019, utilizzando come norma di riferimento il Decreto 7.508/11. I risultati sono stati organizzati in quattro categorie: Pianificazione Sanitaria Regionale; organizzazione di azioni e servizi sanitari: regione sanitaria; Federalismo, CIR e finanziamento dei servizi sanitari; governance e CIR: canale di negoziazione e decisione tra i dirigenti comunali e lo Stato all’interno della Regione Sanitaria. Le Commissioni Intergestione Regionali sviluppano un lavoro significativo nelle discussioni delle politiche regionali, essendo uno strumento fondamentale per rafforzare la governance nei territori, negoziando l’allocazione e la distribuzione delle risorse, essenziali per la pianificazione, i patti interfederativi e il finanziamento della salute, svolgendo un ruolo chiave per il sistema sanitario regionale di Alagoas, spazio democratico, politico e cooperativo.

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Problemas e estratégias de gestão do SUS: a vulnerabilidade dos municípios de pequeno porte

Cited by 15 publications

References 15 publications

A Vulnerability Analysis for the Management of and Response to the COVID-19 Epidemic in the Second Most Populous State in Brazil

A Vulnerability Analysis for the Management of and Response to the COVID-19 Epidemic in the Second Most Populous State in Brazil

A vulnerability analysis for the management of and response to the COVID-19 epidemic in the second most populous state in Brazil

Commissione intermanager regionale: spazio locale di intesa e articolazione interfederale?

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