A multiprofessional perspective on the principal barriers to universal health coverage and universal access to health in extremely poor territories: the contributions of nursing

Abstract

Objective: to investigate the knowledge of managers and health professionals, social workers and education professionals regarding the principal barriers to universal health coverage and universal access to health on the part of the extremely poor population; and to point to the contributions made by nursing for the promotion of this right. Method: a qualitative study whose reference was, for ensuring the right to health, the reorientation of the Brazilian Unified Health System (SUS) towards universal coverage and access in these territories. Interviews were held with 27 members of the multi-professional team of a municipality with high social vulnerability. The data were worked on using thematic content analysis. Results: the following were ascertained as the principal barriers to universal health coverage and access to health: failures in the expansion and strengthening of the services; absence of diagnosis of the priority demands; shortage of technology, equipment, and material and human resources; poor local infrastructure; and actions with low resolutive power and absence of interdepartmental policies. Within the multi-professional team, nursing acts in the SUS in unique health actions and social practices in these territories, presenting an in-depth perspective on this harsh reality, being able to contribute with indispensable support for confronting these disparities in universal health coverage and universal access to health. Conclusion: nursing's in-depth understanding regarding these barriers is essential for encouraging the processes reorienting the SUS, geared towards equality in the right to health.

Equality and poverty: views from managers and professionals from public services and household heads in the Belo Horizonte Metropolitan Area, Brazil

“…Yet, the significant gap in research is noteworthy—at the national and international levels—involving the themes of governance, poverty, and quality of life. There is a dearth of information on plausible and applicable ways to facilitate collaborative decision-making in cooperative work and community networks with the support of priority measures [ 50 ] that help to cope with the social determinants of health and poverty [ 34 , 45 , 51 ]. More in-depth research is needed from scholars of poverty to identify the causes of this phenomenon, of inequality and of deprivation [ 48 ].…”

“…Greater investments are needed in social security, based on the BCE approach, in order to maximize human capital development (basic capabilities and personal potential), ensure adequate well-being, and fulfil the rights to health, education, social security and urban infrastructure. Such investments must be accompanied by equitable intersectoral public policies that target the areas of territories where community life takes place [ 18 , 45 , 51 ].…”

“…Improvements must advance constitutional guarantees for coverage and universal access in all regions. Priority should be given to the poorest people, who are the most historically unassisted groups [45,[50][51][52].…”

Equality and Poverty: Views From Managers and Professionals From Public Services and Household Heads in the Belo Horizonte Metropolitan Area, Brazil

“…Sen points out that this twisted vision of one's own quality of life can be called a "mistake" as it Yet, the significant gap in research is noteworthy-at the national and international levels-involving the themes of governance, poverty and quality of life. There is a dearth of information on plausible and applicable ways to facilitate collaborative decision-making in cooperative work and community networks with the support of priority measures 50 that help to cope with the social determinants of health and poverty 34,45,51 . More in-depth research is needed from scholars of poverty to identify the causes of this phenomenon, of inequality and of deprivation 48 .…”

“…Improvements must advance constitutional guarantees for coverage and universal access in all regions. Priority should be given to the poorest people, who are the most historically unassisted groups 45, [50][51][52] .…”