Access to medicines for chronic diseases in Brazil: a multidimensional approach

Oliveira, Maria Auxiliadora; Luiza, Vera Lúcia; Tavares, Noêmia Urruth Leão; Mengue, Sotero Serrate; Arrais, Paulo Sérgio Dourado; Farías, Mareni Rocha; Pizzol, Tatiane da Silva Dal; Ramos, Luiz Roberto; Bertoldi, Andréa Dâmaso

doi:10.1590/s1518-8787.2016050006161

Cited by 43 publications

(73 citation statements)

References 19 publications

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“…A nationwide survey applied in primary care facilities identified an availability of keymedicines of 56.1% (Mendes et al, 2014). In the same direction, a national household survey shows that the availability of medications for chronic diseases as being of 45.2%, 67.4% and 88.5%, in the SUS, PFPB and in private pharmacies, respectively (Oliveira et al, 2016). The high availability of medications has been reported in PFPB, both in its public pharmacies (Bonotto;Colet, 2013;Pinto et al, 2010) and in ATFP (Pinto et al, 2010), as well as with community pharmacies (Opas, 2005).…”

Section: Discussionmentioning

confidence: 96%

Assistência farmacêutica na atenção básica e Programa Farmácia Popular: a visão de gestores de esferas subnacionais do Sistema Único de Saúde

et al. 2019

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Resumo O trabalho teve como objetivo identificar a percepção de gestores públicos da assistência farmacêutica em esferas subnacionais e de gerentes técnicos de instâncias colegiadas do Sistema Único de Saúde sobre os reflexos do Programa Farmácia Popular do Brasil (PFPB), iniciativa exclusivamente federal, na gestão da assistência farmacêutica na atenção básica (Afab), de responsabilidade tripartite e operacionalizada pelos municípios. Entrevistaram-se gestores municipais, estaduais e gerentes técnicos do Conselho Nacional de Secretarias Municipais de Saúde e do Conselho Nacional de Secretários de Saúde. A análise do conteúdo considerou as categorias (1) desafios e avanços da Afab e do PFPB e (2) conexões entre a Afab e o PFPB. Houve visões divergentes sobre as relações entre Afab e PFPB, se concorrentes ou complementares. Ressaltou-se o contraste entre os crescentes investimentos no PFPB e sua estagnação na Afab, a sobreposição dos elencos, a migração de usuários e o papel do PFPB como alternativa de acesso, entre outros. A implementação centralizada do PFPB parece ter se dado com baixa articulação com as esferas subnacionais de gestão, gerando distintas e contraditórias interpretações sobre seu papel e objetivos para os municípios, considerando-se as diretrizes de descentralização da assistência farmacêutica.

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Section: Discussionmentioning

confidence: 96%

Assistência farmacêutica na atenção básica e Programa Farmácia Popular: a visão de gestores de esferas subnacionais do Sistema Único de Saúde

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“…58 The national immunization programme was expanded to provide 19 vaccines for 20 diseases -accounting for about 95% of all doses given to the population. 59 Access to essential medicines has increased over time, 60 with effect in reducing avoidable hospitalization and mortality. 61 However, catastrophic expenditues for medicines is still a main cause of family budget overload, affecting mainly the low-income groups.…”

Section: Panel 2: Human Resources In the Susmentioning

confidence: 99%

Brazil's unified health system: the first 30 years and prospects for the future

et al. 2019

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In 1988, Brazilian Constitution definedhealth as a universal right and state responsibility. Progress towards universal health coverage (UHC) has been achieved through a Unified Health System (Sistema Único de Saúde, SUS) which was created in 1990. With successes and setbacks in the implementation of health programmes and organization of its health system, Brazil has achieved nearly-universal access to health services for her citizens. The trajectory of the development and expansion of the SUS offers valuable lessons on how to scale UHC in a health system in a highly-unequal country and relatively low resources. The analysis of the 30 years since the inception of SUS shows that innovations in the Brazilian health system extend beyond the development of new models of care and highlights the importance of establishing political, legal, organizational and management-related structures, and the role of the federal and local governments in the governance, planning, financing, and provision of health services. The expansion of SUS has allowed Brazil to rapidly address the changing health needs, with dramatic scaling up health service coverage in just three decades. However, despite its successes, analysis of future scenarios suggests the urgent need to address lingering geographic inequalities, insufficient funding, and the suboptimal private-public collaboration. Recent fiscal policies that ushered austerity measures, environmental, educational and health policies of the new administraion introduced in Brazil could reverse the hard-earned achievements of the SUS and threaten its sustainability and its ability to fulfil its constitutional mandate of providing 'health for all'. 2000 2010 2015 Births attended by skilled health staff (% of total) 87•6 98•6 98•9 99•1 Immunization, BCG (% of one-year-old children) 79 99 99 99 Immunization, measles (% of children ages 12-23 months) 78 99 99 96 Immunization, DPT (% of children ages 12-23 months) 66 98 99 96 Immunization, Hib3 (% of children ages 12-23 months) 90 99 96 Immunization, Pol3 (% of one-year-old children) 58 99 99 98 Immunization, HepB3 (% of one-year-old children) 94 96 96 Antiretroviral therapy coverage (% people living with HIV) 27 38 57

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“…Studies show high prevalence rates of access to medication, ranging from 87 to 97.9% 2, [6][7][8][9] . In Brazil, data from the last national research about access to medication showed that the prevalence of access to medicines prescribed to treat chronic non-communicable diseases and arterial hypertension was 94.3 6 and 97.9% 9 , respectively. However, by observing the free access, there is an important reduction of these numbers, ranging between 45.3 and 56%.…”

Section: Introductionmentioning

confidence: 99%