Challenges in Health Access for Street Vendors on the Railway Paths of Rio De Janeiro

Abstract

This article investigates the challenges faced by street vendors in the Metropolitan Region of Rio de Janeiro (RMRJ) in accessing health care. The research, part of a doctoral thesis in Public Health, adopts a qualitative approach to understand the experiences and perceptions of these workers. The study utilized semi-structured interviews with twelve vendors to identify the main barriers to health care access and assess perceptions of the quality and effectiveness of the services received. Street vendors, essential to the urban economy, face job precarity and significant difficulties accessing health services due to the informality of their employment and limitations of the Unified Health System (SUS), such as long waiting lines, lack of doctors, and structural deficiencies. Thematic analysis revealed widespread criticism of the SUS's inefficiency, exacerbated by poor management and underfunding. Additionally, a lack of knowledge about the National Network for Comprehensive Worker Health Care (RENAST) and its services was identified, which limits vendors' access to specialized worker health care. The article proposes that improvements in health education and awareness campaigns about resources like RENAST are essential to enhance access and quality of health care for this vulnerable population. Furthermore, it emphasizes the need for integrated public policies that address the health and social conditions of street vendors, promoting investments in health infrastructure, improvements in working conditions, and regularization of informal employment. Lastly, it suggests a profound reform of the SUS to increase its efficiency and equity, ensuring equal access to quality health care for all, especially informal workers.