Integrated long‐term care partnerships between government social care and health agencies in Brazil: The Belo Horizonte model

Abstract

The article sets out key elements of the policy agenda for enhanced integration between health and social care for older people in high‐income countries and demonstrates its wider relevance to low‐ and middle‐income countries (LMICs). The article then explores the context for this agenda in Brazil, including growing demand for long‐term care (LTC) and current institutional arrangements. It goes on to discuss a case study project of partnering for LTC between local social assistance and health agencies in the Brazilian city of Belo Horizonte. It identifies challenges and potential benefits of this partnership model, offering policy insights for LTC policy in Brazil and other countries.

Impact Evaluation of Cash-For-Care in Latin America’s New Long-Term Care Policies: A Randomized Controlled Trial Pilot Study in Costa Rica

“…Other countries in the region, such as Uruguay, are also facing similar cost pressures to implement LTCS (Matus-Lopez & Cid, 2016). Currently, studies that estimate the demand of care of dependents and make diagnostics of existing programs are being conducted in several countries in the region, including Argentina, Brazil, and Chile (Aranco et al, 2022;Dabove, 2022;Lloyd-Sherlock et al, 2022;Matus-Lopez & Cid, 2015;Villalobos, 2017). In these countries, the challenge of balancing the imperative to develop long-term care systems with the constraints of public financing for social and health services has led to a growing interest in cash transfers as a potential substitute for in-kind services.…”

Will the SDGs and the UN Decade of Healthy Ageing Leave Older People Behind?

“…While SDGs are an improvement over the MDGs in that they include a target on NCDs, the chosen target and its justification do not challenge biases against older people’s access to healthcare; instead, they could reinforce or exacerbate extant biases. They could reproduce the reallocation of resources towards SDG-specified targets as happened with the MDGs (Fukuda-Parr and Yamin, 2013) and encourage the allocation of health resources towards younger people, as happened in several countries’ roll-out of Covid-19 vaccines (Lloyd-Sherlock et al, 2022b).…”

“…The third is to find new forms of integrated health and social care that enable older people to stay at home while strengthening the local community’s economic base. The Brazilian city of Belo Horizonte has implemented a long-term care model that integrates mainstream health services for care-dependent older people in disadvantaged communities (Lloyd-Sherlock et al, 2022a). The scheme hires and trains people of the favelas to act as the link between up to four families each and the local health centre.…”