The Brazilian health system at crossroads: progress, crisis and resilience

Adriano Massuda · Thomas Hone · Fernando Antônio Gomes Leles · Márcia C. Castro · Rifat Ali Atun

549 citations0/0 files storedBMJ Global Health

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Healthcare Systems and Reforms Healthcare Systems and Practices Public Health in Brazil

Abstract

The Unified Health System (Sistema Único de Saúde (SUS)) has enabled substantial progress towards Universal Health Coverage (UHC) in Brazil. However, structural weakness, economic and political crises and austerity policies that have capped public expenditure growth are threatening its sustainability and outcomes. This paper analyses the Brazilian health system progress since 2000 and the current and potential effects of the coalescing economic and political crises and the subsequent austerity policies. We use literature review, policy analysis and secondary data from governmental sources in 2000-2017 to examine changes in political and economic context, health financing, health resources and healthcare service coverage in SUS. We find that, despite a favourable context, which enabled expansion of UHC from 2003 to 2014, structural problems persist in SUS, including gaps in organisation and governance, low public funding and suboptimal resource allocation. Consequently, large regional disparities exist in access to healthcare services and health outcomes, with poorer regions and lower socioeconomic population groups disadvantaged the most. These structural problems and disparities will likely worsen with the austerity measures introduced by the current government, and risk reversing the achievements of SUS in improving population health outcomes. The speed at which adverse effects of the current and political crises are manifested in the Brazilian health system underscores the importance of enhancing health system resilience to counteract external shocks (such as economic and political crises) and internal shocks (such as sector-specific austerity policies and rapid ageing leading to rise in disease burden) to protect hard-achieved progress towards UHC.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 549 citations exist upstream.

References

2011The Brazilian health system: history, advances, and challenges 2014Health-system reform and universal health coverage in Latin America

Cited by

2020Governing COVID-19 without government in Brazil: Ignorance, neoliberal authoritarianism, and the collapse of public health leadership 2020Mudanças no financiamento da Atenção Primária à Saúde no Sistema de Saúde Brasileiro: avanço ou retrocesso?2020Political and institutional perils of Brazil's COVID-19 crisis 2020The pandemic of poverty, vulnerability, and COVID-19: Evidence from a fuzzy multidimensional analysis of deprivations in Brazil 2022Cost-effectiveness of Artificial Intelligence as a Decision-Support System Applied to the Detection and Grading of Melanoma, Dental Caries, and Diabetic Retinopathy 2020Distanciamento social, sentimento de tristeza e estilos de vida da população brasileira durante a pandemia de Covid-19 2021The next pandemic: impact of COVID-19 in mental healthcare assistance in a nationwide epidemiological study 2019Understanding how low-income communities gain access to healthcare services: A qualitative study in São Paulo, Brazil

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.