Health in Brazil 1 The Brazilian health system: history, advances, and challenges
Health in Brazil 1 The Brazilian health system: history, advances, and challenges
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DOI：
10.1016/s0140-6736(11)60054-8
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发表时间：
2011-05-21
期刊：
影响因子：
168.9
通讯作者：
Macinko, James
中科院分区：
文献类型：
--
作者：
Paim, Jairnilson;Travassos, Claudia;Macinko, James
巴西是一个大陆型国家，区域和社会不平等现象普遍存在。在本报告中，我们审查了巴西卫生系统的历史发展和组成部分，重点是过去40年的改革进程，包括建立统一卫生系统。巴西当代卫生部门改革的一个显著特点是，它是由民间社会而不是政府、政党或国际组织推动的。在统一卫生系统日益私有化的时候，该系统的出现增加了相当一部分巴西人口获得保健的机会。如果要实现全民保健，仍有许多工作要做。在过去20年中，还取得了其他进展，包括对人力资源、科学技术和初级保健的投资，以及大量的权力下放进程，广泛的社会参与，以及公众对保健权的认识不断提高。如果巴西卫生系统要克服目前面临的挑战，就需要加强政治支持，以便能够调整筹资结构，重新界定公共和私营部门的作用。
Brazil is a country of continental dimensions with widespread regional and social inequalities. In this report, we examine the historical development and components of the Brazilian health system, focusing on the reform process during the past 40 years, including the creation of the Unified Health System. A defining characteristic of the contemporary health sector reform in Brazil is that it was driven by civil society rather than by governments, political parties, or international organisations. The advent of the Unified Health System increased access to health care for a substantial proportion of the Brazilian population, at a time when the system was becoming increasingly privatised. Much is still to be done if universal health care is to be achieved. Over the past 20 years, there have been other advances, including investments in human resources, science and technology, and primary care, and a substantial decentralisation process, widespread social participation, and growing public awareness of a right to health care. If the Brazilian health system is to overcome the challenges with which it is presently faced, strengthened political support is needed so that financing can be restructured and the roles of both the public and private sector can be redefined.