This special issue of the journal addresses specific areas of healthcare development and service delivery in Brazil. All of the articles recognize that Brazil, no different than other countries in South America and Europe, is struggling with rising healthcare costs, concerns about quality of care, access to care and the need to increased patient safety and leadership in the healthcare sector. Brazil’s healthcare system consists of political, economic, and institutional health policies designed to create conditions that ensure equality of care and equal access to care. Brazil has formulated very specific health policies and plans to improve population health. The National Health Plan is a tool which has been used to develop guidelines and goals to guarantee the principle of unification and of social participation. Better public health and prevention policies, as well as more effective designs in healthcare delivery, can impact health in Brazil. The Federal Constitution in Brazil declares health “. . . as a fundamental human right and that the state must provide necessary conditions that are essential to maintaining this fundamental human right to health.” Brazil has three levels of government including the Federation, the States and Municipalities. Each of these levels are autonomous but are interdependent in providing access to healthcare services. Health interacts with other sectors of the economy including the environment, work, education, transportation, food service, and access to other social goods. Brazil has a model of care that looks at family health as the first level of primary care. Healthcare is organized to provide for specific needs responding to population and geography. Primary care has been more difficult to achieve in the rural areas, especially the Amazon region. There is a very strong family health strategy that has been implemented in Brazil along with other advanced levels of care. The country has a hospital network and system that is classified according to local, regional, state and national hospitals. The size of the facilities varies depending on the population and healthcare needs of a specific region. Brazil is paying a significant price for chronic diseases and the country as a whole recognizes that there are wide gaps in the provision of healthcare services within regions of the country. The strong primary care system plays an important role in reducing health inequalities, addressing the needs of aging Brazilians, and population health. Overall, it is recognized that the health sector is a key economic sector and job generator in Brazil.
Daniel J. West, Jr., Ph.D., FACHE
Professor and Chairman, Department of Health Administration & Human Resources University of Scranton