Greater access to and quality in care
Increased investments and new actions to ensure quality services to all Brazilians
PREGNANCY CARE – STORK NETWORK (REDE CEGONHA)
New services and more resources to reduce maternal mortality rates
Accession to the Stork Network: 23 states and 1,685 municipalities have joined the network, with 966,266 pregnant women assisted by February 2012.
Increased care to newborns at SUS: 371 new neonatal ICU beds for newborns.
More resources for care to pregnant women and newborns:
For costing: R$213 million invested in mother--child and neonatal care in municipalities in the states of BA, PA, MG, SP, RJ and EP.
For construction, reform and acquisition of facilities: R$239 million approved for 24 states (AC, AM, PA, RR, RO, TO, MA, PI, CE, RN, PB, PE, AL, SE, BA, MG, ES, SP, RJ, PR, SC, RS, GO, DF), for houses for pregnant and postpartum women and babies, normal birthing centers and maternity wards, intensive care units (ICU), beds in the kangaroo methodology for mothers and premature babies and obstetric beds for high-risk pregnant women.
Prenatal care: some 20 million appointments through SUS were reported in 2011 – 133% above the 8.6 million of 2003.
Tests: in 2011, the hemoglobin electrophoresis test for all pregnant women was included in prenatal care as a routine test, with a view to improving the detection and treatment of sickle cell anemia, a disease that is more prevalent among black women.
Financial assistance for transportation: since April 2012, an allowance of up to R$50 has been granted to pregnant women assisted by SUS for commuting to health units providing prenatal and childbirth care. Payment will be made through a magnetic card.
REDUCED MATERNAL MORTALITY RATES
The organization of the network of care for pregnant women, coupled with access to quality prenatal care, tests, extra care to high-risk pregnancy and safe childbirth have led to a reduction in maternal mortality rates.
• From 1990 to 2010, maternal mortality rates fell by half in Brazil - from 141 to 68 deaths per 100,000 live births;
• In 2011, the downward trend continues, with a 19% decrease in maternal deaths compared to 2010. In the first half of 2011, 705 deaths from obstetric causes were reported against 870 over the same period in 2010.
• Between 2003 and 2010, the number of pregnant women with seven or more prenatal visits increased by 125% and the proportion of mothers with zero visit fell from 4.7% to 1.8% (Brazil Health (Saúde Brasil) Report 2010, published in 2011).
NATIONAL PLAN TO STRENGTHEN BREAST AND CERVICAL CANCER PREVENTION, DIAGNOSIS AND TREATMENT
In 2011, 11.33 million Pap tests were performed, with 78.1% in the screening age group (25-64 year olds).
Reference Services for the Diagnosis and Treatment of Cervical Cancer Precursor Lesions: 11 proposals were approved for the states with the highest mortality rates - AC (1), MG (3), MT (1), PE (1), SE (1), RO (1) and TO (3).
In 2011, 3.53 million tests were performed, with 51% in the screening age group (50-69 year olds).
Reference Services for the Diagnosis of Breast Cancer: seven new reference services were established in the states of CE (1), PE (1), SE (1), MG (2), RO (1) and TO (1).
Radiation Therapy Services: expansion, modernization and implementation of new reference services in 11 states - AC, PA, CE, PE, SE, BA, MG, SP, RJ, SC, RS.
HEALTH IS PRICELESS
Access to free diabetes and hypertension drugs increases by three-fold
Free medicines: a 280% increase in the number of people receiving 11 drugs for the treatment of diabetes and hypertension in private institutions participating in the program. In January 2012, 3.6 million people received free medication in pharmacies in the private and public networks.
Popular Drugstore (Farmácia Popular) Program: in 2011, the 20,375 pharmacies and drugstores participating in the program assisted about 10 million Brazilians with some 7.8 million people benefiting from free diabetes and hypertension drugs.
EMERGENCY CARE NETWORK
Funds released by February 2012: R$39.6 million to fund the costs of the 11 existing emergency care units and R$21.7 million for renovations and acquisition of equipment in Belo Horizonte, Brasília, Fortaleza, Goiânia, Porto Alegre, Recife, Salvador, São Paulo and Rio de Janeiro.
Hospital Access and Quality Center: 11 hospitals set up to support management and improve the quality of care.
Process Management: establishment of a computer system to manage health care processes in ERs of two hospitals and risk classification in seven emergency units.
Follow-up of results: development of an information system for monitoring hospital management indicators within the Ministry of Health.
ICU beds: in 2011, 1,296 new beds were provided in 17 states: AL, BA, CE, MA, GO, MG, MS, PA, PB, PE, PR, RJ, RN, RS, SC, SE,SP.
Increased coverage and resources: a 66% increase in resources for service qualification.
Enhanced control over ambulance operation: mandatory registration of vehicles, teams and medical regulation centers of emergency care in the National Register of Health Facilities.
Since January/2011, 608 ambulances have been activated. In February 2012, there were 2,121 ambulances, 400 motorcycle-ambulances, eight boat- -ambulances and six aircrafts / aero doctors in operation.
24-Hour Emergency Care Unit – 24h UPA (Unidade de Pronto Atendimento)
148 UPAs were in operation by February 2012. 117 UPAs began to be built in 96 municipalities in 2011.
NATIONAL SUS FORCE
The force is made up of professionals specialized in assisting victims of natural disasters, public calamity or situations of epidemiological risk requiring rapid response, logistical support and health equipment. A total of 8,073 volunteers have already registered with the Force.
In 2012, the force operated in the states affected by floods: Minas Gerais, Rio de Janeiro, Espírito Santo and Acre. It also participated in the mission of assistance to Indigenous health in Acre and Amazonas, and held the first training for volunteers in Vitória (state of Espírito Santo). A field hospital was purchased, consisting of 15 tents to assist victims of disasters, perform surgeries and stabilize critical / severe patients under intensive care.
HEALTH CLOSER TO YOU
BETTER AT HOME (Melhor em Casa) – Home Care Service
A total 169 home care teams and 65 specialized support teams have been trained to provide home care to the elderly, chronically ill patients, people in motor rehabilitation or postoperative follow-up. Ninety tow teams are already being funded, including 66 home care and 26 supporting teams in 23 municipalities and 10 states.
Program to Improve Access and Quality (Programa de Melhoria do Acesso e da Qualidade - PMAQ)
73% of all municipalities and 17,669 primary care teams have joined the Program, which represents more than 50% of those existing in the country.
Since November 2011, the municipalities have been receiving 20% of the incentive to improve the quality of care. Starting in April, the teams will be evaluated and managers will receive an additional of up to R$8,500 a month per primary care team.
Family Health Strategy
In 2011, 635 new family health teams were accredited. In December, the number of teams in operation reached 32,295. Currently there are 1,525 family health supporting centers (Núcleos de Apoio à Saúde da Família - NASF) and 21,300 teams of oral health professionals in operation.
In 2011, 185 new regional dental prosthetic laboratories were accredited, totaling 991 units throughout the country. More than 290,000 dental prostheses were distributed to municipalities prioritized by the Brazil without Extreme Poverty Program.
In 2011, 100 mobile dental units were acquired for 100 municipalities in a situation of poverty.
In 2011, 970 new oral health teams of the Smiling Brazil program were deployed in 53 municipalities, totaling 21,394 teams in operation in 87% of Brazilian cities.
Basic Health Care Units (Unidades Básicas de Saúde - UBS)
Renovation of UBS: in January 2012, R$107.6 million of the R$538 million available for the renovation of 5,247 basic health care units had been transferred.
Construction of UBS: with an investment of R$1.02 billion, the construction of 3,983 UBS has already started in 2,079 municipalities, of which 2,122 UBS are under PAC2 in 1,163 municipalities, with an investment of R$565 million.
In February 2012, 1,906 academies were in operation and resources had been transferred for building centers with spaces suitable for physical activities under professional supervision and linked to basic health care units, with a view to preventing diseases such as hypertension and diabetes. The goal is to build 4,000 academies by 2014.
A total of 150 units are in operation and receiving funds in the following states: ES (7), GO (1), MG (35), PE (89), PR (4), RN (3), RR (1), RS (2), SE (2), SP (4), AL (2).
Indigenous Health Care
In 2011, 436 vehicles (boats, 4x4 trucks and outboard motors) were purchased for transporting patients and multidisciplinary indigenous health teams.
In February 2012, there was a 50% increase in the number of Multidisciplinary Indigenous Health Teams: from 8,211 to 12,184 professionals.
Rapid syphilis and HIV tests were performed in 46,000 Indigenous people in the states of Amazonas and Roraima and a multi-vaccination campaign for the entire indigenous population living in the Legal Amazon - about 91,000 Indigenous people was carried out.
124% increase in the number of surgeries in one decade
A total of 23,397 transplants were performed in 2011 - 2,357 more than in 2010. By region: 54% in the Southeast, 19% in the South and 16.7% in the Northeast.
The number of transplant surgeries in the Northeast rose from 840 in 2001 to 3,912 in 2011 (a 365.7% increase in 10 years). In 2011 there were 2,207 organ donors, a 16.4% increase in one year (the largest variation in four years).
The national rate is 11.4 donors per million population (pmp). The highest rates are found in the states of Santa Catarina (25 pmp, the exact same as in the USA), Ceará (20.7 pmp) and São Paulo (20.3 pmp).
The National Transplant System has an integrated network in 25 states and the Federal District, with 26 notification, collection and distribution centers; 11 national technical chambers; 60 organ procurement organizations; and 680 transplant centers with 1,074 transplant teams.
Results in 2011
54 new transplant centers established - 16 in the North and Northeast.
72 new transplant teams accredited - 11 in the North and the Northeast.
35 new organ procurement organizations established in 11 states (AC, BA, CE, MS, PE, PI, PR, RN, RS, SC and SE) and 16 under implementation (AM, GO, MG, PB e RO). In 2010 there were 10, all of them in São Paulo.
National Information System implemented throughout the country. Six state capitals included (Rio de Janeiro-RJ; Salvador-BA; Campo Grande-MS, Belém-PA; São Luís-MA; and Rio Branco-AC).
IMPROVEMENT OF MANAGEMENT AND CONTROL
The Government has saved more than R$1.7 billion through new management instruments
Savings of more than R$1.7 billion in the purchase of medicines and supplies through the adoption of management tools, centralized procurement and implementation of recommendations from control agencies. An additional R$96 million have also been saved in indigenous health care through new agreements with entities holding the Charitable Entity Certificate (Certificado de Entidade Beneficente - CEBAS).
Reimbursements by health insurance companies hit a record high: R$82.09 million had been collected by December. The amount exceeds the total of the last seven years.
R$210.8 million were recovered in 2011, through 1,001 audits.
SUS PERFORNANCE INDEX (ÍNDICE DE DESEMPENHO DO SUS - IDSUS)
2012 The tool with 24 indicators assessed the levels of primary, specialized outpatient and inpatient and emergency care by inspecting the infrastructure to assist the population and the capacity of services to address their health problems.
The index will serve as the basis for authorities at the three levels - federal, state and municipal - to make decisions aimed to improve public health actions in the country and give greater transparency to the general framework of supply and the situation of health services.
Data collection for the index will occur every three years. The IDSUS 2012 assessed indicators from 2008 to 2010 and is available at: www.saude.gov.br/idsus.
More Transparency in the Health Portal
Since November 2011, the Portal has been publishing the transfers of funds to states and municipalities, public bids underway, plans and management reports of the Federal Government, states and municipalities.