Increased Access and Better Quality Services
Increased investments to ensure quality services to all Brazilians
PREGNANCY CARE – STORK NETWORK (REDE CEGONHA)
In its first year, the program is helping to reduce maternal death by 21%
Accession to the Stork Network: 27 states and 2,900 municipalities had joined the network by June 2012, covering more than 1.4 million pregnant women, which represent 63% of pregnant women assisted by the Unified Health System (SUS).
New hospital beds: more than R$ 2.63 billion have been transferred to states and municipalities for the purchase of new hospital beds and qualification and funding of health care. In June 2012, 3,492 beds under the Stork Network were available in SUS facilities and another 2,001 new beds will be provided by the end of 2012.
Prenatal care: 1,885 municipalities in 26 states received the lump sum of R$ 46 million in June 2012 for the increase of prenatal testing and the acquisition of rapid pregnancy tests.
Sonar: all basic health units that perform prenatal tests will receive sonars to hear and monitor the baby’s heartbeat in the mother’s womb. Over 6,000 sonars have already been delivered to the Bahia and Pernambuco units.
Commuting support for prenatal visits and childbirth: 721 pregnant women have already received the commuting support of up to R$ 50. In June 2012, 5,553 pregnant women in 304 municipalities of 16 states had registered to receive the support.
Low income pregnant and lactating women: in April 2012, 181,300 lactating and 101,000 pregnant women became beneficiaries of the Family Grant program.
Maternal mortality drops
21% Deaths from complications during pregnancy and childbirth totaled 1,308 between January and September 2011, compared with 1,317 deaths over the same period in 2010. In 2011, more than 1.7 million pregnant women had at least seven prenatal visits.
PROGRAM FOR THE PREVENTION, DIAGNOSIS AND TREATMENT OF CERVICAL AND BREAST CANCER
Mammograms: more than 986,000 tests were performed in priority age group 50-69 years from January to May 2012, a 19% increase over the same period in 2011. For all age groups, preliminary data indicate that 1.3 million mammography screening tests were performed between January and March 2012.
Pap tests: more than 3.4 million tests were performed in priority age group 25-64 years from January to May 2012.
Reference Services for the Diagnosis of Breast Cancer (Serviços de Referência para o Diagnóstico do Câncer de Mama): more than R$ 5 million have been transferred to improve the conditions and service capacity of mastology clinics.
Radiotherapy Services: R$ 505 million transferred for investments: R$ 325 million in physical structure works (casemate) and R$ 180 million in the purchase of linear accelerators - high-tech equipment used in radiotherapy.
HEALTH IS PRICELESS (SAÚDE NÃO TEM PREÇO)
The inclusion of free asthma medication in the Health Program is part of the Caring Brazil Action launched in May 2012. There are three drugs in ten presentations, which may be obtained in units of the Popular Drugstore Network (Aqui Tem Farmácia Popular).
Forty five days into the beginning of the free distribution of anti-asthma drugs, more than 83,000 people had obtained them in Popular Drugstores across the country. Access has increased 60%, compared to the number of people who obtained the drugs 45 days before the beginning of the free distribution.
Access to treatment increased 447% among hypertensive and 325% among diabetic patients
Nearly 11 million people have received free medication in over 20,500 public and private pharmacies since the inception of the program, in February 2011.
INCREASE IN THE SUS NATIONAL LIST OF ESSENTIAL MEDICINES (RELAÇÃO NACIONAL DE MEDICAMENTOS DO SUS - RENAME)
The list of medicines supplied by SUS has increased by 260 items. The list now has 810 items, including all outpatient prescription drugs such as pharmaceutical raw materials and vaccines, in addition to primary care medicines. Special mention should be made to the inclusion in the list of drugs used for the diagnosis, care and prevention of stroke, thus improving treatment and reducing the risk of stroke sequelae by 31%.
INTEGRATED PLAN TO FIGHT CRACK AND OTHER DRUGS (PLANO DE ENFRENTAMENTO AO CRACK E OUTRAS DROGAS)
Expansion of services to improve assistance and health care to users
Eight states (states of Pernambuco, Alagoas, Rio de Janeiro, Rio Grande do Sul, Minas Gerais, Acre, Santa Catarina e Espírito Santo) have joined the Crack, You Can Beat It! (Crack, é Possível Vencer!) program. The Federal Government has already provided more than R$ 1 bilion to be invested by 2014 in actions of assistance to users and fight against trafficking, focusing in the areas of health care, prevention and authority.
Services implemented and in operation by June 2012
• 74 health street health clinics.
• 4,121 specialized ward beds.
• 22 addiction sheltering units for adults and 22 for children and adolescents.
• 130 Psychosocial Care Centers for Alcohol and Drugs (CAPS-AD).
• Eight 24-hour CAPS-AD.
• 78 therapeutic communities offering 985 places.
• Nine Regional Reference Centers: DF(2), BA(2), RJ(1), AL(1), RS(1), CE(1) and MG(1).
• 13,000 nurse AIDS and another 177,000 health community agents trained.
• 500 university-level professionals trained by the SUS Open University to work in street health clinics and emergency care.
• 30,000 undergraduate students from the health area trained in the subject crack and other drugs.
• 27 new medical residency positions in psychiatry for regions with shortage of professionals.
• 93 new positions in multiprofessional residency.
NON-STOP HEALTH CARE (SAÚDE TODA HORA)
Transfer of resources: R$ 23.1 million released for renovation (R$ 2.1 million per hospital) and R$ 43.7 million for the purchase of equipment for 11 emergency care hospitals.
More hospital beds: 1,710 new hospital beds available for adult and pediatric ICU and 2,899 for clinical wards, besides 738 spare beds.
100% SUS Ordinance, of May 2012, earmarks 20% of the Medium-to-High Complexity threshold to units providing 100% of their health services exclusively under SUS.
24-Hour Emergency Care Unit (24-hour UPA)
• In June 2012 there were 181 24-hour UPA in operation and 648 under construction.
• 136 new units and 56 expansions have been selected by the Growth Acceleration Program 2 (Programa de Aceleração do Crescimento – PAC 2) in 21 states.
• The 83 24-hour UPA operating in the Legal Amazon region have been receiving, since June 2012, an additional 30% adjustment in the monthly transfer of funds, to help establish teams in remote locations.
Samu 192 (Mobile Urgency Care Service)
Demographic coverage: more than 114.5 million Brazilians or the equivalent to 57.3% of the country’s overall population.
Municipalities covered: 1,604.
Regulation Centers: 162 units.
Ambulances: 2,150 units (1,695 basic and 455 advanced units); 400 motorcycle-ambulances; 8 boat-ambulances; and 6 aircraft/aero physicians.
Funding transfers: more than R$ 392 million per year.
BASIC HEALTH UNITS (UBS)
In June 2012, 3,966 basic health units were under construction, 5,247 were being remodeled and 5,458 had been expanded with funds from the UBS Upgrading Program. Besides these, the selection of projects for the expansion of more than 5,000 units around the country and the remodeling of an additional 46 units in nine states has also been authorized.
In May 2012, there were 33,663 basic health units in the country, a 7.8% increase over 2011.
HEALTH CLOSER TO YOU (SAÚDE MAIS PERTO DE VOCÊ)
Better at Home (Melhor em Casa)- Home Care Service
By June 2012, 346 home care teams and 142 specialized support teams had qualified for the program to assist the population of 74 municipalities in 19 states. Of these, 152 teams had already been deployed, with monthly funding worth R$ 7 million.
Program to Improve Access and Quality in Primary Health Care
Of the 17,700 primary care teams that joined the program in 2011, 17,500 distributed in 3,972 municipalities requested an external evaluation. The teams that are well evaluated in indicators such as prenatal care, care of chronic patients, waiting time for medical visits and adequate health care for the elderly may receive additional funding of up to 100%. Today, each team receives up to R$ 10,600, according to socioeconomic and demographic criteria. Teams that achieve the highest score in the performance evaluation may receive up to R$ 21,600 per month.
Program to Acknowledge the Value of Primary Health Care Professionals (Programa de Valorização dos Profissionais na Atenção Básica – PROVAB)
• Professionals hired: in June 2012 there were 334 physicians, 122 nurses and 110 dentists, totaling 566 professionals in 266 municipalities of 24 states. The professionals were hired by the municipalities.
• Specialization Course focused on primary health care offered by UNA-SUS: in June 2012 there were 61 physicians, 431 dentists and 1,250 nurses, totaling 1,742 professionals being trained in 463 municipalities.
Mortality from Tuberculosis – Brazil met the Millennium Development Goal of reducing by half the number of death from the disease between 1990 and 2015, five years ahead of the established deadline.
More funds for Primary Health Care in 2012
• Minimum Variable Primary Health Care Funding (Piso da Atenção Básica variável – PAB Variável): increased to R$ 8.31 billion, up 23% compared to 2011. Among the benefited are the Program to Improve Access and Quality , Family Health (Saúde da Família), Oral Health (Saúde Bucal) and the Family Health Support Center (Núcleo de Apoio à Saúde da Família). Mortality from Tuberculosis – Brazil met the Millennium Development Goal of reducing by half the number of death from the disease between 1990 and 2015, five years ahead of the established deadline.
• Minimum Primary Health Care Funding – annual fixed PAB (Piso de Atenção Básica – PAB anual): increased to R$ 4.1 billion, up 11% compared to 2011.
SMILING BRAZIL (BRASIL SORRIDENTE)
Additional funds ensure the entry into operation of the thousandth Dental Prosthesis Laboratory in the country
• More dental prostheses produced: by April 2012, 102,000 prostheses had been produced; the target is to produce another 400,000 in 2012. In 2011, 340,000 prostheses were produced.
• Between January 2011 and June 2012, 314 new regional dental prostheses laboratories were accredited, totaling 1,120 units in the country.
• By May 2012, 1,163 new oral health teams had been established, totaling 21,587 teams working in 87.7% of Brazilian cities.
• 100 mobile dental units were delivered in March 2012, benefiting 100 municipalities in poverty situation.
• Dental care with prosthetic rehabilitation started in May in 10 municipalities for students of technical courses under Pronatec and the Thousand Women (Mulheres Mil) program, with the aim to facilitate their integration or reintegration into the labor market.
IMPROVED SUS MANAGEMENT
SUS Survey (Carta SUS)
By May, nearly 1.3 million patients in the public hospital network had received a reply-letter at home with a questionnaire to assess the care provided to them. Users can check whether the data correspond to the service actually rendered and find out the total cost of hospitalization. The survey can be answered either by the patients themselves or by a family member.
The Security Deposit Law passed in May criminalizes the requirement of promissory note or the completion of a form as a condition for providing emergency health care.
Evidence-Based Health Portal
The portal provides scientific content to health professionals through access to reviewed publications with clinical protocols based on evidence available in databases in the health care area.
Saving of R$ 15 million in the purchase of Alzheimer drugs increases access by 30%
The purchase of Rivastigmine, an Alzheimer drug, through the Partnership for Productive Development (Parceria para Desenvolvimento Produtivo - PDP) initiative has generated savings of R$ 15 million for SUS. Until 2011 the drug used to be purchased by state secretariats, with funds transferred by the federal government. By June 2012 the SUS had signed 32 partnerships with 34 laboratories (10 public and 24 private) for the production of 27 drugs besides Rivastigmine and other products such as vaccines, diagnostic tests and IUD. In this partnership, the private laboratory produces the active principle and transfers technology to the public laboratory that manufactures the drug. In return, the government commits to purchasing the drug exclusively from that laboratory for a five-year period. The distribution of Rivastigmine to state secretariats started in June 30, 2012.