- Criado: 16 Setembro 2013
Actions and Programs
The Ministry of Health develops a wide array of actions and programs aimed at bringing health closer to citizens, while offering the required specialization to the professionals to carry out high-quality work.
In this room, users have access to programs and projects recently developed by the Ministry, and get acquainted to how the public money is being invested to promote health and the Brazilian’s quality of life.
SAMU 192 and UPA 24H
In 2003, the Ministry of Health launched the National Policy on Urgency and Emergency Care to structure and organize the urgency and emergency care network in Brazil. Since its early stages, the Policy aimed at integrating the urgency care services. Today, primary care is composed by basic health units and the Family Health Teams, while the intermediary care level is assigned to the Mobile Urgency Care Service - SAMU 192 (Serviço de Atendimento Móvel a Urgências), and to the Emergency Care Units - UPA 24H (Unidades de Pronto Atendimento). The medium and high complexity care is delivered at hospitals.
Networked Care – The Network of Urgency and Emergency Care aims at articulating and integrating the health equipment to expand and qualify the humanized and integral access for users in situation of urgency/emergency at the health care units, in an agile and timely way.
The Urgency Care Network is conceived in an integrated way, and provides the population with services nearer to their residences. With the SAMU 192 Regulation Units, the Ministry of Health works for organizing the existing structure: when an ambulance belonging to the program is sent to render care, the health professionals already know whereto they should refer the patient. The SAMU 192 puts an end to the pilgrimage seeking for a hospital bed, the ambulance seeking a place to leave the patient.
Mobile Urgency Care Service (SAMU 192)– When citizens dial 192, they are calling a regulation unit staffed with health professionals and physicians trained to provide first-aid guidance by phone. These professionals define the kind of care, ambulance and team responsive to each case. In some cases, the guidance by phone is enough. SAMU renders care to patients at their homes, work place, on the street. In brief, the 192 allows users to get care wherever they are.
The team renders service on the site, at the shortest time, before getting to a hospital, thus saving lives and reducing sequels. The program refers the patient to the nearest and most suitable service; so, the team in the ambulance gains time (reduces the time/response) which is crucial in emergency situations.
Emergency Care Units (UPA 24H)– The objective of the Emergency Care Units is to reduce lines on the emergency rooms of hospitals, thus avoiding that cases that could be solved at the UPAS or basic health units be referred to the hospital units.
The UPAs work 24/7 and can solve most of the urgency and emergency cases. The SAMU 192 and UPA 24h work in an integrated fashion to provide urgency and emergency care.
POPULAR DRUGSTORE (Farmácia Popular)
In June 2004, the Federal Government established the Brazil’s Popular Drugstore Program. With the Own Network (Rede Própria), the purpose is to provide essential medications at low-cost to the population, improving access and benefiting a larger number of individuals.
In 2006, the initiative was expanded and started comprising the private network, which was named “Here you Find Popular Drugstore” (Aqui Tem Farmácia Popular). Besides the medications for hypertension and diabetes, there are drugs for asthma, rhinitis, Parkinson’s disease, osteoporosis and glaucoma, additionally to geriatric diapers. Medications are available at the network of pharmacies and drugstores associated to the Here you Find Popular Drugstore network.
Except for medications for diabetes and hypertension, which are for free, the Here you Find Popular Drugstore Program offers prices that are up to 90% cheaper than those at the non-associated private facilities. The purpose is to reach the population that does not use the SUS, but faces difficulty in remain attached to the treatment due to the high price of medications.
Today, more than 2.5 thousand municipalities count on facilities belonging to the program, and nearly 1.3 million Brazilians are benefited each month. Of these, about 660 thousand have hypertension, and 300 thousand suffer from diabetes.
On February 3, 2011, the President Dilma Roussef launched the program Health is Priceless (Saúde Não Tem Preço) to provide free medications for hypertension and diabetes at the pharmacies and drugstores accredited to the Here you Find Popular Drugstore Program.
With the Health is Priceless Program, the Brazilians who suffer from hypertension or diabetes have free access to medications to treat these diseases. This offer of free medications at the Here You Find Popular Drugstore network results from an agreement between the Ministry of Health and seven entities of the industry and commerce. The agreement benefits 33 million Brazilians with hypertension and 7.5 million with diabetes, besides assisting the neediest families that commit 12% of their income with medications.
To get information about the Here You Find Popular Drugstore (private pharmacies and commercial drugstores), e-mail to:
Right of All
A big jump to significantly improve the Brazilian’s health status and quality of life, with more access to quality actions and services. That’s how we could define the “More Health: Right of All”(Mais Saúde: Direito de Todos) which was launched in December 2007, and comprises 86 goals and 208 actions distributed in eight intervention axes.
Throughout the years, the Ministry of Health and other entities managing the SUS have implemented many actions to reach the objectives and goals established by the More Health, like holding public contests, strengthening the Mobile Urgency Care Service (SAMU), implementing the Emergency Care Units (UPAs), expanding the Family Health Program, among others. Because More Health is a right of all the Brazilians.
Promotion and maintenance of the Brazilians’ health
Family Health Strategy – ESF (Estratégia Saúde da Família)- The Family Health teams, strengthened and expanded, are the main gateway for citizens to access the public health network, since they work on diseases prevention, diagnosis and health promotion. Thus, they guide and show the best way for patients to have their problems solved.
Due to the size of the SUS, increased demand resulting from the population’s aging, changes in the epidemiological profile and financing-related difficulties, the challenge posed is a huge one. But the federal government bets on this organized and integrated network to reduce queues in hospitals and make a
SMILING BRASIL (Brazil Sorridente)
More oral health for all (Mais saúde bucal para todos)
The delivery of public oral health services in Brazil has been historically characterized by actions of low complexity, mostly curative and mutilating ones, with restricted access. Most of the Brazilian municipalities developed actions aimed at the schooling age (6 to 12 years old) and pregnant women. Adults and aged people had access only to emergency and urgency care, typically mutilating ones. That used to characterize dental services as one of the health areas of extreme social exclusion. According to the National Survey on Oral Health (SB Brasil), which was concluded in 2003 by the Ministry of Health, 13% of the adolescents had never gone to a dentist, 20% of the Brazilian population had already lost all teeth, and 45% of the Brazilians missed regular access to tooth brush.
In the last two decades, only some few isolated and punctual experiences expanded the access and developed actions on promotion and prevention, additionally to more complex curative actions. Brazil missed an effective national policy on Oral Health.
The implementation of the National Policy on Oral Health – Smiling Brazil Program – changed the focus of oral health, which now aims at increasing the better organization of the health system as a whole, proposing a model capable of coping with universality, integrality and equity - principles so valuable to those who fought for implementing the Unified Health System in Brazil.
Following are the main lines of action of the Smiling Brazil: reorganize the Basic Care in oral health (notably through the Family Health Strategy); expand and qualify the Specialized Care (mainly through the implementation of Dental Specialties Centers and Regional Labs of Dental Prostheses); and, enable the addition of fluorine at the public water treatment stations.
Guidelines of the National Policy on Oral Health– “Ensure a basic care network articulated to the entire service network, and as crucial part of it; […] ensure integrality to actions on oral health, articulating the individual and the collective, promotion and prevention, and treatment and recovery of the population’s health.”
FIGHT AGAINST DENGUE
Help fighting the disease
Every year, the Ministry of Health launches the National Campaign of Fight against Dengue. The initiative provides continuity and strengthens the actions on prevention and fight against the disease. These actions are carried out throughout the year. Advertisement pieces are developed to help disseminating the campaign: films, spots, posters, flyers, T-shirts, caps, hotsite, broadsite and banner. Materials are oriented to citizens, managers, health professional and educators.
What is Dengue?
Dengue is an acute infectious disease, and has four serotypes (DENV-1, DENV-2, DENV-3 and DENV-4). It is transmitted by the bit of the infected Aedes aegypti mosquito. It happens mainly at tropical and sub-tropical areas of the world, including Brazil. Epidemics typically occur in the summer, during or immediately after the rainy seasons.
Clinical profile is broad, ranging from unspecific fever syndrome to serious profiles, like hemorrhage, shock and, sometimes, death. It is a disease of compulsory reporting, and its serious form is subject to PROMPT reporting. The classic clinical profile is known as classic dengue or dengue fever, while the serious form is known as hemorrhagic dengue fever.
DECADE OF ACTION FOR ROAD SAFETY 2011 - 2020
The United Nations General Assembly, through the Resolution A/RES/64/255, issued on March 02, 2010, proclaimed the period 2011 to 2020 as the “Decade of Action for Road Safety”.
The resolution was elaborated drawing upon studies carried out by the World Health Organization according to which in 2009 there were 1.3 million deaths from road traffic crashes in 178 countries. It calls upon Member States to outline a master plan for the decennium to guide the actions in this area, targeting to stabilize and reduce in up to 50% the road traffic crashes all over the world.
According to estimates by the World Health Organization - WHO:
::. 1.3 million people lose their lives every year in road traffic crashes, and up to 50 million people incur road traffic injuries.;
::.All around the world, road traffic accidents are the 3rd cause of death among the group of 30 to 44 years old, the 2nd in the age group of 5 to 14 years old, and 1st in the age group of 15 to 29 years old;
::. The average costs of road traffic accidents were estimated in 1% to 2% of the countries’ GDP, or a global cost of $518 bi/year;
::. The impact on health sector is significant, notably in low and medium-income countries where road traffic crashes overload the emergency rooms, radiology, physiotherapy and rehabilitation services.
::. In developing countries the road traffic injuries can account for half of the surgery rooms occupied, and from 30% to 86% of hospitalizations (20 days of hospitalization, on average);
::. However, there are less tangible or hardly measurable consequences like family dysfunction, loss of breadwinners, and lifelong sequels;
::. The problem is global, but the issue is more serious in medium and low-income countries, either regarding the existing situation, or regarding the estimated scenario for the next 10 years.
::. These countries report the highest rates of road traffic mortality (from 21.5 to 19.5 for each 100 thousand inhabitants, as happens in Brazil), accounting for 90% of all road traffic deaths, although holding less than half of the registered vehicles fleet.
::. If nothing is done, road traffic deaths should reach 1.9 million as of 2020, jumping from the current 9th to the 5th cause of deaths on earth, as of 2030. This forecast has direct links to the increased rates of motorization in poor and emerging countries, without the corresponding investment in road safety.
::. It is worth highlighting that Brazil is ranked 5th among countries with more road deaths, behind only India, China, USA and Russia. Data from the Ministry of Health and Ministry of the Cities have recorded, in 2008, nearly 39 thousand deaths and 619 non-fatal injuries, many of which with lifelong sequels, resulting from road accidents.
Brazil launches pact to reduce road traffic accidents
The Ministries of Health and of the Cities have launched, on May 11, 2011, the National Pact for Reduction of Road Traffic Accidents - Pact for Life. The goal is to stabilize and reduce the number of road traffic deaths and injuries in the next 10 years, by adhering to the Plan of Action of the Decade for Road Safety 2011 – 2020, launched on the same date (May/11/2011) by the World Health Organization (WHO).
According to the Heath Surveillance Secretariat (SVS) of the Ministry of Health, Brazil is now living an epidemic of motorcycle accidents, with a boom in the number of medical care services. Expenses with hospitalizations due to motorcycle accidents have doubled from 2007 to 2010. In 2010, there were 150 thousand hospitalizations due to road traffic accidents. Among others, the MoH aims at setting goals to reduce the number of road traffic accidents in the states.
The improved emergency care service provided by the SAMU/192, which now relies on more skilled professionals, prevented an increase in mortality resulting from road traffic crashes.
During the launching of the Pact, the data from an unpublished survey sponsored by the Ministry of Health were also presented. The survey analyzed the links between alcohol and road traffic accidents in six capital cities of the country: Recife, Manaus, Fortaleza, Brasília, São Paulo and Curitiba. According to that paper, pedestrians, cyclists and passengers are also responsible for road traffic crashes. The paper reinforces the need for public education policies oriented to these audiences.
Mobilization – All over the world, mobilization was marked by the yellow-orange lighting of the main public monuments in each country; in Brazil, the statue of Christ, the Redeemer (Rio de Janeiro) and the Main Building of the Ministry of Health (Brasilia) were lightened. By adhering to the Pact, the Brazilian government undertakes the international commitment toward reducing deaths, based on a national action plan to be publicized in September 2011.
In 2010, 145,920 victims of road traffic accidents were hospitalized, with the Unified Health System (SUS) affording with a cost of nearly R$ 187 million in worth. Men represented 78.3% of the victims (114,285), while women represented 21.7%. Most of the individuals hospitalized were in the 15 – 59 age group: 84.9% of the men and 70.8% of the women. Almost half of these hospitalizations (44.9%) are in the Southeast region.
Still according to the MoH data, out of every 100 thousand Brazilians, 76.5 have been hospitalized in 2010 due to road traffic accidents. The highest rates are among motorcyclists (36.4/100 thousand) and pedestrians (20.5/100 thousand).
Deaths – According to the MoH’s Mortality Information System, in 2008 Brazil reported 38,273 deaths resulting from road traffic crashes. These figures stand for almost 10 thousand more deaths than in 2000, when 28,966 individuals lost their lives in road traffic accidents – both in cities and on the highways.
The analysis of the MoH data discloses a sharp increase in the number of victims of motorcycle crashes (both passengers and drivers). Of the fatal victims in 2008, 8,898 were riding a motorcycle. The country’s increased motorization in the last few years, notably the use of motorcycles and motor-bicycle – which are highly vulnerable transportation means – hinders the drop of road traffic mortality rates.
Safety belt – According to a survey by the Ministry of Health among 74 urgency and emergency care units in 23 capital cities and the Federal District, from September to November 2009 less than half of the victims served by these units were using the safety belt (43%), with men using it more frequently than women (49% and 36%, respectively).
As regards the use of helmets, 65% of the motorcyclists and passengers used this safety item, with no significant different between sexes. This information is part of the System of Surveillance of Violence and Road Traffic Accidents – Life Inquiry (Viva Inquérito). The sampling is composed of 35,646 victims of accidents in general, of which 27.9% (9,934) were victims of road traffic crashes.
Accidents – Brazil recorded 428,970 road accidents in 2008, according to the Yearbook of the National Register of Road Traffic Accidents and Statists (RENAEST). The number of vehicles involved was 597,786, of which 246,712 were automobiles; 200,449 motorcycles; 54,463 trucks; and, 32,496 bicycles. These accidents resulted in 619,831 non-fatal victims. The RENAEST is fed with information from the bodies belonging to the National Road Traffic System - SNT (DETRAN, municipal road traffic bodies, DER and the Federal Highway Patrol.)
Brazilian fleet – Brazil has a motorized fleet of 66,116,077 vehicles, of which 57% are automobiles. The motorcycles, motor scooters and motor-bicycles account for 26% of the national fleet, with higher concentration in the South and Southeast regions which bear 60% of the motorcycles in the country. The information was provided by the National Road Traffic Department (Denatran), with data for March 2011. Considering the automobile/motorcycle ratio, there are significant differences among the Brazilian regions.
While in the South and Southeast motorcycles account for 20% of the fleet, in the Center-West this percentage increases to 29%. In the Northeast rates are virtually the same (43% of automobiles and 41% of motorcycles), while in the North the percentage of motorcycles (45%) exceeds to that of automobiles (36%).
Global overview – In the global setting, Brazil is ranked 5th in number of road traffic deaths, behind India, China, the United States and Russia, according to the Global Report on Road Safety Situation, published in 2009. The WHO estimates that, all over the world, nearly 1.3 million individuals lose their lives in road traffic crashes every year, while 50 million incur in road traffic injuries. The estimated total cost is $518 billion a year; the costs of road traffic accidents have been estimated in 1% to 2% of the countries’ GDP.
The Ministry of Health's actions and commitments:
1. Improvement and integration of databases from different sectors (Public Security, Health, Transportation/Road Traffic and others) to produce analyses on tendencies and scenarios, monitor indicators and identify critical points (hot areas) of occurrence of road traffic injuries and deaths;
2. Surveillance of risk and protection factors related to the occurrence of road traffic injuries and deaths;
3. Prevention of violence and accidents through the National Network of Centers of Prevention of Violence and Health Promotion;
4. Implementation of the Network of Urgency Care, prioritizing the road traffic victims (emphasis on motorcyclists);
5. Support to states and municipalities as regards actions related to education, prevention and promotion of health, in articulation with other governmental sectors and the civil society, like the Project on Reduction of Morbidity and Mortality due to Road Traffic Accidents, and the Life in Road Traffic (Vida no Trânsito) Project;
6. Advocacy in the implementation of laws to protect life and of safe and healthy rooms;
7. Development of studies and research, and human resources capacity-building, among other actions oriented to surveillance and prevention of road traffic injuries and deaths.
TELE-HEALTH BRAZIL (Telessaúde Brasil)
Qualification of the Family Health Program’s teams
The National Program Tele-health Brazil – an action by the MORE HEALTH Program – was established in the Ministry of Health through the Administrative Rule GM 35/2007 – revoked by the Administrative Rule GM 402/2010 – and is coordinated by the Secretariat of Management of Labor and Education in Health (SGTES) and the Health Care Secretariat (SAS), in articulation with other Ministries, Public Universities, Technical Health Schools and entities in the field of Health and Education.
The Program started with the implementation of the Pilot Project involving nine Tele-health Centers located at universities in the states of Amazonas, Ceará, Pernambuco, Goiás, Minas Gerais, Rio de Janeiro, São Paulo, Santa Catarina and Rio Grande do Sul.
The Tele-health Brazil enables actions like:
- Expansion of the Family Health Teams’ capacity of action;
- Reduction of costs and risks related to the displacement of patients;
- Incentive to fix health professionals in remote municipalities;
- Incorporation of the Digital Inclusion Program.
Improve the quality of Primary Care services in the Unified Health System (SUS), integrating education and service through information technology tools that provide the conditions required to promote Tele-care and Tele-education.
Second Formative Opinion – The Second Formative Opinion is an approach that mixes Care and Education, enabling the training of professionals according to the everyday situations/problems.
The Tele-health Brazil Program aims at establishing Tele-health centers all over the country, prioritizing the Northeast region and the Legal Amazon, pursuant to the goals set out in the Pact to Reduce Child Mortality.