DOCSLIB.ORG

Public Health Expenditure in Brazil: an Analysis of Efficiency

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Public Health Expenditure in Brazil: an Analysis of Efficiency Public Health Expenditure in Brazil: an Analysis of Efficiency Autoria: Lucas Maia dos Santos, Marco Aurélio Marques Ferreira, Márcio Augusto Gonçalves, Evandro Rodrigues de Faria Abstract An univocal understanding of the relationship between public administration and performance is an important and elusive goal for researchers in public administration. After decentralization of both actions and services of healthcare system, the financial resources passed to be transferred to the municipal health funds, as being the administration of the resources under the responsibility of the municipal manager. Taking into account the limited existence of resources it is opportune to question the way the application of the resources in health has been managed. So, this study was carried out to investigate the performance of public expenditures in the public healthcare, as taking 160 administrative microregions on southeastern Brazil as reference. With limitation of the internal availability of governmental resources, mainly aggravated by the Brazilian government's impossibility to republish the provisory contribution on monetary transactions called Contribuição Provisória Sobre Movimentação Financeira (CPMF), in which most resources were consigned to healthcare, the current discussion leans over the optimization capacity of those limited sources against the need for enlargement of the attendance to population. Initially, the relevant variables were explored after the descriptive analysis with quantitative and qualitative efforts. The efficiency scores were generated, by applying the data envelopment analysis (DEA) and using the bootstrap procedure on the sample’s efficiency mean, in order to create the mean’s confidence intervals. According to the results, higher efficiency was observed for the microregions with more than 500 thousand inhabitants as well as in the capitals to detriment of the interior. High amplitude of the efficiency scores from 0.26 to 1 were observed, that means disparity in resource application or no standardizations of output creation. It is distinguished that 16.8% microregions presented the highest scores, as most being in the State of São Paulo. The efficiency means is between 0.68 and 0.75, at 95% confidence. Thus, the results showed that the performance of the Southern microregions can be considered as intermediary and 18,8% of microregions have a weak performance. Finally, it assures the importance of the promotion of policies for improvement of the health efficiency as a function of the interregional particularities. The mainly limitation of this study is that was impossible to measure the quality of the services. Microregions that make more ambulatory procedures and taking care of more families don’t mean owning the better health system. But in a country where many people have no accesses to some healthcare services is important to consider the quantity despite of quality. 1 1. Introduction This study was carried out to investigate the performance of the public expenditure in healthcare, as taking the administrative microregions on southern Brazil as reference for analysis from the IBGE (Brazilian Institute of Geography and Statistics) classification. The study is based on the factual presupposition of optimization of the resources in the public sector, because the idea that performance understood as the production of good results must be the main objective of all governor, as seeking the maximization of the social welfare. An univocal understanding of the relationship between public administration and performance is an important and elusive goal for researchers in public administration. The health, education, feeding and freedom constitute a fundamental right of the human being, since they situate as essential dimension of the quality of life (QOL). It is a result from the combination among the social, economical, political and cultural factors that are particularly presented in each society. Moreover, understand the performance of public expenditure is a way to manage accountability and proceed the idea of the the best value for money. Since the 19-ies, in Brazil there is a concern on the part of the health researchers and governmental heads in verifying the quality and effectiveness in the delivery of the health services in the public sector. See Serapioni (1999) and Castiel (2008). Thus, it becomes more and more necessary the use of techniques and methods that make possible an evaluation of the sector performance, as taking the regional public units responsible for execution of the health services as reference. After decentralization of the actions and services of health, the financial resources were transferred from the Ministério da Saúde (Brazilian Healthcare Ministry) to the municipal health funds, as being the administration of resources and the warranty of quality services for the population under the responsibility of the municipal governors. Due to the complexity of some health services and to the partition of the regional infrastructure through displacement of assistance, municipal consortia and concentration of attendance services on microregional plan, it becomes appropriate to use the registrations and accountancy of the information in this territorial unit, on such a way that several counties are represented by pole-cities. Thus, taking into account the limited existence of resources as well as the characteristics and specificities of each Brazilian microregion, it is opportune to question how application of the resources has been managed, as well as to investigate the products from those applications at interregional level, as a form to creating public intervention policies in favor of quantitative and qualitative improvements in the health. So, the analysis of the performance in public expenditures of the health sector will be accomplished by applying the Data Envelopment Analysis (DEA) that seeks to quantify and compare the efficiency in using the resources for the provision of goods and services. For complementation of this stage, the bootstrap procedures will be used to measure the effect of the errors on the efficiency estimators. This study takes as reference either the works by either O´Toole (1999) and Bretschneider et al. (2007) who measured the performance in education by applying DEA, and those by Marinho (2001; 2003), Faria et al. (2008) and Gonçalves et al. (2008) who discourse on the performance in the health area. The researches and scientific productions mentioned on health sector have been contributing for the comparative evaluation of efficiency in the area, as establishing internal reference units in studies addressed to hospitals, clinics and health ambulatory services. So, the present work will show the inter comparison as methodological progress, as being an unpublished application in the Brazilian scenery. 2 2. Theoretical Framework 2.1. Understanding the healthcare system in Brazil The debate about the reality of the healthcare in Brazil was supported on studies and researches that pointed out the fragility of the development model and also characterized the healthcare system adopted during the military dictatorship as centralizer, hierarchized and mainly inefficient and irrational. In the 1970s, the sanitary movement appeared from the population’s dissatisfaction to discuss how would should be the health management. In 1987, the federal government created the unified health decentralized system named Sistema Único Descentralizado de Saúde - SUDS, that implemented some proposals of the sanitary movement, as mainly looking for decentralization of the system. Then, the sanitary reform project named Projeto de Reforma Sanitária was taken to the National Constituent Assembly and approved in almost its totality in the Federal Constitution of 1988, that adopted the proposal of a unified health system called Sistema Único de Saúde – SUS. The Federal Constitution of 1988 considers the health, from art. 196 to art. 200, and the most important point is the conception of the health as right of all and the duty of the State, as well as its universal and equalitarian access, besides its inclusion into tripod of the social security together with the social welfare (BRAZIL, 1988). For several economical and political matters due to the privatizing character of the State, the SUS still was not implemented in its plenitude; however its guidelines are the pathway for the improvement of the health system in Brazil, as the recent researches point out. With the creation of regulating agencies in Brazil, there was a decrease in the role of the State as concerning to the supply of public services as well as a regulation process that stimulates both competition and innovation. Thus, “the control and evaluation of the processes that are interesting for all have been transferred “to no-state entities, as dislocating the focus of the government's collection to society" (RIZZOTTO, 2000:210). In Brazil, the problems involving the health sector are many and they stand out when analyzing the medical establishments, the sectored policies and the health model that has been adopted in the last decades. Then, there is a need for rationalization of the actions in this extent and always looking for optimization of the resource applications. Thus, this study will approach a multidimensional focus of the performance according to Forbes and Lynn (2007), to the detriment of other approaches only under the monetary viewpoint. Nowadays, it is possible to notice the effort of the counties towards the attendance
Load more

Recommended publications
  • The Healthcare Market in Brazil
    www.pwc.com.br The Healthcare market in Brazil Brazilian Healthcare market: one of the most promising and attractive in the world Context Fifth largest country in area and global financial crisis - intensified population, with 8.51 million square in Europe - the Brazilian territory kilometers and about 196 million was the main destination for direct inhabitants, Brazil recorded in 2012, a foreign investment in Latin America, Gross Domestic Product (GDP) of receiving $ 65.3 billion. US$ 2.2 trillion, the seventh largest on the planet. Market estimates indicate Brazil has a fast growing consumer that, in this decade, the country may market, positioned in several be consolidated as the fifth largest segments as one of the largest in the global economy. world. The power of its domestic market in consumer goods and For almost two decades the country services has been particularly has been undergoing a process of promising in the healthcare and economic stabilization which ensured pharma industries. tremendous social advances to Brazilians. Most notably, for over two Based on those macroeconomic years national unemployment rate indicators an outlook for the hovers around 5% of the economically Brazilian healthcare industry is also active population, which represents, in optimistic, considering the market the view of many experts, a situation growth drivers listed below: of full employment. This improvement • purchasing power increase is also reflected in rising wages and escalating consumption, boosted by • new entrants into the strong credit growth combined with emergent middle class lower interest rates and government tax incentives for durable goods, the white • consumers are willing line, automobiles and construction.
    [Show full text]
  • Bolsa Família Cash Transfer Programs in South Africa and Brazil
    A COMPARATIVE STUDY OF THE CHILD SUPPORT GRANT AND BOLSA FAMÍLIA CASH TRANSFER PROGRAMS IN SOUTH AFRICA AND BRAZIL Francesca G. Reece TC 660H Plan II Honors Program The University of Texas at Austin May 2019 _________________________________ Wendy A. Hunter, PhD Department of Government Supervising Professor _________________________________ Raúl Madrid, PhD Department of Government Second Reader Abstract Author: Francesca G. Reece Title: A Comparative Study of the Child Support Grant and Bolsa Família Cash Transfer Programs in South Africa and Brazil Supervising Professor: Wendy A. Hunter, PhD This thesis examines the Bolsa Família and Child Support Grant cash transfer programs in Brazil and South Africa along two aspects: children’s educational attainment and health outputs. Drawing on available statistical information and impact studies by other scholars, metrics for the aspects above are analyzed to determine where and why adjustments to either program design or state capacity are needed to accomplish each program’s respective goals. The primary conclusion for Brazil’s Bolsa Família program is that—despite widespread and replicable successes within each aspect—numerous adjustments to program design are needed to standardize opportunities for success, particularly for participants in rural regions. For South Africa’s Child Support Grant program, a major overhaul of state capacity is long overdue. Supply-side issues in program administration fundamentally disrupt the program and inhibit its goals attainment. Overall, Brazil’s program provides a reliable and feasible model for South Africa and other countries to draw on when modifying the program design of their own cash transfer programs. However, without adequate state capacity for carrying out such changes, South Africa’s program will continue to fall far short of the expectations set by Brazil’s, revealing that the state capacity context into which cash transfer programs are introduced matters more for success or failure than mere program design.
    [Show full text]
  • Tatiana Dassi “O(S) Perigo(S) De Uma Única História”
    UNIVERSIDADE FEDERAL DE SANTA CATARINA CENTRO DE FILOSOFIA E CIÊNCIA HUMANAS PROGRAMA DE PÓS-GRADUAÇÃO EM ANTROPOLOGIA SOCIAL Tatiana Dassi “O(s) perigo(s) de uma única história”: uma etnografia de políticas públicas com crianças em um Projeto Social em Florianópolis, SC Florianópolis 2019 1 Tatiana Dassi “O(s) perigo(s) de uma única história”: uma etnografia de políticas públicas com crianças em um Projeto Social em Florianópolis, SC Tese submetida ao Programa de Pós-graduação em Antropologia Social do Centro de Filosofia e Ciências Humanas da Universidade Federal de Santa Catarina, para a obtenção do título de Doutora em Antropologia Social. Orientador: Prof. Dr. Theóphilos Rifiotis Florianópolis 2019 2 3 Tatiana Dassi “O(s) perigo(s) de uma única história”: uma etnografia de políticas públicas com crianças em um Projeto Social em Florianópolis, SC O presente trabalho em nível de doutorado foi avaliado e aprovado por banca examinadora composta pelos seguintes membros: Dr. Theóphilos Rifiotis (PPGAS/UFSC – Orientador) Dra. Patrice Schuch (PPGAS/UFRGS) Dra. Sonia Weiner Maluf (PPGAS/UFSC) Dra. Antonella Tassinari (PPGAS/UFSC) Certificamos que esta é a versão original e final do trabalho de conclusão que foi julgado adequado para obtenção de título de doutora em Antropologia Social ____________________________________ Prof. Dr. Jeremy Paul Jean Loup Deturche Coordenador do PPGAS/UFSC ___________________________________ Theóphilos Rifiotis Orientador Florianópolis, 2019. 4 À Patrick Cristóvão Pereira (Tistu), em memória. 5 Agradecimentos Agradeço ao CNPq por ter possibilitado esta pesquisa através da concessão de minha Bolsa de Doutorado. E à Universidade Federal de Santa Catarina por oferecer educação superior de excelência gratuitamente. Agradeço às funcionárias e funcionários do Conselho de Moradores do Saco Grande, em especial à Tati, Marilda, Nina e Aristides.
    [Show full text]
  • Perceptions and Uses of Public and Private Healthcare in a Brazilian Favela
    Perceptions and uses of public and private healthcare in a Brazilian favela Castiglione, Déboraa; Lovasi, Gina S.b and Carvalho, Mariliaa aOswaldo Cruz Foundation, National School of Public Health bDrexel University, Dornsife School of Public Health Corresponding author: Castiglione, Débora Av. Brasil, 4365 CEP 21040-900 Rio de Janeiro Brazil email: [email protected] DOI: 10.1177/1049732317739611 Approved for publication in Qualitative Health Research 1 Abstract Since 1988, Brazil has reorganized and expanded its public healthcare system, defining access to healthcare as a right of every citizen. In parallel, the private healthcare sector grew rapidly to become one of the largest in the world. We explore the use of public and private health care by a low-income population living a favela, Rio das Pedras, in Rio de Janeiro. At the time of data collection, only part of the community was covered by the primary health care program. We conducted semi-structured interviews with 14 adults, both with and without access to the public primary care program. Regardless of program coverage, participants noted barriers and negative experiences while accessing public healthcare. The perceived inability of health professionals to deal compassionately with a low-income population was prominent in their narratives, and in the expressed motivation for pursuing private sector healthcare alternatives. We explore the tension arising from the more recent rights-based healthcare provision and historic social control and assistentialist framing of state intervention in Brazilian favelas. Keywords: Brazil; public healthcare; private healthcare; access to care; qualitative interviews 2 Introduction Since 1988, Brazil has reorganized and expanded its public healthcare system, defining access to healthcare as “a right of every citizen and the duty of the State”, with a series of reforms that led to the Unified National Health System (SUS).
    [Show full text]
  • Pet Insurance Difference
    PleasureMuito to prazermeet you SomosWe are aD’Or D’Or Consultoria:Consultoria An: especialista Insurance emandseguros Benefitse Specialist benefícios We are part of the Rede D’Or São Luiz Group . THOUSAND ACCREDITED HOSPITAL BEDS ONCOLOGY CLINICS HOSPITALS HOSPITALS . THOUSAND THAN THOUSAND HOSPITAL BEDS NEW PROJECTS UNDER EMPLOYEES HOSPITALS UNDER CONSTRUCTION EXPANSION Rede D’Or São Luiz Hospitals Rio de Janeiro São Paulo BrasíliaBrasília (Federal (DF) District) Recife Bahia Maranhão Our Figures More than R$ Over 400 80Million Collaborators Revenue 1.5 million Our investors R$ de vidasadministeredadministradas lives 2 Billion dePremium prêmio Some of Our Clients Property/Casualty What is your need? D’Or always has a customized solution for your case. And this makes all the Portable Valuables Insurance Home Insurance Pet Insurance difference. Did it fall, get wet, break down? We’ll help you To take even better care of your home, Friends are to be taken care of. Check prevent it. ask for an exclusive quotation. out the special conditions to take good care of your pet. Car Insurance Life Insurance Travel Insurance Private Pension Differentiated advantages so you will only worry Your future is a serious matter. How If being protected is your priority, you Your trip will give you only about planning it in a personalized way? about the road. can count on us. unforgettable moments. In a good way... D’Or Surety Bond DedicatedHeadcountHeadcountdedicado and Agility ReinsuranceAgilidade • Bid, Performance, Advance Payment and Supply Bonds • Court and Custom Bonds • Concession Bonds CustoCost Bond Types Our Services and differentials What we offer What we offer in addition • Access to the largest hospital network in Brazil; Operational Management • Service agility; Access • Monitoring of cases and hospitalizations; • Concierge project under development.
    [Show full text]
  • Redalyc.Can Conditional Cash Transfer Programs Generate Equality Of
    Revista de Sociologia e Política ISSN: 0104-4478 [email protected] Universidade Federal do Paraná Brasil Bohn, Simone; Fernandes Veiga, Luciana; Da Dalt, Salete; Pereira Brandão, André Augusto; de Carvalho Gouvêa, Victor Hugo Can conditional cash transfer programs generate equality of opportunity in highly unequal societies? Evidence from Brazil Revista de Sociologia e Política, vol. 22, núm. 51, septiembre, 2014, pp. 111-133 Universidade Federal do Paraná Curitiba, Brasil Available in: http://www.redalyc.org/articulo.oa?id=23832703007 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Can conditional cash transfer programs generate equality of opportunity in highly unequal societies? Evidence from Brazil DOI 10.1590/1678-987314225107 Simone Bohn, Luciana Fernandes Veiga, Salete Da Dalt, André Augusto Pereira Brandão, Victor Hugo de Carvalho Gouvêa ABSTRACT This article examines whether the state, through conditional cash transfer programs (CCT), can reduce the poverty and extremely pov- erty in societies marred by high levels of income concentration. We focus on one of the most unequal countries in the globe, Brazil, and analyze the extent to which this country’s CCT program – Bolsa Família (BF, Family Grant) program – is able to improve the life chances of extremely poor beneficiaries, through the three major goals of PBF: First, to immediately end hunger; second, to create ba- sic social rights related to healthcare and education; finally, considering also complementary policies, to integrate adults into the job market.
    [Show full text]
  • Covid-19 Is Causing the Collapse of Brazil's National Health Service
    FEATURE São Paulo, Brazil CORONAVIRUS BMJ: first published as 10.1136/bmj.m3032 on 30 July 2020. Downloaded from [email protected] Cite this as: BMJ 2020;370:m3032 http://dx.doi.org/10.1136/bmj.m3032 Covid-19 is causing the collapse of Brazil’s national health service Published: 30 July 2020 Brazil is one of the few countries in the Americas that has free universal healthcare. But years of neglect and the pandemic have left the system on the verge of collapse, writes Rodrigo de Oliveira Andrade. Rodrigo de Oliveira Andrade freelance journalist As the number of covid-19 cases in Brazil soars, so providing primary healthcare for people living in do concerns that the country’s celebrated public rural and remote regions. The Family Health healthcare system will be overwhelmed after four Programme (now called the Family Health Strategy, years of severe budget cuts. or FHS) operates through health teams made up of a doctor, a nurse, a nurse assistant, and community “Covid-19 has reached Brazil at a moment when it is health agents. “Brazil has 263 756 health agents, each seriously weakened,” Marco Akerman, an one responsible for nearly 150 households in a epidemiologist at the University of São Paulo, told geographically delineated area—usually the same The BMJ. area where the agent lives,” says Jesem Orellana, an Today nearly 160 million people—around 75% of epidemiologist at the Oswaldo Cruz Foundation, in Brazil’s population—depend solely on the Unified Amazonas. Health System (known as SUS) for healthcare. The agents visit each home at least once a month, Launched in 1988 as part of a wide-ranging checking, for instance, whether patients have been constitutional reform after two decades of military taking their medications, or that prescriptions have dictatorship, SUS has been cited as an example of a been filled out.
    [Show full text]
  • An Analysis of Its Impact on the Incidence and Mortality Rates of Oral
    Rocha et al. BMC Cancer (2017) 17:706 DOI 10.1186/s12885-017-3700-z RESEARCHARTICLE Open Access Oral primary care: an analysis of its impact on the incidence and mortality rates of oral cancer Thiago Augusto Hernandes Rocha1,11*, Erika Bárbara Abreu Fonseca Thomaz2, Núbia Cristina da Silva3, Rejane Christine de Sousa Queiroz2, Marta Rovery de Souza4, Allan Claudius Queiroz Barbosa5, Elaine Thumé6, João Victor Muniz Rocha3, Viviane Alvares3, Dante Grapiuna de Almeida7, João Ricardo Nickenig Vissoci8, Catherine Ann Staton9 and Luiz Augusto Facchini10 Abstract Background: Oral cancer is a potentially fatal disease, especially when diagnosed in advanced stages. In Brazil, the primary health care (PHC) system is responsible for promoting oral health in order to prevent oral diseases. However, there is insufficient evidence to assess whether actions of the PHC system have some effect on the morbidity and mortality from oral cancer. The purpose of this study was to analyze the effect of PHC structure and work processes on the incidence and mortality rates of oral cancer after adjusting for contextual variables. Methods: An ecological, longitudinal and analytical study was carried out. Data were obtained from different secondary data sources, including three surveys that were nationally representative of Brazilian PHC and carried out over the course of 10 years (2002–2012). Data were aggregated at the state level at different times. Oral cancer incidence and mortality rates, standardized by age and gender, served as the dependent variables. Covariables (sociodemographic, structure of basic health units, and work process in oral health) were entered in the regression models using a hierarchical approach based on a theoretical model.
    [Show full text]
  • Identification of Business Opportunities for Small and Medium-Sized Dutch Companies in Minas Gerais
    Identification of business opportunities for small and medium-sized Dutch companies in Minas Gerais Commissioned by the Netherlands Enterprise Agency 1 1 INDEX EXECUTIVE SUMMARY .............................................................................................................................. 6 1 Brazilian Health System Overview .................................................................................................... 8 1.1 Health expenditure in Brazil....................................................................................................... 9 1.2 Minas Gerais Brief Overview .................................................................................................... 10 2 Health Sector Value Chain in Minas Gerais .................................................................................... 12 2.1 The Healthcare value chain of Minas Gerais............................................................................ 12 3 Analysis of Stakeholders of Minas Gerais ....................................................................................... 16 3.1 The multiplicity of the biotechnological pole of Minas ........................................................... 16 3.1.1 Anbiotec ............................................................................................................................ 18 3.1.2 Biominas Brasil .................................................................................................................. 18 3.1.3 BiotechTown ....................................................................................................................
    [Show full text]
  • The Brazilian Constitution Defines Health As a “Fundamental Right”, Holding the Government Responsible for Providing Citizens with Healthcare
    HEALTHCARE IN BRAZIL The Brazilian constitution defines health as a “fundamental right”, holding the government responsible for providing citizens with healthcare. The United Health System (SUS) provides universal healthcare to citizens and legal residents. Private health insurance is also available at an added cost. HEALTHCARE COVERAGE Many middle and high income Brazilians purchase private health insurance in addition to their SUS coverage due to the comfort and technological advancements the system offers Public (75%) Private (25%) PUBLIC HEALTH (SUS) $r Funding Health outcomes Special Programs Current Challenges SUS is funded Since the system's The Programa Saúde Low doctor/patient by federal, state, implementation, Brazil da Familia (PSF) ratios in public and municipal has experienced an provides primary care healthcare facilities, high governments increase in life in low income areas hospital wait times, and resource scarcity in expectancy and a through teams of public hospitals. These reduction in infectious healthcare problems are diseases, despite professionals exacerbated in poorer recent outbreaks states PRIVATE HEALTH Brazil is the second 50 million largest private health 57% Brazilians are covered of health spending by private plans market in the world is private sector $r Funding Spending Current Challenges COVID-19 The private sector is More than half of As private healthcare is As the Covid-19 financed by patient private sector based in hospitals, not pandemic progresses, expenditures and spending comes primary care facilities, the the government may partially by the from out of pocket private sector shifts to temporarily nationalize government through tax private hospitals to payments for focus away from account for shortages in breaks from privately services in private preventative care to the public hospitals insured individuals who hospitals treatment of already sick use high cost services patents.
    [Show full text]
  • Geographic Access to COVID-19 Healthcare in Brazil Using a Balanced Float Catchment Area Approach
    medRxiv preprint doi: https://doi.org/10.1101/2020.07.17.20156505; this version posted July 19, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. It is made available under a CC-BY-NC-ND 4.0 International license . Preprint July 2020 Geographic access to COVID-19 healthcare in Brazil using a balanced float catchment area approach Rafael H. M. Pereira* Carlos Kauê Vieira Braga Luciana Mendes Servo Institute for Applied Economic Research - Ipea, Brazil Bernardo Serra Institute for Transport Policy & Development - ITDP Brazil, Brazil Pedro Amaral Universidade Federal de Minas Gerais (UFMG), Brazil Nelson Gouveia University of São Paulo Medical School (FMUSP), Brazil Antonio Paez McMaster University, Canada Abstract: The rapid spread of the new coronavirus across the world has raised concerns about the responsiveness of cities and healthcare systems during pandemics. Recent studies try to model how the number of COVID- 19 infections will likely grow and impact the demand for hospitalization services at national and regional levels. However, less attention has been paid to the geographic access to COVID-19 healthcare services and to the response capacity of hospitals at the local level, particularly in urban areas in the Global South. This paper shows how transport accessibility analysis can provide actionable information to help improve healthcare coverage and responsiveness. It analyzes accessibility to COVID-19 healthcare at high spatial resolution in the 20 largest cities of Brazil. Using network-distance metrics, we estimate the vulnerable population living in areas with poor access to healthcare facilities that could either screen or hospitalize COVID-19 patients.
    [Show full text]
  • Therapeutic Communities in Brazil
    Working Paper Series THERAPEUTIC COMMUNITIES IN BRAZIL Editors Mauricio Fiore Social Science Research Council Taniele Rui One Pierrepont Plaza, 15th Floor Brooklyn, NY 11201 www.ssrc.org JUNE 2021 Working Paper Series THERAPEUTIC COMMUNITIES IN BRAZIL Editors Mauricio Fiore Taniele Rui Social Science Research Council | Drugs, Security and Democracy Program JUNE 2021 PROJECT COORDINATOR ABOUT THE SSRC Cleia de S. Noia The Social Science Research Council (SSRC) is an independent, international, nonprofit organization founded in 1923. The SSRC fosters innovative research, nurtures EDITORIAL TEAM new generations of social scientists, deepens how inquiry Clare McGranahan is practiced within and across disciplines, and mobilizes Christopher Takacs – English copyedit necessary knowledge on important public issues. Vanessa Rosa – Portuguese copyedit David Rodgers – English translation ABOUT THE DSD PROGRAM The Drugs, Security and Democracy (DSD) Program supports PUBLICATION DESIGN AND LAYOUT research on drugs in Latin America and the Caribbean with Beth Post a goal of producing evidence-based knowledge to inform Juni Ahari drug policy in the region and beyond. The program seeks to foster a global interdisciplinary network of researchers engaged with drug policy, committed to policy-relevant outcomes, and able to communicate their findings to relevant audiences. ACKNOWLEDGEMENTS In addition to the co-editors and authors of the series, the This work carries a Creative Commons Attribution- SSRC and the DSD Program would like to thank Gabriela NonCommercial-NoDerivs
    [Show full text]