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• W1997070070 abstract "The Lancet's Series on Brazil1Victora CG Barreto ML do Carmo Leal M et al.Health conditions and health-policy innovations in Brazil: the way forward.Lancet. 2011; 377: 2042-2053Summary Full Text Full Text PDF PubMed Scopus (316) Google Scholar covers almost all important health fields: health politics, violence, infectious diseases, chronic non-communicable diseases, and maternal and child health. But overall it gives a biased view of a poor country with a vertical health system based on programmes. The Series is missing at least a paper on the theory of primary care and how it is working in Brazil and a paper on health service organisation in general. Such papers might cover the uneven geographical distribution of physicians (eg, one per 574 inhabitants in the Amazonas state capital, Manaus, compared with one per 9000 in the rest of Amazonas),2Conselho Federal de MedicinaCFM divulga dados sobre a concentração de médicos no Brasil. CFM, Brasília (DF)2010http://portal.cfm.org.br/index.php?option=com_content&view=article&id=9777&catid=3:portalGoogle Scholar or the poor accessibility of health centres forcing patients to visit walk-in clinics with no continuity of care. Questions that remain unanswered are: does Brazilian society want a universal public health system?; do members of Brazil's upper and middle classes know the importance of a strong public health system?; are Brazilian politicians promoting a public health system for the poor and a private one for the rest of the population? One main obstacle to being open to these questions is the pressure on epidemiologists, managers, and academics to collect data in a vertical fashion. Yet violence cannot be seen as detached from infectious disease, maternal mortality, drug addiction, or unemployment. The Family Health Strategy, cited in most of the Series papers, has been a vehicle by which many vertical actions have already been integrated, and the results have been well studied.3Macinko J Dourado I Aquino R et al.Major expansion of primary care in Brazil linked to decline in unnecessary hospitalization.Health Affairs. 2010; 29: 2149-2160Crossref Scopus (125) Google Scholar What readers really need to know are the obstacles to going further in this regard. The outcome of The Lancet's Series is a collection of excellent health data empty of relevant messages for taking decisions around health-policy organisation. There is a need to understand health in Brazil in terms of the best answers to health service problems. We declare that we have no conflicts of interest." @default.
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• W1997070070 date "2011-07-01" @default.
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• W1997070070 title "Brazilian health-service organisation: problems at a glance" @default.
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• W1997070070 doi "https://doi.org/10.1016/s0140-6736(11)61167-7" @default.
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