SUS could be the best health system in the world – 02/28/2023 – Saúde em Público

2023 will be a tough year for public health. The health crisis in the Yanomami territory, the low rates of vaccination coverage that warn of the return of already eradicated diseases, the effects on the system left by the pandemic and the huge waiting lists reaffirm the need to strengthen primary health care.

We know that the way to achieve this, in the long term, is to allocate more resources to the SUS. But in the meantime, we need to make the best possible use of the resources we already have.

In recent years, the financing of primary care has undergone profound transformations that generated important lessons for the new Federal Government. The creation of financial incentives by the Union for municipalities with good performance in indicators related to women’s health, maternal and child health, immunization and health of people with chronic non-communicable diseases stands out.

Having indicators to monitor the provision of care for priority groups, who need greater attention from Primary Health Care (PHC), has also facilitated the organization of the work routine of SUS professionals. And this is not restricted to large urban centers.

In municipalities as diverse as Bonfim, in Roraima, on the border with Guyana, to São José do Herval, in the interior of Rio Grande do Sul, we see managers analyzing their indicators and adopting effective and creative measures to offer the best service to the local population. .

The indicators are also useful for civil society, which in a scenario of misinformation and data blackouts, can monitor how health services are doing throughout Brazil in initiatives such as the impulseprevine.org tool, designed by the health NGO Impulso Gov, or the IEPS Data, maintained by the Institute of Studies for Health Policies (IEPS).

Another advance was the creation of financial incentives for user registration, which made it possible to link the population, through the detailed record, to the primary care team responsible for their longitudinal care. According to the most recent data from the Ministry of Health, there are currently 168.6 million people identified and linked to health teams in the country – 90% registered by the CPF number. This advance in the expansion and qualification of registrations was possible due to the stimulus created by the federal program.

It is necessary to recognize what worked: according to a recent study by the IEPS, the transition of financing models generated a redistribution of resources between municipalities, benefiting rural and more remote ones, with a greater number of beneficiaries of social programs and with more elderly people and children linked to the APS teams.

However, the change was not accompanied by a significant increase in regular APS funding. The study shows that what increased significantly, more precisely 715% between 2016 and 2022 against 10% of regular funding, were the extraordinary transfers made through parliamentary amendments, subject to allocation choices different from those strategically defined by the Ministry of Health.

There’s a lot to improve. Necessary changes include investment in digital health and integration of information systems to facilitate data registration and qualification; the expansion of monitored and remunerated performance indicators so that they include other relevant aspects for the promotion of the population’s comprehensive health; and simplifying the rules of the policy so that it is more easily understood and implemented.

It is also important that municipalities receive technical support so that they can understand the new rules, monitor their results, achieve goals and thus offer a better health service to Brazilian citizens. The few civil society organizations that offer this support free of charge are overwhelmed by so much demand: Impulso Gov, for example, has more than 370 city halls in the queue.

The most urgent thing now is for the new Federal Government to assume its role of national articulation and dialogue with the states and municipalities and their representatives. Using data and technology intelligently, it will be possible to allocate existing SUS resources to where they are most needed and where they generate the most positive impacts: in preventive measures for those who need them most. In 2023, we will have great challenges, but also the opportunity to make SUS the best health system in the world.

Isabel Opice and João Abreu, Masters in Public Administration from Harvard University and founders of Impulso Gov, an NGO that supports municipal governments in the use of data and technology in the SUS. Daniel Soranz, sanitarian, federal deputy and former municipal health secretary of Rio de Janeiro.

PRESENT LINK: Did you like this text? Subscriber can release five free hits of any link per day. Just click the blue F below.