School of Dentistry, Positivo University, Curitiba, Paraná State, Brazil.
Int Dent J. 2013 Oct;63(5):237-43. doi: 10.1111/idj.12039. Epub 2013 Apr 26.
This article presents an integrative literature review that analyses the advances and challenges in oral health care of the Brazilian primary health care system, based on a political agenda that envisages re-organising the unified health system (SistemaÚnico de Saúde - SUS). It is presumed that the actions suggested by the Alma-Ata Conference of 1978 are still up-to-date and relevant when adapted to the situation in Brazil. Several studies and policies are reviewed, including works demonstrating the importance of primary care as an organising platform in an integrated health-care network, Brazil's strategy for reorganising the primary care network known as the Family Health Strategy, and the National Oral Health Policy. This review discusses results obtained over the last twenty years, with special attention paid to changes in oral health-care practices, as well as the funding of action programmes and assistance cover. The conclusion is that oral healthcare in the Brazilian primary health care system has advanced over the past decades; however, serious obstacles have been experienced, especially with regard to the guarantee of universal access to services and funding. The continuous efforts of public managers and society should focus on the goal of achieving universal coverage for all Brazilians.
本文通过综合文献回顾,分析了巴西初级卫生保健系统口腔卫生保健的进展和挑战,其基础是一项旨在重组统一卫生系统(Sistema Único de Saúde - SUS)的政治议程。人们认为,1978 年阿拉木图会议提出的行动方案,如果适应巴西的情况,仍然是最新和相关的。本文回顾了几项研究和政策,包括展示初级保健作为综合医疗保健网络组织平台的重要性的研究,巴西重组初级保健网络的战略,即家庭健康战略,以及国家口腔卫生政策。本文讨论了过去二十年取得的成果,特别关注口腔卫生保健实践的变化,以及行动方案和援助范围的供资情况。结论是,巴西初级卫生保健系统的口腔卫生保健在过去几十年中取得了进展;然而,也遇到了严重的障碍,特别是在服务和资金普遍获得的保障方面。公共管理者和社会的持续努力应集中在为所有巴西人实现全民覆盖的目标上。