Cesar C L, Walker G J
Ann Trop Paediatr. 1986 Sep;6(3):167-74. doi: 10.1080/02724936.1986.11748432.
Health services in Brazil are characterized by a multiplicity of providers. While many are ultimately funded from public sources, notably the National Social Security Scheme, a large proportion are provided by the private sector. This variety of providers of health care has hindered the development of comprehensive care and the coverage of those in greatest need. In recent years increasing attention has been given to ways of reducing the undesirable aspects of this situation. The Federal and State Governments have established committees to improve coordination between services and set up several pilot programmes. One concerned with improving the effective coverage of maternal and child services has been established in Sorocaba. Sorocaba is a medium-sized city which is typical of the many urban centres in the state of São Paulo. This paper describes a study which has provided information from a representative sample of women, who had recently had a baby, on their eligibility for care from the various health services available in the city and on their actual use of those services. This information has been used in the implementation of a pilot programme. Most mothers attended some service for antenatal care. Almost 20% used several services because their entitlement varied from scheme to scheme and some services provided only specific components of care. This applied also to preventive and curative infant care.
巴西的卫生服务具有提供者多元化的特点。虽然许多服务最终由公共资金提供，特别是国家社会保障计划，但很大一部分是由私营部门提供的。这种多样的医疗服务提供者阻碍了综合护理的发展以及最需要者的覆盖范围。近年来，人们越来越关注减少这种情况不良方面的方法。联邦和州政府已成立委员会以改善服务之间的协调，并设立了几个试点项目。在索罗卡巴设立了一个旨在提高母婴服务有效覆盖范围的项目。索罗卡巴是一个中等规模的城市，是圣保罗州众多城市中心的典型代表。本文描述了一项研究，该研究从最近生育的有代表性的女性样本中获取了信息，内容涉及她们从该市各种可用卫生服务中获得护理的资格以及她们对这些服务的实际使用情况。这些信息已用于一个试点项目的实施。大多数母亲都接受了某种产前护理服务。近20%的人使用了多种服务，因为她们的权益因计划而异，而且一些服务仅提供特定的护理内容。这也适用于预防性和治疗性的婴儿护理。
