Vaitsman Jeni, Lobato Lenaura de Vasconcelos Costa
Escola Nacional de Saúde Pública, Fiocruz. R. Leopoldo Bulhões 1480, Manguinhos. 21041-210 Rio de Janeiro RJ Brasil.
Escola de Serviço Social, Universidade Federal Fluminense. Niterói RJ Brasil.
Cien Saude Colet. 2017 Nov;22(11):3527-3536. doi: 10.1590/1413-812320172211.20042017.
The 1988 Constitution approved the Continuous Cash Benefit (BCP) directed to elders and disabled persons with a household per capita income of 25% of the minimum wage, and around 4 million people received this benefit in 2015. The design of BPC for disabled persons involves organizations of social security, social welfare and health. This paper discusses how some intersectoral coordination mechanisms gaps between these areas produce access barriers to potential beneficiaries. Results stem from a qualitative study performed with physicians, administrative staff and social workers from the National Institute of Social Security (INSS) and of the Social Welfare Reference Center (CRAS) in three municipalities of different Brazilian regions. Intersectoral coordination and cooperation are more structured at the Federal level. At the local level, they rely on informal and horizontal initiatives, which produce immediate but discontinuous solutions. The role of the CRAS remains contingent on the implementation. The need to establish institutionalized mechanisms for coordination and cooperation between social welfare, health and social insurance to improve the implementation and reduce barriers to access to the BCP is apparent.
1988年宪法批准了面向老年人和残疾人的持续现金福利(BCP),这些人的家庭人均收入为最低工资的25%,2015年约有400万人领取了这项福利。针对残疾人的持续现金福利计划的设计涉及社会保障、社会福利和卫生等组织。本文讨论了这些领域之间部门间协调机制的一些差距如何给潜在受益人造成获取障碍。研究结果源于对巴西不同地区三个城市的国家社会保障局(INSS)和社会福利参考中心(CRAS)的医生、行政人员和社会工作者进行的定性研究。部门间的协调与合作在联邦层面的组织架构更为完善。在地方层面,它们依赖非正式的横向举措,这些举措能产生即时但不连续的解决方案。社会福利参考中心的作用仍取决于实施情况。显然,需要建立社会福利、卫生和社会保险之间协调与合作的制度化机制,以改进实施情况并减少获取持续现金福利的障碍。