Faculty of Medical Sciences, University of Pernambuco, Recife 50100-130, Brazil.
Political Science Department, Federal University of Pernambuco, Recife 50070-460, Brazil.
Int J Environ Res Public Health. 2022 Jan 28;19(3):1472. doi: 10.3390/ijerph19031472.
People with disabilities have greater need for healthcare on average, but often face barriers when accessing these services. The Brazilian government launched the National Health Policy for People with Disabilities (PNSPD) in 2002 to address this inequality. PNSPD has six areas of focus: quality of life, impairment prevention, comprehensive health care, organization and functioning of health services, information mechanisms, and training of human resources. The aim of this article was to undertake a scoping review to assess the evidence on the experience of people with disabilities in Brazil with respect to the six themes of the PNSPD. The scoping review included articles published between 2002 and 2019, from four electronic databases: PUBMED/MEDLINE, LILACS, Science Direct, and Scielo. In total, 8076 articles were identified, and after review of titles, abstracts, and full texts by two independent reviewers, 98 were deemed eligible for inclusion. The evidence was relatively limited in availability and scope. However, it consistently showed large gaps in delivery of healthcare to people with disabilities across the six dimensions considered. There was lack of actions aimed at promoting quality of life; insufficient professional training about disability; little evidence on the health profile of people with disabilities; large gaps in the availability of care due to widespread physical, informational, and attitudinal barriers; and poor distribution of the supply and integration of services. In conclusion, the policy framework in Brazil is supportive of the inclusion of people with disabilities in health services; however, large inequalities remain due to poor implementation of the policy into practice.
残疾人平均对医疗保健的需求更大，但在获得这些服务时往往面临障碍。巴西政府于 2002 年推出了《残疾人国家卫生政策》（PNSPD），以解决这一不平等问题。PNSPD 有六个重点领域：生活质量、预防残疾、全面保健、卫生服务的组织和运作、信息机制以及人力资源培训。本文的目的是进行范围综述，以评估巴西残疾人在 PNSPD 的六个主题方面的经验证据。范围综述包括 2002 年至 2019 年期间发表的文章，来自四个电子数据库：PUBMED/MEDLINE、LILACS、Science Direct 和 Scielo。共确定了 8076 篇文章，经过两位独立审稿人的标题、摘要和全文审查后，有 98 篇被认为符合纳入标准。证据在可用性和范围上相对有限。然而，它始终表明在考虑的六个维度上向残疾人提供医疗保健方面存在巨大差距。在促进生活质量方面缺乏行动；关于残疾的专业培训不足；关于残疾人健康状况的证据很少；由于普遍存在的身体、信息和态度障碍，护理的可及性存在很大差距；以及供应和服务整合的服务分布不佳。总之，巴西的政策框架支持将残疾人纳入卫生服务；然而，由于政策执行不力，仍存在巨大的不平等。
