Challenges for ensuring availability and accessibility to health care services under Brazil’s Unified Health System (SUS)

Ana Paula Cavalcante de Oliveira Mariana Gabriel Mario Roberto Dal Poz Gilles Dussault About the authors


Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas. This review focused on eight interventions in the last 30 years, whose mainly aim was to correct the maldistribution of physicians in the SUS such as Rondon Project, Interiorization of Health Work Program, Medical Specialists Training Program, PHC Program and More Doctors Program. The discussion focuses on the factors that influence the outcome of these interventions.

Human resources in for health; Health employment labour market; Public health policies in health; Physicians distribution of doctors; Access to health care

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