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      Política de saúde e eqüidade

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          Abstract

          O artigo analisa a inclusão da questão da eqüidade na área da saúde, sobretudo nas políticas de saúde. Apresenta informações recentes quanto à alocação de recursos financeiros, oferta e utilização de serviços em saúde no Brasil, em um universo particular de municípios, e conclui que ocorreram alguns avanços positivos do ponto de vista da eqüidade, desde a implantação do SUS, notadamente quando do processo de descentralização da política de saúde.

          Translated abstract

          This article analyses the issue of equity in the area of health, particularly with regard to health care policy. It presents recent information on the allocation of financial resources and the supply and utilization of health care services throughout a selected group of municipalities in Brazil, and concludes that progress has been made in terms of equity since the establishment of SUS, particularly as reflected in the decentralization of health care policy.

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          The concepts and principles of equity and health.

          In 1984, the 32 member states of the World Health Organization European Region took a remarkable step forward in agreeing unanimously on 38 targets for a common health policy for the Region. Not only was equity the subject of the first of these targets, but it was also seen as a fundamental theme running right through the policy as a whole. However, equity can mean different things to different people. This article looks at the concepts and principles of equity as understood in the context of the World Health Organization's Health for All policy. After considering the possible causes of the differences in health observed in populations--some of them inevitable and some unnecessary and unfair--the author discusses equity in relation to health care, concentrating on issues of access to care, utilization, and quality. Lastly, seven principles for action are outlined, stemming from these concepts, to be borne in mind when designing or implementing policies, so that greater equity in health and health care can be promoted.
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            Improving equity in health: a research agenda.

            Equity in health and health care have become important priorities for the world. If efforts at achieving equity are to have any basis in evidence concerning which strategies are likely to work, a research agenda is necessary. An adequate research agenda requires a knowledge of what the problem is, an understanding of the genesis and correlates of the problem, methods to measure these correlates, and rigorous testing of alternative explanations and interventions. This article presents a working definition of equity in health and health services, a conceptual framework in which to view the various types of influence on health and distribution of health in populations, a summary of evidence on the effects of some of these categories, and a research agenda for guiding efforts to improve knowledge on which to base interventions that enhance the attainment of equity. Because of their relative neglect in the existing literature on equity in health, the special roles of political forces and of primary care as a particularly key element of health services are stressed.
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              Eqüidade e o Sistema Único de Saúde: uma contribuição para debate

              Neste artigo, destacam-se pontos relevantes sobre a questão das desigualdades no consumo de serviços de saúde e colocam-se em discussão alguns de seus determinantes e algumas questões para a construção, no País, de um sistema de saúde socialmente mais justo. Aponta-se a importância de se distinguir o conceito de eqüidade em saúde do conceito de eqüidade no con- sumo de serviços de saúde. A desigualdade geográfica é apresentada como uma das dimensões da desigualdade no consumo de serviços de saúde, distinta da dimensão social. Políticas de alocação de recursos financeiros entre níveis de governo atuam no campo das desigualdades geográficas, mas podem ser insuficientes para alterar as desigualdades sociais no uso de serviços de saúde. A criação de um sistema de traço igualitário vai depender de uma maior contribuição ao financiamento do sistema dos indivíduos de maior poder aquisitivo. Ao princípio de igualdade tem-se que associar o princípio de solidariedade. A atual situação de insuficiência de recursos financeiros exige que sejam definidas prioridades. Entretanto, a definição de prioridades na disponibilidade de serviços de saúde só é eticamente aceitável enquanto estratégia de transição para uma situação de universalidade do acesso com base em necessidades.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                spp
                São Paulo em Perspectiva
                São Paulo Perspec.
                Fundação SEADE (São Paulo )
                1806-9452
                March 2003
                : 17
                : 1
                : 58-68
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Fundação Oswaldo Cruz
                Article
                S0102-88392003000100007
                10.1590/S0102-88392003000100007
                d9f42ae6-faeb-4e20-881b-4968a75f43d9

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0102-8839&lng=en
                Categories
                ECONOMICS

                General economics
                health care policy,equity and supply,utilization of heath care services,política de saúde,eqüidade e oferta,utilização de serviços de saúde

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