%0 Journal Article
%T Universalization of the access to the Unified Health System in Brazil: challenges
%A Regina Maria Giffoni Marsiglia
%J Cadernos de Terapia Ocupacional
%D 2012
%I Universidade Federal de S?o Carlos
%X Introduction: Twenty-five years after the promulgation of the 1988 Federal Constitution in Brazil, whichdefined a ¡°Sistema ¨²nico de Sa¨²de¡± (¡®SUS¡¯, or ¡°Unified Health System¡± - UHS) for the country, many advanceshave occurred, but many challenges still remain. Objective: To present the theoretical and practical bases of the¡°Aten  o Prim¨¢ria ¨¤ Sa¨²de¡± (¡®APS¡¯, or ¡°Primary Health Care¡± - PHC), in the Brazilian and Sao Paulo Stateexperiences; to discuss the service ¡°access¡± category, entrances to UHS and challenges for the universalizationof the access based on PHC. Methodology: Results analysis of the researches that have investigated the differentBrazilian and Sao Paulo State situations. Results: Different organization models coexist in PHC: the ¡°A  esProgram¨¢ticas¡± (or ¡°Programmatic Actions¡± - 1970) and the ¡°Sa¨²de da Fam¨ªlia¡± (or ¡°Family Health¡± - 1996).Results that are slightly more positive appear in the ¡°Family Health¡± strategy: health indicators, staff, completenessof approach, and quality of assistance and access. Difficulties: different degrees in the deployment of the programand staff in different municipalities; home visits only by CHA (community health agent); constant human resources (HR) shifts; difficulties in the follow-up to other levels of assistance; inequality among municipalities;fragmentation and different development levels of the local systems and health regions; under-financing of the system, especially at out-patient level and diagnosis support. Conclusion: Strategic importance of Human Resource matters: relation between services and education institutions, amount of professionals and workers,distribution, labor market, formation, profile, expectations and resistance.
%K Primary Health Care
%K Health Services Accessibility
%K Human Resource.
%U http://dx.doi.org/10.4322/cto.2012.032