ReviewBMJ global health2018
The Brazilian health system at crossroads: progress, crisis and resilience.
Review in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 197 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
197 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Health insurance status, lifestyle choices and the presence of non-communicable diseases: a systematic review.Journal of public health (Oxford, England) · 2024Pooled it
- Computational methods applied to syphilis: where are we, and where are we going?Frontiers in public health · 2023Pooled it
- Economic burden of colorectal and breast cancers attributable to lack of physical activity in Brazil.BMC public health · 2021Pooled it
- miRNAs as biomarkers for early cancer detection and their application in the development of new diagnostic tools.Biomedical engineering online · 2021Pooled it
- Trial
- Re-thinking Physical Activity Programs for Older Brazilians and the Role of Public Health Centers: A Randomized Controlled Trial Using the RE-AIM Model.Frontiers in public health · 2020Trial
- "Jack of all trades, master of none?" rethinking the value of diversity in pharmacy practice.BMC medical education · 2026Article
- Global Asthma Burden due to Attributable Risk Factors, 1990-2021, and Forecast to 2050: A Systematic Analysis of the Global Burden of Disease Study 2021.NPJ primary care respiratory medicine · 2026Article
- Nationwide decline in psychiatric hospitalizations and costs in Brazil, 2008-2022: a retrospective descriptive study evidencing reform-driven community mental health gains.Lancet regional health. Americas · 2026Article
- Beyond Triage: Cognitive Profiles and ED-To-Inpatient Costs and Resource Pathways in Older Adults.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Building a health system resilience framework: national, state, regional, and local perspectives.Lancet regional health. Americas · 2026Review
- Scaling up long-acting reversible contraception through task sharing and capacity building: an implementation science approach in Balsas, Brazil.Frontiers in global women's health · 2026Article
- Drivers and barriers for the implementation of value-based healthcare in Latin America: a cross-country qualitative policy analysis.Lancet regional health. Americas · 2026Article
- Barriers and facilitators to deprescribing in primary care in Brazil: a qualitative study of pharmacists' perspectives mapped to the Theoretical Domains Framework.Geriatrics, gerontology and aging · 2026Article
- Temporal trends in long-term relative survival of cutaneous verrucous carcinoma: a period analysis from a large-scale SEER-based cohort.Frontiers in medicine · 2026Article
- Accountability and equity in primary health care: co-creating user-centered evaluation systems for public-private partnerships.Frontiers in public health · 2026Article
- Spatial disparities of COVID-19 pandemic in cerebrovascular diseases in Brazil.Communications medicine · 2025Article
- Financing surgery in LMICs: building sustainable and equitable systems for universal surgical access - a narrative review.BMC surgery · 2025Review
- Primary health care policy investments in the Latin America context: Health systems experiences from Brazil, Chile, and Colombia.Health policy OPEN · 2025Article
- Preventable hospitalizations due to ambulatory care sensitive conditions in Latin America (2015-2019): a multi-country descriptive analysis.Lancet regional health. Americas · 2025Article
137 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
The Unified Health System (Sistema Único de Saúde (SUS)) has enabled substantial progress towards Universal Health Coverage (UHC) in Brazil. However, structural weakness, economic and political crises and austerity policies that have capped public expenditure growth are threatening its sustainability and outcomes. This paper analyses the Brazilian health system progress since 2000 and the current and potential effects of the coalescing economic and political crises and the subsequent austerity policies. We use literature review, policy analysis and secondary data from governmental sources in 2000-2017 to examine changes in political and economic context, health financing, health resources and healthcare service coverage in SUS. We find that, despite a favourable context, which enabled expansion of UHC from 2003 to 2014, structural problems persist in SUS, including gaps in organisation and governance, low public funding and suboptimal resource allocation. Consequently, large regional disparities exist in access to healthcare services and health outcomes, with poorer regions and lower socioeconomic population groups disadvantaged the most. These structural problems and disparities will likely worsen with the austerity measures introduced by the current government, and risk reversing the achievements of SUS in improving population health outcomes. The speed at which adverse effects of the current and political crises are manifested in the Brazilian health system underscores the importance of enhancing health system resilience to counteract external shocks (such as economic and political crises) and internal shocks (such as sector-specific austerity policies and rapid ageing leading to rise in disease burden) to protect hard-achieved progress towards UHC.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.