Evidence map›Paper›PMID 40985341›Full record

ArticleGlobal health action2025

Disability inclusion in the Brazilian health system: results of a health system assessment.

Sarah Polack, Vinicius Delgado Ramos, Luciana Sepúlveda Köptcke, Indyara de Araujo Morais, Veronika Reichenberger, Nathaniel Scherer, Maria Do Socorro Veloso de Albuquerque, Hannah Kuper, Tereza Maciel Lyra, Christina May Moran de Brito

Abstract read
In one paragraph

Article in Global health action, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Sarah PolackInternational Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.ORCID 0000-0002-7524-7396
Vinicius Delgado RamosHospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.ORCID 0000-0002-4566-6637
Luciana Sepúlveda KöptckeFundação Instituto Oswaldo Cruz, Brasília, Brazil.ORCID 0000-0001-7079-6575
Indyara de Araujo MoraisDisability Observatory, Center for Public Health Studies, University of Brasilia, Brasília, Brazil.ORCID 0000-0001-6662-0788
Veronika ReichenbergerInternational Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.ORCID 0000-0001-6778-2682
Nathaniel SchererInternational Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.ORCID 0000-0003-1846-8691
Maria Do Socorro Veloso de AlbuquerqueCenter for Medical Sciences, Federal University of Pernambuco, Recife, Brazil.ORCID 0000-0002-1520-700X
Hannah KuperInternational Centre for Evidence in Disability, London School of Hygiene & Tropical Medicine, London, UK.ORCID 0000-0002-8952-0023
Tereza Maciel LyraDepartment of Collective Health, Aggeu Magalhães Institute, FIOCRUZ/PE, Recife, Brazil.ORCID 0000-0002-3600-7250
Christina May Moran de BritoCancer Institute of the State of São Paulo of the Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, and Hospital Sírio-Libanês, São Paulo, Brazil.ORCID 0000-0003-3775-6533

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPeople with disabilities face more barriers accessing healthcare and on average experience worse health outcomes. Strengthening health access for people with disabilities requires coordinated action across the health system. The Missing Billion Inclusive Health System Framework is a new tool to support policy makers to assess levels of disability inclusion within health systems.

objectivesThis study uses the Missing Billion framework in Brazil to i) contribute to the further testing and development of the framework and ii) assess the level of disability inclusion within the Unified Health System.

methodsInformation sources used to complete the assessment included Brazilian laws and policies, publicly available data, published literature, literature reviews and interviews with people with disabilities and service providers in São Paulo, Santos, Brasília and Arcoverde. A workshop with stakeholders was held to co-develop key recommendations.

resultsOverall, the Missing Billion framework was comprehensive and feasible to complete. It highlighted key strengths in terms of disability inclusion in the Brazilian health system as well as gaps and leverage points for action.

conclusionsThe Missing Billion framework can identify progress and opportunities to strengthen disability inclusion in health systems. In Brazil, key promotive factors include supportive policies, leadership and financing structures. There are also opportunities for strengthening data and evidence, healthcare worker training on disability and health service accessibility. Actions must be centered on and informed by people with disabilities.

Indexed as

Delivery of Health CareHealth Services AccessibilityNational Health ProgramsPersons with DisabilitiesBrazilHealth PolicyHumansBrazildisabilityfeasibilityframeworkhealth systemsservice delivery

Identifiers

PMID40985341
PMCPMC12459170

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.