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ASSESSING THE RELEVANCE OF INDICATORS IN TRACKING SOCIAL DETERMINANTS AND PROGRESS TOWARD EQUITABLE POPULATION HEALTH IN BRAZIL
Determinantes sociais da saúde
Desigualdade
Capital próprio
Cobertura universal de saúde
Social determinants of health
Inequality
Equity
universal healthcare coverage
Autor(es)
Afiliação
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Brasília, DF, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Fiocruz. ICICT. Rio de Janeiro, RJ, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Brasília, DF, Brasil / University of Brasilia. Nucléo de Medicina Tropical. Brasilia, DF, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Fiocruz. ICICT. Rio de Janeiro, RJ, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil
Fundação Oswaldo Cruz. Brasília, DF, Brasil / University of Brasilia. Nucléo de Medicina Tropical. Brasilia, DF, Brasil
Federal University of Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil / Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil
Resumo em Inglês
The importance of the social determinants of health (SDH) and barriers to the access and utilization of healthcare have been widely recognized but not previously studied in the context of universal healthcare coverage (UHC) in Brazil and other developing countries. Objective: To evaluate a set of proposed indicators of SDH and barriers to the access and utilization of
healthcare proposed by the SDH unit of the World Health Organization with respect to their relevance in
tracking progress in moving toward equitable population health and UHC in Brazil.
Design: This study had a mixed methodology, combining a quantitative analysis of secondary data from
governmental sources with a qualitative study comprising two focus group discussions and six key informant
interviews. The set of indicators tested covered a broad range of dimensions classified by three different
domains: environment quality; accountability and inclusion; and livelihood and skills. Indicators were stratified
according to income quintiles, urbanization, race, and geographical region.
Results: Overall, the indicators were adequate for tracking progress in terms of the SDH, equity, gender, and
human rights in Brazil. Stratifications showed inequalities. The qualitative analysis revealed that many of the
indicators were well known and already used by policymakers and health sector managers, whereas others
were considered less useful in the Brazilian context.
Conclusions: Monitoring and evaluation practices have been developed in Brazil, and the set of indicators
assessed in this study could further improve these practices, especially from a health equity perspective.
Socioeconomic inequalities have been reduced in Brazil in the last decade, but there is still much work to be
done in relation to addressing the SDH.
Palavras-chave
AcompanhamentoDeterminantes sociais da saúde
Desigualdade
Capital próprio
Cobertura universal de saúde
Palavras-chave em inglês
MonitoringSocial determinants of health
Inequality
Equity
universal healthcare coverage
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