The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil

Detalhes bibliográficos
Autor(a) principal: Carvalho, Fabio Fortunato Brasil de
Data de Publicação: 2024
Outros Autores: Vieira, Leonardo Araújo, Malhão, Thainá Alves, Loch, Mathias Roberto
Tipo de documento: preprint
Idioma: por
Título da fonte: SciELO Preprints
Texto Completo: https://preprints.scielo.org/index.php/scielo/preprint/view/8137
Resumo: Public health policies aim to provide equitable access to healthcare services as a fundamental right. In 2022, the Ministry of Health created a financial incentive to promote physical activity (IAF) in SUS Primary Health Care. The objectives of this study were to present the national panorama of the first year of implementation of the IAF and to analyze whether the municipal prioritization score, created considering the existing budget availability, was an effective criterion for greater equity in the distribution of resources in the different implementation periods (without and with targets). This is a descriptive study analyzing the absolute and relative number of municipalities and health units approved, the number of health units that received funds and the amounts paid out. To analyze equity, measures of absolute and relative inequalities between health units were calculated, grouped into quartiles according to the municipal prioritization score. The percentage of approved health units that received funds was no more than 37.6%, with R$18.05 million paid out (period without targets) and R$10.10 million (with targets). There was a 68.9% reduction in the number of health units that received funds after the targets were set. Important inequalities in the receipt of resources were revealed, with a higher percentage of health units located in municipalities with lower priority. Thus, the criteria adopted by the Ministry of Health were insufficient to guarantee equity in the allocation of resources to promote physical activity.
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spelling The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in BrazilLa búsqueda de equidad en las políticas públicas de salud: análisis de la implementación de incentivos a la actividad física en la Atención Primaria en BrasilA busca pela equidade nas políticas públicas de saúde: análise da implementação do incentivo à atividade física na Atenção Primária do BrasilEquidade em saúdeFinanciamento GovernamentalPráticas CorporaisPromoção da SaúdeHealth EquityFinancing, GovernmentBody PracticesHealth PromotionEquidad en SaludFinanciación GubernamentalPrácticas CorporalesPromoción de la SaludPublic health policies aim to provide equitable access to healthcare services as a fundamental right. In 2022, the Ministry of Health created a financial incentive to promote physical activity (IAF) in SUS Primary Health Care. The objectives of this study were to present the national panorama of the first year of implementation of the IAF and to analyze whether the municipal prioritization score, created considering the existing budget availability, was an effective criterion for greater equity in the distribution of resources in the different implementation periods (without and with targets). This is a descriptive study analyzing the absolute and relative number of municipalities and health units approved, the number of health units that received funds and the amounts paid out. To analyze equity, measures of absolute and relative inequalities between health units were calculated, grouped into quartiles according to the municipal prioritization score. The percentage of approved health units that received funds was no more than 37.6%, with R$18.05 million paid out (period without targets) and R$10.10 million (with targets). There was a 68.9% reduction in the number of health units that received funds after the targets were set. Important inequalities in the receipt of resources were revealed, with a higher percentage of health units located in municipalities with lower priority. Thus, the criteria adopted by the Ministry of Health were insufficient to guarantee equity in the allocation of resources to promote physical activity.Las políticas de salud pública apuntan a brindar acceso equitativo a los servicios de salud como un derecho fundamental. En 2022, el Ministerio de Salud creó un incentivo financiero para promover la actividad física (IAF) en la Atención Primaria de Salud del SUS. El presente trabajo tuvo como objetivo presentar el panorama nacional del primer año de implementación del IAF y analizar si el puntaje de priorización municipal, creado considerando la disponibilidad presupuestaria existente, fue un criterio efectivo para una mayor equidad en la distribución de los recursos en los diferentes períodos de implementación (sin y con metas). Se trata de un estudio descriptivo con análisis del número absoluto y relativo de municipios y unidades de salud aprobadas, unidades de salud que recibieron recursos y los montos pagados. Para analizar la equidad se calcularon medidas de desigualdades absolutas y relativas entre unidades de salud, agrupadas en cuartiles según el puntaje de priorización municipal. Se demostró que el 74% de los municipios y el 16,7% de las unidades de salud elegibles fueron aprobados por el IAF. El porcentaje de unidades de salud aprobadas que recibieron recursos no superó el 37,6%, siendo pagados R$ 18,05 millones (período sin metas) y R$ 10,10 millones (con metas). Hubo una reducción del 68,9% en las unidades de salud que recibieron recursos luego de establecer metas. Se revelaron importantes desigualdades en la recepción de recursos, con un mayor porcentaje de unidades de salud ubicadas en municipios con menor prioridad. Por tanto, los criterios adoptados por el Ministerio de Salud fueron insuficientes para garantizar la equidad en la asignación de recursos para promover la actividad física.As políticas públicas de saúde têm como objetivo proporcionar acesso equitativo aos serviços de saúde como um direito fundamental. Em 2022, o Ministério da Saúde criou um incentivo financeiro para a promoção da atividade física (IAF) na Atenção Primária à Saúde do SUS. O presente trabalho teve como objetivos apresentar o panorama nacional do primeiro ano de implementação do IAF e analisar se a nota de priorização municipal, criada considerando a disponibilidade orçamentária existente, foi um critério efetivo para maior equidade na distribuição dos recursos nos diferentes períodos de implementação (sem e com metas). Trata-se de um estudo descritivo com análises do número absoluto e relativo de municípios e unidades de saúde homologadas, de unidades de saúde que receberam recursos e dos valores pagos. Para analisar a equidade, foram calculadas as medidas de desigualdades absolutas e relativas entre as unidades de saúde, agrupadas em quartis conforme a nota de priorização municipal. Foi demonstrado que 74% dos municípios e 16,7% das unidades de saúde elegíveis foram homologadas ao IAF. O percentual de unidades de saúde homologadas que receberam recursos não passou de 37,6%, sendo pagos R$18,05 milhões (período sem metas) e R$10,10 milhões (com metas). Houve uma redução de 68,9% nas unidades de saúde que receberam recursos após o estabelecimento de metas. Foram reveladas importantes desigualdades no recebimento de recursos, com maior percentual de unidades de saúde localizadas em municípios com menor prioridade. Assim, os critérios adotados pelo Ministério da Saúde foram insuficientes para garantir equidade na alocação de recursos para a promoção da atividade física.SciELO PreprintsSciELO PreprintsSciELO Preprints2024-02-27info:eu-repo/semantics/preprintinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://preprints.scielo.org/index.php/scielo/preprint/view/813710.1590/SciELOPreprints.8137porhttps://preprints.scielo.org/index.php/scielo/article/view/8137/15172Copyright (c) 2024 Fabio Fortunato Brasil de Carvalho, Leonardo Araújo Vieira, Thainá Alves Malhão, Mathias Roberto Lochhttps://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessCarvalho, Fabio Fortunato Brasil deVieira, Leonardo AraújoMalhão, Thainá AlvesLoch, Mathias Robertoreponame:SciELO Preprintsinstname:Scientific Electronic Library Online (SCIELO)instacron:SCI2024-02-26T15:59:26Zoai:ops.preprints.scielo.org:preprint/8137Servidor de preprintshttps://preprints.scielo.org/index.php/scieloONGhttps://preprints.scielo.org/index.php/scielo/oaiscielo.submission@scielo.orgopendoar:2024-02-26T15:59:26SciELO Preprints - Scientific Electronic Library Online (SCIELO)false
dc.title.none.fl_str_mv The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
La búsqueda de equidad en las políticas públicas de salud: análisis de la implementación de incentivos a la actividad física en la Atención Primaria en Brasil
A busca pela equidade nas políticas públicas de saúde: análise da implementação do incentivo à atividade física na Atenção Primária do Brasil
title The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
spellingShingle The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
Carvalho, Fabio Fortunato Brasil de
Equidade em saúde
Financiamento Governamental
Práticas Corporais
Promoção da Saúde
Health Equity
Financing, Government
Body Practices
Health Promotion
Equidad en Salud
Financiación Gubernamental
Prácticas Corporales
Promoción de la Salud
title_short The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
title_full The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
title_fullStr The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
title_full_unstemmed The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
title_sort The search for equity in public health policies: analysis of the implementation of incentives for physical activity in Primary Care in Brazil
author Carvalho, Fabio Fortunato Brasil de
author_facet Carvalho, Fabio Fortunato Brasil de
Vieira, Leonardo Araújo
Malhão, Thainá Alves
Loch, Mathias Roberto
author_role author
author2 Vieira, Leonardo Araújo
Malhão, Thainá Alves
Loch, Mathias Roberto
author2_role author
author
author
dc.contributor.author.fl_str_mv Carvalho, Fabio Fortunato Brasil de
Vieira, Leonardo Araújo
Malhão, Thainá Alves
Loch, Mathias Roberto
dc.subject.por.fl_str_mv Equidade em saúde
Financiamento Governamental
Práticas Corporais
Promoção da Saúde
Health Equity
Financing, Government
Body Practices
Health Promotion
Equidad en Salud
Financiación Gubernamental
Prácticas Corporales
Promoción de la Salud
topic Equidade em saúde
Financiamento Governamental
Práticas Corporais
Promoção da Saúde
Health Equity
Financing, Government
Body Practices
Health Promotion
Equidad en Salud
Financiación Gubernamental
Prácticas Corporales
Promoción de la Salud
description Public health policies aim to provide equitable access to healthcare services as a fundamental right. In 2022, the Ministry of Health created a financial incentive to promote physical activity (IAF) in SUS Primary Health Care. The objectives of this study were to present the national panorama of the first year of implementation of the IAF and to analyze whether the municipal prioritization score, created considering the existing budget availability, was an effective criterion for greater equity in the distribution of resources in the different implementation periods (without and with targets). This is a descriptive study analyzing the absolute and relative number of municipalities and health units approved, the number of health units that received funds and the amounts paid out. To analyze equity, measures of absolute and relative inequalities between health units were calculated, grouped into quartiles according to the municipal prioritization score. The percentage of approved health units that received funds was no more than 37.6%, with R$18.05 million paid out (period without targets) and R$10.10 million (with targets). There was a 68.9% reduction in the number of health units that received funds after the targets were set. Important inequalities in the receipt of resources were revealed, with a higher percentage of health units located in municipalities with lower priority. Thus, the criteria adopted by the Ministry of Health were insufficient to guarantee equity in the allocation of resources to promote physical activity.
publishDate 2024
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