Atenção à saúde nas cidades fronteiriças de Bonfim e Pacaraima: implementação do SIS-Fronteiras em Roraima

Abstract

This dissertation deals with the observed changes in health status in the municipalities of Bonfim and Pacaraima with the implementation of the SIS-Borders Project, Ministry of Health. It was found that the demand for health care services by foreigners and Brazilians living in neighboring countries has led to municipal responsible for management of the Unified Health System - SUS, negative impact on the financing of health activities and services. The research, which used primary and secondary data, was developed in the border towns of Bonfim and Pacaraima in Brazil, from March to December 2013. Health services in the public and private system have been performed in the cities were studied, and the social and economic indicators available arraised. We conducted a survey to databases of the Ministry of Health, State and Municipal Secretaries of Health, as well as other official agencies to characterize the specifics of health care in the municipalities border. Semi-structured interviews with key informants from the health systems of municipalities were also performed to size the strain experienced by the system for its use by foreigners. From the data collected we tried to show that the demand for local health services in Brazilian borders on the part of foreigners, directly impacts the planning and financing of health in the cities studied. It was found that the demand for health care services by foreigners and Brazilians living in neighboring countries has led to municipal responsible for management of the Unified Health System - SUS, negative impact on the financing of health activities and services. Various cooperation initiatives between countries were found in the area of health, but none succeeded to integrate health activities and services continuously and organized manner. The implementation of the SIS-Borders, is not enough to change the reality of public health structure of municipalities and integration between health services in border towns, particularly with Guyana.