Reducing Health Inequalities in Brazil’s Universal Health-Care System: Accountability Politics in São Paulo

Brazil relies on the Sistema Único de Saúde (SUS), a public health-care system used by nearly 65 per cent of the population. This article analyses the role played by accountability mechanisms in expanding access to primary health care in the municipality of São Paulo, Brazil’s largest city. Two accountability mechanisms are described and discussed: political competition and outsourcing. The article shows that from 2001 to 2016 the supply of primary care grew and the disparities in access to public health services decreased across the city areas with both the best and worst indices of income, education, and health. These distributive results are striking given how difficult it is to reverse inequalities, as attested by the findings of a number of studies in different parts of the world which indicate that the richest populations tend to persistently benefit more than the poorest from public spending on health.Open Society Foundations, Vozes Desiguais/Unequal Voices, Future Health Systems consortium, the Impact Initiative and Health Systems Globa

Equipamentos urbanos em territórios socialmente vulneráveis : os CEUs na Área Metropolitana de Brasília

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Arquitetura e Urbanismo, Programa de Pós-Graduação em Arquitetura e Urbanismo, 2020.O presente trabalho é uma contribuição às pesquisas sobre a política urbana a partir da análise do papel dos Centros de Artes e Esportes Unificados (CEUs) na configuração de tecidos urbanos com alta vulnerabilidade social, situados na Área Metropolitana de Brasília (AMB), especialmente no Município de Águas Lindas de Goiás/GO e na Região Administrativa de Ceilândia/DF. Essa análise situa os equipamentos sociais urbanos como lócus de descentralização de serviços públicos que, ao mesmo tempo, constituem a própria realidade espacial na qual atuam. Desse modo, o estudo sobre o seu possível enquadramento na categoria de políticas públicas espaciais busca consolidar elementos que permitam discutir os limites e potencialidades da atuação desses bens de consumo coletivo como suporte à estruturação dos tecidos urbanos onde estão localizados.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).This study is a contribution to the research on urban policy based on the analysis of the role of the Unified Arts and Sports Centers (Centros de Artes e Esportes Unificados – CEUs) in the context of the urban fabric with higher rates of social vulnerability, situated in the Metropolitan Area of Brasilia (AMB), in particular in the Municipality of Águas Lindas de Goiás – GO and in the Administrative Region of Ceilândia – DF. This analysis situates the urban social equipment as the locus of decentralization of public services that, at the same time, constitute the very spatial reality in which they are situated and operate. Therefore, the study on their possible classification in the category of spatial public policies seeks to consolidate elements that allow discussing the limits and potentialities of the efficiency of these collective consumer goods as a support for the structuring of the urban fabric where they are located

Novos estud . ❙❙ CeBRAP ❙❙ s à o PA uL o ❙❙ v38n02 ❙❙ 271-289 ❙❙ MAI.–AGo . 2019

Inequality is a key political issue of our times. It has political consequences, fuelling conflict and raising legitimacy chal‑ lenges for regimes around the world, in democratic and non‑demo‑ cratic settings alike. At the centre of these challenges is the question of accountability: who can be held accountable, on what basis, how and by whom for tackling or failing to tackle which inequalities. In the field of global health, inequality has long been a key issue. A significant body of work — in global health and health systems research — has approached the issue of health inequalities and in‑ equities by highlighting the role of social determinants (Marmot, 2015; Wilkinson; Pickett, 2006; Barreto, 2017). A more recent and less developed stream of work frames them in terms of political de‑ terminants: in other words, seeing them as issues that may be ad‑ dressed through politics as well as policy