Twenty Years of Health System Reform in Brazil


Book Description

It has been more than 20 years since Brazil's 1988 Constitution formally established the Unified Health System (Sistema Unico de Saude, SUS). Building on reforms that started in the 1980s, the SUS represented a significant break with the past, establishing health care as a fundamental right and duty of the state and initiating a process of fundamentally transforming Brazil's health system to achieve this goal. This report aims to answer two main questions. First is have the SUS reforms transformed the health system as envisaged 20 years ago? Second, have the reforms led to improvements with regard to access to services, financial protection, and health outcomes? In addressing these questions, the report revisits ground covered in previous assessments, but also brings to bear additional or more recent data and places Brazil's health system in an international context. The report shows that the health system reforms can be credited with significant achievements. The report points to some promising directions for health system reforms that will allow Brazil to continue building on the achievements made to date. Although it is possible to reach some broad conclusions, there are many gaps and caveats in the story. A secondary aim of the report is to consider how some of these gaps can be filled through improved monitoring of health system performance and future research. The introduction presents a short review of the history of the SUS, describes the core principles that underpinned the reform, and offers a brief description of the evaluation framework used in the report. Chapter two presents findings on the extent to which the SUS reforms have transformed the health system, focusing on delivery, financing, and governance. Chapter three asks whether the reforms have resulted in improved outcomes with regard to access to services, financial protection, quality, health outcomes, and efficiency. The con




Hospital Performance in Brazil


Book Description

Hospitals are at the center of the health care universe in Brazil. When ill, many Brazilians go straight to the hospital for want of a family doctor or primary care network. Hospitals are a critical part of the government's budget, absorbing nearly 70 percent of public spending on health. Hospitals influence the ebb and flow of politician's careers when hospital mishaps hit the headlines or the limelight falls on high-performing hospitals. Hospitals are at the forefront of policy discussions in Brazil. The discussions reflect their promise as centers of technological innovation and medical advances as well as widespread concern about their cost and quality. Brazilian hospitals are important to many people for many different reasons. What makes hospitals important is easy to understand. What makes hospitals deliver quality care efficiently or not is much harder to grasp. Can Brazil improve the performance of its hospitals? The evidence presented in this volume suggests that the answer is yes. However, it will take strong leadership, coordinated efforts of federal, state, and municipal governments, direct engagement with the private health sector, and systematic but continuous vision, policies, and actions. Such enabling factors have been generally weak or absent in the Brazilian health system. Promising initiatives have often been gutted or scrapped after changes of government.




Access to Financial Services in Brazil


Book Description

There is an increasing awareness that access to financial services can contribute to economic growth and poverty reduction. This study focuses on the delivery of financial services in Brazil, one of the world's most important emerging financial markets. It examines different aspects of financial service provision, and explores approaches to address problems of financial exclusion. Topics discussed include: microfinance schemes; private banking; rural finance systems; institutional infrastructure; and the role of government policy.




Causes of Deforestation of the Brazilian Amazon


Book Description

Annotation This title studies the role of cattle ranching its dynamic and profitability in the expansion of deforestation in Brazilian Amazonia. It provides a social evaluation of deforestation in this region and presents and compares a number of different scenarios and proposed recommendations.




Expanding Bank Outreach Through Retail Partnerships


Book Description

"This paper explores the extent to which formal, regulated financial institutions such as banks have been able to partner with "correspondents"- commercial entities whose primary objective and business is other than the provision of financial services. The paper illustrates the case of Brazil, where banks recently have developed extensive networks of such correspondents. Such arrangements result in lower costs and shared risks for participating financial institutions, making these arrangements an attractive vehicle for outreach to the underserved. Correspondent banking requires an enabling environment to emerge, and poses some regulatory challenges and some increase in risk. While there are reasons why this model was particularly successful in Brazil, it may be replicable elsewhere if appropriate regulatory adjustments are undertaken."




Great Teachers


Book Description

This book analyzes teacher quality in Latin America and the Caribbean, which is the key to faster education progress. Based on new research in 15,000 classrooms in seven different countries, it documents the sources of low teacher quality and distills the global evidence on practical policies that can help the region produce "great teachers."




Jobs and Growth


Book Description

Brazil approaches its 2018 election with an economy that is gradually recovering from the deepest recession in its recent economic history. However, for many Brazilians, the recovery has not yet translated into new and better jobs, or rising incomes. This book explores the drivers of future employment and income growth. Its key finding: Brazil needs to dramatically improve its performance across all industries in terms of productivity if the country is to provide better jobs for its citizens and generate lasting gains in incomes growth for all. This is particularly important as Brazil is aging rapidly and the boost the country has enjoyed thanks to its young and growing labor force in the past decades will disappear in just a few years’ time. The book recommends a change in the relationship between the state and business, from rewarding privileged incumbents to fostering competition and innovation—together with supporting workers and firms to adjust to the demands of the market. The book is addressed to all scholars and students of Brazil’s economy, especially those interested in why the country’s economic performance has not kept up with earlier achievements since the reintroduction of democracy in the mid-1980s. Its conclusions are urgent and pertinent but also optimistic. With the right policy mix, Brazil could enter the third century of its independence in 2022 well on track to join the ranks of high income countries.




What a Waste 2.0


Book Description

Solid waste management affects every person in the world. By 2050, the world is expected to increase waste generation by 70 percent, from 2.01 billion tonnes of waste in 2016 to 3.40 billion tonnes of waste annually. Individuals and governments make decisions about consumption and waste management that affect the daily health, productivity, and cleanliness of communities. Poorly managed waste is contaminating the world’s oceans, clogging drains and causing flooding, transmitting diseases, increasing respiratory problems, harming animals that consume waste unknowingly, and affecting economic development. Unmanaged and improperly managed waste from decades of economic growth requires urgent action at all levels of society. What a Waste 2.0: A Global Snapshot of Solid Waste Management to 2050 aggregates extensive solid aste data at the national and urban levels. It estimates and projects waste generation to 2030 and 2050. Beyond the core data metrics from waste generation to disposal, the report provides information on waste management costs, revenues, and tariffs; special wastes; regulations; public communication; administrative and operational models; and the informal sector. Solid waste management accounts for approximately 20 percent of municipal budgets in low-income countries and 10 percent of municipal budgets in middle-income countries, on average. Waste management is often under the jurisdiction of local authorities facing competing priorities and limited resources and capacities in planning, contract management, and operational monitoring. These factors make sustainable waste management a complicated proposition; most low- and middle-income countries, and their respective cities, are struggling to address these challenges. Waste management data are critical to creating policy and planning for local contexts. Understanding how much waste is generated—especially with rapid urbanization and population growth—as well as the types of waste generated helps local governments to select appropriate management methods and plan for future demand. It allows governments to design a system with a suitable number of vehicles, establish efficient routes, set targets for diversion of waste, track progress, and adapt as consumption patterns change. With accurate data, governments can realistically allocate resources, assess relevant technologies, and consider strategic partners for service provision, such as the private sector or nongovernmental organizations. What a Waste 2.0: A Global Snapshot of Solid Waste Management to 2050 provides the most up-to-date information available to empower citizens and governments around the world to effectively address the pressing global crisis of waste. Additional information is available at http://www.worldbank.org/what-a-waste.




Public Debt


Book Description




The Global Findex Database 2017


Book Description

In 2011 the World Bank—with funding from the Bill and Melinda Gates Foundation—launched the Global Findex database, the world's most comprehensive data set on how adults save, borrow, make payments, and manage risk. Drawing on survey data collected in collaboration with Gallup, Inc., the Global Findex database covers more than 140 economies around the world. The initial survey round was followed by a second one in 2014 and by a third in 2017. Compiled using nationally representative surveys of more than 150,000 adults age 15 and above in over 140 economies, The Global Findex Database 2017: Measuring Financial Inclusion and the Fintech Revolution includes updated indicators on access to and use of formal and informal financial services. It has additional data on the use of financial technology (or fintech), including the use of mobile phones and the Internet to conduct financial transactions. The data reveal opportunities to expand access to financial services among people who do not have an account—the unbanked—as well as to promote greater use of digital financial services among those who do have an account. The Global Findex database has become a mainstay of global efforts to promote financial inclusion. In addition to being widely cited by scholars and development practitioners, Global Findex data are used to track progress toward the World Bank goal of Universal Financial Access by 2020 and the United Nations Sustainable Development Goals. The database, the full text of the report, and the underlying country-level data for all figures—along with the questionnaire, the survey methodology, and other relevant materials—are available at www.worldbank.org/globalfindex.