This Tuesday, September 19th, the Unified Health System (SUS) celebrates its anniversary. 33 years ago, Law No. 8,080 of 1990 regulated equal and universal public health for all Brazilians. It is one of the largest and most complex public health systems in the world.
The SUS serves a national population of more than 200 million inhabitants, offering not only assistance care (medical-hospital), but also prevention and health promotion services, from pregnancy and throughout life.
“All these years of SUS services represent a milestone in the history of Brazilian public health. This complex and comprehensive system has been a fundamental pillar in promoting equality and improving quality of life”, reinforces the Deputy Secretary of Health Assistance , Luciano Agrizzi.
For citizens to have access to all this assistance, Primary Health Care (PHC) – Basic Health Units (UBSs) – is the gateway. In the DF, an average of 2.5 million individual consultations are carried out annually at this level of care, according to data from InfoSaúde. There are, in total, 175 UBSs distributed among the seven health regions. In Planaltina alone, for example, twenty-one stations operate.
APS is also primarily responsible for offering immunizations. This year alone, around 2.6 million vaccines were administered in eight and a half months, 38,600 in actions carried out in 232 schools, and 64,350 in other extramural activities, such as at fairs, parks, shopping malls and through the Vaccine Car . There were 750,000 doses against Covid-19, 895,000 against dengue and 940,000 for the so-called routine vaccination, as the immunization by age group foreseen in the annual calendar is called, today with 20 different types of immunizations planned.
In a large task force to expand vaccination coverage, held on August 26, almost 9 thousand children and adolescents under the age of 15 were present at the 99 points made available by the Department of Health (SES-DF).
Administrator Daiane, her husband Marcelo and the couple’s son, Andraus Otoni, 10 years old, were one of the first families to arrive at UBS 1 in Asa Norte on D-Day. “It has to be our first responsibility, our first agenda of the day. This is what we can do for ourselves and our children”, said the mother. She took the opportunity to get immunized against Covid-19. The child took the second dose to combat HPV (acronym in English for Human Papillomavirus). “I woke up early to get vaccinated because I think it’s important to stay protected,” Andraus highlighted.
Urgency and emergency
Specialized care (secondary and tertiary) is divided into two segments: medium and high complexity (outpatient and hospital specialized), respectively. They are part of medium complexity, for example, the Emergency Care Units (24h UPAs), Polyclinics and Psychosocial Care Centers (Caps). Every year, almost 5.5 million procedures at this level of care are performed in the DF, according to figures from the Ambulatory Information System (SIA) of the Ministry of Health (MS). The majority, around 61%, have diagnostic purposes.
Unresolved cases in this segment are guaranteed continued treatment with hospitalization and more complex medical-hospital intervention, through regulation of access to care. In 2023, until the month of July, more than 70 thousand surgeries were performed – 33,688 on an outpatient basis, reported in the SIA; and 40,802 during hospitalization, according to data from the Hospital Information System (SIH).
Marluce Pereira Gonçalves, 58 years old, had to undergo a procedure to remove her uterus. “From the first care I received at the UBS until the surgery here at the Ceilândia Regional Hospital (HRC) took less than two months. I was called very quickly,” she celebrates after realizing she could have the free procedure sooner than she expected.
The patient is one of those who benefited from the operational force promoted by the HRC in July this year to reduce the waiting list for elective surgeries – scheduled interventions, not considered urgent. At the time, the measure increased the number of procedures by 20% compared to the same period of the previous year. In addition to satisfaction with the speed, Marluce makes a point of highlighting the quality of the service. “I was very well received at the time, from the first consultations, the exams, the surgery and my recovery,” she says.
Shared management
The management of the SUS is divided between the three entities of the Federation: the Union, the states and the municipalities. The network is broad and encompasses primary, medium and high complexity care, urgent and emergency services, hospital care, epidemiological, health and environmental surveillance actions and services, in addition to pharmaceutical assistance.
SES-DF has more than 30 thousand employees working directly to operate the three levels of health care in an area of almost 5,800 square kilometers and more than three million inhabitants.
To cover this entire area and the constantly growing number of inhabitants, services are distributed in assistance units present in seven Health Regions: Center-South (Guará I and II, Estrutural/SCIA, Candangolândia, Núcleo Bandeirante, Riacho Fundo I and II, and Parkway); Central (Asa Sul, Asa Norte, Varjão, Lago Norte, Lago Sul, Cruzeiro, Sudoeste and Octogonal); North (Planaltina, Sobradinho I and II, and Fercal); South (Gama and Santa Maria); West (Ceilândia, Brazlândia, Sol Nascente and Pôr do Sol); East (Paranoá, Itapoã, Jardim Botânico and São Sebastião); and Southwest (Taguatinga, Samambaia, Vicente Pires, Águas Claras and Recanto das Emas).
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