Brazil - Health

A health and welfare program, Prevsaúde, introduced by the government in 1981, was intended to double health services by 1987. In 1993, however, Brazil's national health care system came to an end, chiefly due to extensive fraudulent activity by hospitals, physicians, and state and municipal health secretariats. The new Brazilian Minister of Health planned to implement a new system and supported legislation to increase funds for the public health sector. As of 1998, public health services, complemented by private services, covered 75% of the population. The Ministry of Health has made efforts to encourage the federal district and 26 states to participate in some quality of care projects. Initiatives include certification by the International Standards organizations, consulting services, total quality management, patient satisfaction, and development of new technologies to increase efficiency. As of 1999, total health care expenditure was estimated at 6.5% of GDP.

Health and sanitary conditions vary widely from region to region. The large cities have competent physicians, generally with advanced training abroad, but there is a dearth of doctors, hospitals, and nurses in most towns in the interior. In 1999, there were approximately 237,000 physicians, 145,000 dentists, and 77,000 nurses in Brazil. As of 1999, there were an estimated 1.3 physicians and 3.1 hospital beds per 1,000 people.

In 2000, 87% of the population had access to safe drinking water and 77% had adequate sanitation. As part of a pilot program, Brazil is fortifying sugar with vitamin A and is currently investigating the feasibility of fortifying foods with vitamin A or iron. As of 1999, children one year old and under were immunized as follows: diphtheria, pertussis, and tetanus, 90%; and measles, 99%. In 1995, cholera affected many Brazilians; 15,915 new cases were reported in 1995. The number of new AIDS cases increased each year until 1997, when 32,172 new cases were reported, with 7,545 confirmed deaths. Since then, the epidemic seems to have stabilized, with slightly fewer new cases the following year. In 1999, the number of people living with HIV/AIDS was estimated at 540,000. HIV prevalence was 0.6 per 100,000 adults in 1999.

The infant mortality rate is high, but it has declined over the last 15 years. In 2000, the infant mortality was 32 per 1,000 live births. Many Brazilian women die during childbirth. In 1998, 160 maternal deaths occurred for every 100,000 live births. As of 1999, an estimated 77% of married women between the ages of 15 and 49 years used contraception. The death rate was estimated at 9 per 1,000 people in 2002, while the average life expectancy in 2000 declined to 68 years.