[The public health care system and rehabilitation actions in Brazil]. / O sistema público de saúde e as ações de reabilitação no Brasil.

OBJECTIVE: To produce a historical account of rehabilitation actions in the context of the Brazilian Unified Health Care System (SUS). METHODS: Search of SciELO, LILACS, and MEDLINE databases for literature published between 1980 and 2009. The following Portuguese search terms were used: Sistema Unico de Saúde, reabilitação, políticas de saúde, assistência médica, história. The English terms "rehabilitation" and "public health" were also used. Federal laws and Ministry of Health manuals available at the city of Rio de Janeiro Coordinating Office for Rehabilitation Programs, Fundação Instituto Oswaldo Cruz library, and in BIREME database were also surveyed. RESULTS: Only a small number of publications were recovered (four books, three Health Ministry manuals, four articles published in Brazil, one master's thesis, and one doctoral dissertation). Nevertheless, analysis of these materials revealed that since many municipalities are still incapable of ensuring the right to universal and comprehensive health care, rehabilitation actions are often carried out in a precarious manner, unsupported by an adequate and comprehensive policy. On the other hand, there have been real improvements in terms of expanding care to the population with special needs. CONCLUSIONS: There still are factors hindering the achievement of optimal results in the care to people with special needs. The challenge of action planning must be undertaken especially by municipal governments to ensure an adequate supply of services and thus equity of access and comprehensive health care.

O sistema público de saúde e as ações de reabilitação no Brasil / The public health care system and rehabilitation actions in Brazil

OBJETIVO: Realizar um levantamento histórico das ações de reabilitação no contexto do Sistema Único de Saúde (SUS). MÉTODOS: Pesquisa de materiais publicados entre 1980 e 2009 nas bases de dados SciELO, LILACS e MEDLINE. Foram utilizadas as seguintes palavras-chave em português: Sistema Único de Saúde, reabilitação, políticas de saúde, assistência médica, história. Em inglês foram utilizadas as palavras rehabilitation e public health. Também foram pesquisadas as leis federais e os manuais do Ministério da Saúde, junto à Coordenação de Programas de Reabilitação da Cidade do Rio de Janeiro, na biblioteca da Fundação Instituto Oswaldo Cruz e na base de dados BIREME. RESULTADOS: Obteve-se apenas um pequeno número de publicações (quatro livros, três manuais do Ministério da Saúde, quatro artigos nacionais, uma dissertação de mestrado e uma tese de doutorado). Entretanto, a análise desses materiais mostrou que, como muitos municípios ainda não são capazes de garantir o direito universal e integral à saúde, as ações de reabilitação são muitas vezes levadas a cabo de forma precária, sem apoio de uma política adequada e integral. Por outro lado, houve avanços concretos no sentido de ampliar o atendimento à população com necessidades especiais. CONCLUSÕES: Ainda persistem fatores que dificultam o alcance de ótimos resultados na atenção à pessoa com necessidades especiais. Cabe especialmente aos municípios o desafio de assumir o planejamento das ações, estabelecendo a oferta adequada de serviços e promovendo, assim, a equidade de acesso e a integralidade da assistência.

OBJECTIVE: To produce a historical account of rehabilitation actions in the context of the Brazilian Unified Health Care System (SUS). METHODS: Search of SciELO, LILACS, and MEDLINE databases for literature published between 1980 and 2009. The following Portuguese search terms were used: Sistema Único de Saúde, reabilitação, políticas de saúde, assistência médica, história. The English terms "rehabilitation" and "public health" were also used. Federal laws and Ministry of Health manuals available at the city of Rio de Janeiro Coordinating Office for Rehabilitation Programs, Fundação Instituto Oswaldo Cruz library, and in BIREME database were also surveyed. RESULTS: Only a small number of publications were recovered (four books, three Health Ministry manuals, four articles published in Brazil, one master's thesis, and one doctoral dissertation). Nevertheless, analysis of these materials revealed that since many municipalities are still incapable of ensuring the right to universal and comprehensive health care, rehabilitation actions are often carried out in a precarious manner, unsupported by an adequate and comprehensive policy. On the other hand, there have been real improvements in terms of expanding care to the population with special needs. CONCLUSIONS: There still are factors hindering the achievement of optimal results in the care to people with special needs. The challenge of action planning must be undertaken especially by municipal governments to ensure an adequate supply of services and thus equity of access and comprehensive health care.