Challenges to the provision of specialized care in remote rural municipalities in Brazil.

This case study analyses the challenges to providing specialized care in Brazilian remote rural municipalities (RRM). Interviews were conducted with managers from two Brazilian states (Piauí and Bahia). We identified that the distance between municipalities is a limiting factor for access and that significant care gaps contribute to different organizational arrangements for providing and accessing specialized care. Physicians in all the RRMs offer specialized care by direct disbursement to users or sale of procedures to managers periodically, compromising municipal and household budgets. Health regions do not meet the demand for specialized care and exacerbate the need for extensive travel. RRM managers face additional challenges for the provision of specialized care regarding the financing, implementation of cooperative arrangements, and the provision of care articulated in networks to achieve comprehensive care, seeking solutions to the locoregional specificities.

Ações intersetoriais para a promoção da saúde / Intersectorial action for the promotion of health

Apresenta-se o projeto intersetorial de fomento à Cultura de Paz, desenvolvido pela Prefeitura Municipal de Juazeiro (BA). O Projeto prevê inicialmente a identificação de parceiros e a implantação do Fórum de Construção da Paz, com o objetivo de analisar os indicadores da situação de vida no municipio e formular um plano intersetorial de prevenção à violência orientado para a promoção da saúde e qualidade de vida. As ações desenvolvidas demonstram novas formas de organização e intervenção, integrando o governo municipal e a sociedade civil