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Brazil: Emphasis on Family Health
Wentz/Miller & Associates Global CME Newsletter

Brazil, a country of 175 million people, has a National Health System which provides care to about 75% of the population, mainly through its Family Health System.

In many parts of the country, health teams consisting of a family doctor, nurse, nurse tech and community health agents, are each responsible for the health of 1500 families. They offer health promotion, disease prevention, clinical care and public health procedures. There have been "outstanding results" from this strategy, says Laura Feuerwerker of the Brazilian Ministry of Health.

There are problems, however. Ms. Feuerwerker notes the difficulty of expanding the strategy to big cities and linking the system to secondary level health units. Others have noted that many of the "family" doctors lack training as such, and may be specialists who couldn't find a position elsewhere.

Brazil has yet to create a continuing medication education system, though there are many CME programs in existence. But it is not clear that much is being done yet to systematically upgrade the competence of the family health professionals, despite a recent agreement between the Ministries of Health and Education to build initiatives in undergraduate, graduate and continuing education. There is also an effort by the Innovare Institute to develop and disseminate inovations and creative solutions for health professions education, health management and primary care.

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