Table 6 Timeline of the development of the HRH elements of SUS
From: Continuity and change in human resources policies for health: lessons from Brazil
1920s | Policy to establish social security insurance (initially covering workers living with families and rural workers) that was finally established in 1966 with the creation of Instituto Nacional de Previdência Social. |
|---|---|
1960-1970s | Social medicine departments created in the universities of São Paulo, Campinas, Ribeirão Preto, Minas Gerais and Rio de Janeiro. This led to development of Movimento Sanitarista which advocated and militated for universal access to care [9]. The development of this movement found fertile ground in the Centro Nacional de Recursos Humanos do Instituto de Pesquisa Económica Aplicada (CNRH/Ipea), in the financing agency Financiadora de Estudos e Projectos (Finep) and in the PREPS Program. In the late 1970s the Brazilian Association for Collective Health (ABRASCO) was created and there was the academic consolidation of the Movimento Sanitarista, with the development of a post-graduate course in collective health. This course bridged the gap between several academic institutions. It also set the basis for the latter discussions that occur in the National Health Conferences. |
1974 onwards | Beginnings of focus on social determinants of health and of reform of medical curriculum: rural internship and need to provide HR in underserved areas |
1975 | PAHO/MoH initiates new teaching method: PREPS |
1976 | Beginnings of Governmental programs to extend health coverage to the rural and underserved population (PIASS) |
1977 | Creation of a mandatory rural internship for medical doctors in Minas Gerais |
1980 | Development of Programa larga escala (training of auxiliary and elementary personnel), based on a new pedagogic approach developed by Paulo Freire. |
1982 to 1986 | Development of PREV Saúde (the Brazilian health plan), with important HRH component. |
1985 | End of dictatorship - several key appointments in Ministry of Health; HR Secretary within MoH |
1986 | 8th National Health Conference - sets the basis for the Sistema Único de Saúde (SUS), a health services system based on universal access, equality and equity and a decentralized model. |
1988 | The fundamental right to health, and the State's duty to account for citizens' health, are mentioned in the Brazil constitution of 1988. SUS is legally created and in 1990 SUS regulating laws are published |
c. 1991-1993 | Economic and financial crisis compromises implementation of SUS |
1996 | Legal norms and laws had been formulated; the SUS had begun to be implemented. |
2003 | SGTES established to handle HRH in a strategic way (National high level commission (Ministry of Health, Ministry of Education) |
Sept 2006 | Career guidelines approved by Comissão Intergestores Tripartite (CIT) and sent to the National Health Council |