Relatório luz da Agenda 2030 de desenvolvimento sustentável: síntese III / Relatório Luz / Spotlight report on the 2030 sustainable development agenda: synthesis III Brazil

O Grupo de Trabalho da Sociedade Civil para a Agenda 2030, GTSC A2030, foi formalizado em setembro de 2014 e é resultado do encontro entre organizações não governamentais, movimentos sociais, fóruns e fundações brasileiras durante o seguimento das negociações da Agenda pós-2015. Desde então, atua na difusão, promoção e monitoramento da Agenda 2030, assim como da Agenda de Ação de Adis Abeba, em âmbito local, nacional e internacional.

This summary version of the Civil Society Spotlight Report indicates the magnitude of Brazil's challenges, whose policies to promote equality, and access to social and environmental justice have been losing status, budget, or have been simply eliminated in the last six months. It shows a rapid dismantling of strategic programs to achieve the Sustainable Development Goals, permeated by scandals in the three levels of power, fuelled by ultra-liberal, elitist, and ineffective policies that deepen the social-economic crisis which, in turn, is used to justify environmental degradation and social aggression. The federal government ignores laws and evidence, insisting on simplistic and misguided solutions to complex challenges, including by reorienting the foreign policy to the point of alienating historic geopolitical allies. The data presented here is from official sources, revealing a trend toward increasing inequalities and violence, which, if not reversed, will make Brazil an unsustainable country by 2030.

Equidad en la Política de Reforma del Sistema de Salud / Reform and equity in the access to and use of health services in Bogotá, Colombia

En el presente estudio nos propusimos evaluar el impacto de la transformación del Sistema Nacional de Salud en Sistema de Seguridad Social en Salud, sobre la equidad en el acceso, la utilización y la calidad de los servicios de salud. Interpretamos la equidad como la igualdad de todos los individuos frente a las oportunidades de acceso real a los servicios de salud. Llevamos a cabo un estudio transversal para detectar las diferencias que pudiesen existir entre los afiliados y los no afiliados, y los tipos de afiliación en términos de acceso y utilización de los servicios de salud. Se aplicó una encuesta a 364 hogares con 1.324 personas mayores de 9 años sobre aspectos sociodemográficos y laborales, afiliación a la seguridad social, tipo de afiliación (régimen contributivo y subsidiado) utilización de los servicios de salud, atención y gasto en salud. En hospitales de nivel 1, 2 y 3 se escogieron al azar 297 usuarios del servicio de consulta externa y se les aplicó una encuesta sobre afiliación, conocimiento de derechos, oportunidad de atención, calidad del servicio, satisfacción general y participación social. Una vez que se controló para género, edad, estrato de vivienda, ocupación e ingreso se encontraron numerosas diferencias no justificadas en la necesidad, la consulta, el sitio al que se acude, el motivo para no consultar, la atención recibida y la utilización de servicios. Estos problemas de equidad remiten al diseño, la estructura y la operación del modelo de competencia regulada.(AU)

In the present study we intended to evaluate the impact of the transformation of the national health system into the Social Security Health System upon the equity in access to health services as well as their use and quality. We interpreted equity as the equal opportunity for all people of gaining real access to health services. A cross-sectional study was designed to detect the differences, which might exist between affiliated and non-affiliated people, and the differences in access to and use of health services according to the nature of affiliation. A survey was carried out in 364 households comprising 1324 people aged 9 years or older, in which socio-demographic and labor aspects, affiliation to social security, nature of the affiliation (contributive or subsidized regime), use of health services, attention and expenditure in health services were studied. 297 randomly chosen patients of the outpatient clinics of hospitals of levels 1,2 and 3 were asked to answer a survey about affiliation, awareness of their rights, opportunity and quality of the health service, general satisfaction and social participation. Numerous differences, which could not be justified by necessity, cause for requesting attention, place where people demanded health services, attention received or use of health services, were found once adjustments for gender, age, housing stratum, occupation and income were made. These problems in equity relate to the design, structure and operation of the model of regulated competition.(AU)