Health Professionals and Resources
Paralleling private insurance, human resources are disproportionately distributed in Brazil, with overrepresentation in the wealthy states. A strong demand for physicians persists in the Amazon region, while 61.5 percent of doctors are located in the Southeast. Physicians also dominate the health field, comprising 46.8 percent of the work force and serving an average of 847 people per doctor between 1988 and 1991, while nurses (one for every 3,448 people) and other auxiliary personnel lag behind in supply.
Although most health establishments belong to the public sector (65.2 percent public and 34.8 percent private), more private institutions (43.2 percent) provide inpatient care than public (6.8 percent). These establishments range from federal, state, municipal, and university hospitals and health posts to private clinics. The distribution of hospitals and outpatient facilities favors the South and Southeast, at levels two to four times higher per capita than in the North and Northeast, where health conditions are more precarious and the need for health care is greater. The ratio of hospital beds per 1,000 population has remained fairly constant between 1985 (3.9) and 1990 (3.6), and is 33 percent higher than predicted in relation to Brazil's gross national product (GNP--see Glossary).
Brazil has adopted new medical technologies from industrialized countries. However, specialized and high-technology services benefit a minority of privileged patients. Many poor Brazilians, unable to afford hospital-based medical care, rely on both prescription and nonprescription medication to relieve their ailments. The national pharmaceutical market in 1990 was valued at close to US$4 billion, 70.5 percent of which was earned by commercial pharmacies. Judging from the disproportionate availability of drugs and medical equipment to different income groups, universal and equitable access to health care remains a goal to be reached.
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