LEADER 04685nam 2200721Ia 450 001 9910971188703321 005 20200520144314.0 010 $a9780821399323 010 $a0821399322 024 7 $a10.1596/978-0-8213-9843-2 035 $a(CKB)2550000001100295 035 $a(OCoLC)857076888 035 $a(CaPaEBR)ebrary10731996 035 $a(SSID)ssj0000917176 035 $a(PQKBManifestationID)11576127 035 $a(PQKBTitleCode)TC0000917176 035 $a(PQKBWorkID)10878250 035 $a(PQKB)11706037 035 $a(MiAaPQ)EBC1316477 035 $a(Au-PeEL)EBL1316477 035 $a(CaPaEBR)ebr10731996 035 $a(CaONFJC)MIL504721 035 $a(OCoLC)853548999 035 $a(DNLM)101609520 035 $a(US-djbf)17762529 035 $a(Perlego)1484307 035 $a(EXLCZ)992550000001100295 100 $a20130603d2013 uy 0 101 0 $aeng 135 $aurcn||||||||| 181 $2rdacontent 182 $2rdamedia 183 $2rdacarrier 200 10$aTwenty years of health system reform in Brazil $ean assessment of the Sistema Un?ico de Saud?e /$fMichele Gragnolati, Magnus Lindelow, Bernard Couttolenc 205 $a1st ed. 210 $aWashington, D. C. $cWorld Bank$d2013 215 $a1 online resource (pages cm) 300 $aBibliographic Level Mode of Issuance: Monograph 311 08$a9780821398432 311 08$a0821398431 311 08$a9781299734708 311 08$a1299734707 320 $aIncludes bibliographical references and index. 327 $aHave the SUS reforms transformed the Brazilian health system? -- Have the SUS reforms led to better outcomes?. 330 $aIt has been over twenty years since the Brazilian Sistema Único de Saúde (Unified Health System or SUS) was formally established by the 1988 Constitution. The impetus for the SUS came in part from rising costs and a crisis in the social security system that preceded the reforms, but also from a broad-based political movement calling for democratization and improved social rights. Building on reforms that started in the 1980s, the SUS was based on three overarching principles: (i) universal access to health services, with health defined as a citizen’s right and an obligation of the state; (ii) equality of access to health care; and (iii) integrality (comprehensiveness) and continuity of care; along with several other guiding ideas, including decentralization, increased participation, and evidence-based prioritization. The SUS reform established health a fundamental right and duty of the state, and started a process of fundamentally transforming Brazil’s health system to achieve this goal. So, what has been achieved since the SUS was established? And what challenges remain in achieving the goals that were established in 1988? These questions are the focus of this report. Specifically, it seeks to assess whether the SUS reforms have managed to transform the health system as envisaged more than 20 years ago, and whether the reforms have led to improved outcomes in terms of access to services, financial protection, and health status.Any effort to assess the performance of a health system runs into a host of challenges concerning the definition of boundaries of the "health system", the outcomes that the assessment should focus on, data sources and quality, and the role of policies and reforms in understanding how the performance of the health system has changed over time. Building on an extensive literature on health system assessment, this report is 330 8 $abased on a simple framework that specifies a set of health system "building blocks", which affect a number of intermediate outcomes such as access, quality and efficiency, which, in turn, contribute to final outcomes, including health status, financial protection, and satisfaction. Based on this framework, the report starts by looking at how key building blocks of Brazil’s health system have changed over time and then moves on to review performance in terms of intermediate and final outcomes. 410 0$aWorld Bank e-Library. 606 $aPublic health administration$zBrazil 606 $aHealth care reform$zBrazil 615 0$aPublic health administration 615 0$aHealth care reform 676 $a362.10981 700 $aGragnolati$b Michele$f1968-$01811170 701 $aLindelow$b Magnus$01811411 701 $aCouttolenc$b Bernard$01805155 712 02$aWorld Bank. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9910971188703321 996 $aTwenty years of health system reform in Brazil$94363276 997 $aUNINA LEADER 04919nam 2200721Ia 450 001 9911019640003321 005 20250212142122.0 010 $a9786612025389 010 $a9781282025387 010 $a1282025384 010 $a9783527616053 010 $a3527616055 010 $a9783527616046 010 $a3527616047 035 $a(CKB)1000000000578771 035 $a(EBL)482244 035 $a(SSID)ssj0000101645 035 $a(PQKBManifestationID)11127015 035 $a(PQKBTitleCode)TC0000101645 035 $a(PQKBWorkID)10043026 035 $a(PQKB)10542837 035 $a(MiAaPQ)EBC482244 035 $a(OCoLC)264716668 035 $a(Perlego)2750593 035 $a(EXLCZ)991000000000578771 100 $a19931109d1994 uy 0 101 0 $aeng 135 $aur|n|---||||| 181 $ctxt 182 $cc 183 $acr 200 00$aAlternatives to animal testing $enew ways in the biomedical sciences, trends and progress /$fedited by Christoph A. Reinhardt on behalf of the Swiss Institute for Alternatives to Animal Testing, SIAT 210 $aWeinheim ;$aNew York $cVCH$dc1994 215 $a1 online resource (202 p.) 300 $aPapers from a symposium held at the ETH, Zurich on Nov. 30, 1992, and updated to include developments through fall 1993. 311 08$a9783527300433 311 08$a3527300430 320 $aIncludes bibliographical references and index. 327 $aAlternatives to Animal Testing; Preface; In memoriam; Foreword; List of contributors; Contents; 1 Looking Back 33 Years to Russell and Burch: The Development of the Concept of the Three Rs (Alternatives); 2 The OECD and International Regulatory Acceptance of the Three Rs; 3 The European Centre for the Validation of Alternative Methods (ECVAM); 4 A Timetable for Replacing, Reducing and Refining Animal Use with the Help of in Vitro Tests: The Limulus Amebocyte Lysate Test (LAL) as an Example 327 $a5 The Fund for the Replacement of Animals in Medical Experiments (FRAME): 23 Years of Campaigning for the Three Rs6 Animal Use and Alternatives: Developments in the Netherlands; 7 The RIVM Center for Alternatives to Animal Testing and the Concept of the Three Rs in the Quality Control of Vaccines; 8 ZEBET: Three Years of the National German Center for Documentation and Evaluation of Alternatives to Animal Experiments at the Federal Health Office (BGA) in Berlin; 9 Reviewed Literature Databank for Alternatives to Animal Experiments - "Gelbe Liste" 327 $a10 The SIAT Research, Teaching and Consulting Program in the Area of in Vitro Toxicology. Experimental Research, Screening and Validation11 Computer-Aided Drug Design and the Three Rs; 12 Computer-Aided Programs in Biomedical Education; 13 Alternatives to Experiments with Animals in Medical Education: A TEMPUS Joint European Project; 14 Replacement of Laboratory Animals in the Management of Blood- Sucking Arthropods; 15 Maintenance of Filarial Cycles in the Laboratory: Approaches to Replacing the Vertebrate Host 327 $a16 Improved Drug Metabolizing Capacity of Hepatocytes Co-Cultured with Epithelial Cells and Maintained in a Perifusion System17 Characterization and Use of Long-Term Liver Cultures to Evaluate the Toxicity of Cyclophosphamide or Benzene to Bone Marrow Cultures; 18 European Interlaboratory Evaluation of an in Vitro Ocular Irritation Model (Skin2TM Model ZK1100) Using 18 Chemicals and Formulated Products; 19 Cellular Assays for Testing Peritoneal Dialysis Bags; 20 The Position of the Authorities; Subject index 330 $aOpinion leaders in science and politics examine findings and legislation in alternatives to animal testing!Refine, reduce, replace - These are the three demands that scientists have placed upon themselves in their search for alternatives to animal testing. Indeed much interdisciplinary research is being carried on today, and new fields have emerged, such as in-vitro toxicology. The three R's call for new scientific insights. Moreover, validation and acceptance strategies have to be adapted, a process of much ongoing interest and vital concern to the pharmaceutical and cosmetic 606 $aAlternative toxicity testing$vCongresses 606 $aAnimal experimentation$vCongresses 606 $aTests de toxicitat$2thub 606 $aExperimentació animal$2thub 608 $aCongressos$2thub 608 $aLlibres electrònics$2thub 615 0$aAlternative toxicity testing 615 0$aAnimal experimentation 615 7$aTests de toxicitat 615 7$aExperimentació animal 676 $a619 701 $aReinhardt$b Christoph A$0974294 712 02$aSwiss Institute for Alternatives to Animal Testing. 801 0$bMiAaPQ 801 1$bMiAaPQ 801 2$bMiAaPQ 906 $aBOOK 912 $a9911019640003321 996 $aAlternatives to animal testing$92218145 997 $aUNINA