“Inequalities in access to medicines for diabetes and hypertension across the capitals in different regions of Brazil: a population-based study”

Abstract

Background To guarantee prevention and adequate treatment, as required for the population to have access to health services and technologies, including medicines. The purpose of this study is to analyse the economic and regional inequalities in access to medicines for diabetes and hypertension among the adult population in Brazil. Methods This was a cross-sectional study with adults aged 18 and over from the VIGITEL study conducted in 2019 in all Brazilian regions. Non-access to antidiabetic and antihypertensive drugs was assessed according to formal education and housing macro-region. The slope index of inequality (SII) was used to analyse absolute inequalities. Results The total number of individuals interviewed was 52,443. Approximately 10.0% of the people with diabetes and/or hypertension reported not having access to drug treatment. The major means for having access to antihypertensive drugs, in all regions, was private pharmacies; for antidiabetics, in the North region, people had greater access through private pharmacies, while in the Northeast, Southeast and South, they had greater access through the public sector. Inequalities were found in the lack of access to medicines according to the region of residence, especially in the North region. Conclusion The lack of access to medicines showed regional disparities, particularly in the most economically vulnerable regions.

Inequalities in unmet need for health care services and medications in Brazil: a decomposition analysis

“…This mainly affects low-income households 15 with pronounced regional disparities. 16 The highly-fragmented nature of Brazil's health care system and persistent regional disparities remain major barriers to more equitable access to health care services. 17 Brazil has large geographical variations with respect to the distribution of infrastructure, human resources, access to medication, and coverage by its national health care programs.…”

“…17 Brazil has large geographical variations with respect to the distribution of infrastructure, human resources, access to medication, and coverage by its national health care programs. 16 , 18 , 19 , 20 These geographical variations in the supply of health care resources coupled with the aforementioned two-tiered (public versus private) financing system lead to disparities in both access to and quality of health care as well as protection from financial risk. 17 , 21 Results from previous studies suggest that the limited availability of health care providers, infrastructure, and pharmaceuticals in underserved areas remains among the major challenges.…”

Association Between Alcohol Consumption and Blood Pressure Levels Among HIV Sero-Positive and Sero-Negative Cohorts: A Secondary Analysis of the Vukuzazzi Study

“…Several reasons account for the problem of uncontrolled hypertension in SSA. 42 - 49 These include inadequate access to healthcare facilities and lack of affordable antihypertensive medications in situations where patients are supposed to purchase the medications themselves to treat an asymptomatic condition such as hypertension. 42 - 49 .…”

“… 42 - 49 These include inadequate access to healthcare facilities and lack of affordable antihypertensive medications in situations where patients are supposed to purchase the medications themselves to treat an asymptomatic condition such as hypertension. 42 - 49 . In fact, the Vukuzazi study was done in a district which was one of the most deprived in South Africa.…”

Persistent inequalities in health care services utilisation in Brazil (1998–2019)

“…The highly fragmented nature of the current health care system and persistent regional disparities remain major barriers to more equitable access to health care services throughout Brazil [ 15 ]. Brazil has large geographical variations with unequal distribution of infrastructure, human resources, access to medications, and coverage by national health care programmes [ 16 – 19 ]. Variations in the supply of health care resources coupled with the two-tiered (public versus private) financing system has led to disparities in both access to and quality of health care delivered as well as protection from undue financial risk [ 15 , 20 ].…”