Integração regional em cidades gêmeas do Paraná, Brasil, no âmbito da saúde

Abstract

This field research aimed to identify healthcare integration among four twin cities in Paraná State, Brazil, the determinants of cross-border movements of foreigners, and the obstacles to such integration. Data were collected through in-depth interviews with key informants that were analyzed with thematic content analysis. The results showed that asymmetries in the structure, resources, supply, and quality of the network's health services are determinants of cross-border movements. The experiences with integration are limited basically to emergency measures in health surveillance. Working groups are formed with limited case-resolution capacity, depending on personal, non-institutionalized initiatives. Public underfinancing is a limiting factor for access to health services. Municipal health services managers play a leading role in border areas, and they should be acknowledged as international political actors.

Aspects related to the outcomes of the treatment, in international borders, of cases of tuberculosis as associated to comorbidities

“…In border regions, health is a strategic element for integrating border societies and citizens. Therefore, studies have been highlighting the importance of implementing strategies that can bring together separate health systems (19) , offering healthcare actions targeted at the first level of healthcare.…”

“…Not only this integration is necessary, but it is also essential to invest in the diminution of social inequalities and of the negative impact of TB in the economic growth and social development of these countries (19) .…”

HIV/AIDS em região de tríplice fronteira: subsídios para reflexões sobre políticas públicas

“…Brazil, for example, when compared to Paraguay and Bolivia, presents a public health policy of universal access, which leads to the process of Pendular Migration. 11,12 That is, individuals leave their city of residence/origin for another, in search of better conditions, either of access to health, work or education, returning in the same day or in a few days. 13 The Bolivian National Health System, for example, is not universally accessible, care actions are fragmented and citizens need to pay for care, whether in public or private establishments.…”

Pandemia e imigração: famílias haitianas no enfrentamento da COVID-19 no Brasil

“…Integration among countries is the result of social, cultural, and economic public policies strategically decided for the development of nations. 1 In a cooperative and humanitarian manner, Brazil has adopted immigration policies for people seeking residence and work in the country. In the last 10 years, the emigration and immigration movement has intensified, and there has been the departure from the country of origin and arrival of Haitians in Brazil, especially after the earthquake that hit the capital Port-au-Prince in 2010.…”

“…In the case of health, the principles of equity, integrality, and universality of the Single Health System (SUS) are frequently pointed out by immigrants moving to the country. 1 Most Haitian immigrants are black and poor people who are underemployed and face competitive disadvantages due to racism, difficulties in cultural and linguistic adaptation, access to information, and little knowledge of their rights and duties. 2 Add to this concerns and feelings related to the estrangement of family members, since many have left children, spouses, parents, grandparents and others in precarious social and financial situations in their country of origin.…”