The Lancet: Heath in Brazil

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The Lancet released a series of articles in May 2011 that looked at the progress made, policies enacted and remaining challenges in Brazil’s push for universal health care.

Brazil has made significant improvements in maternal and child health, emergency care, and in reducing the burden of infectious diseases. However, the country continues to have a high levels of obesity and a burden of injury deaths that is different from other countries due to the large number of murders.

The series includes six articles that critically examine what the country’s policies have achieved and where future challenges lie. Topics include: the Brazilian health system; maternal and child health; infectious diseases; non-communicable diseases; violence and injuries; and health policy innovations.

The Lancet: Heath in Brazil

All articles are open acces, free registration is required.

Obesity prevention in Brazil should focus on eating healthy and eating less

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Obesity prevention messages should not only focus on eating healthy, but also eating less food, finds a study from Brazil. According to the study, a high availability of healthy foods does not necessarily mean a low availability of unhealthy foods, i.e., people are not replacing the purchase of unhealthy foods with healthy foods. They, in fact, just eat more overall.

Among populations with low access to food, a higher diversity of available healthy foods was associated with a lower prevalence of underweight. As expected, households with higher incomes and education levels had greater dietary diversity.

1. Bezerra IN, Sichieri R. Household food diversity and nutritional status among adults in Brazil. International Journal of Behavioral Nutrition and Physical Activity 2011; 8: 22. (open access)

Knowledge of HPV, cervical cancer and vaccines among young women in Brazil

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HPV and cervical cancer education is needed for young Brazilian women

Young Brazilian women of low socioeconomic status were found to have low levels of knowledge of human papillomavirus (HPV) and cervical cancer development and prevention, according to a study of women age 15-24 years after their first delivery in Sao Paulo, Brazil.

Only one third of the women reported having “ever heard about HPV”, despite the fact that the study began 16 days after public news and announcements about the first regulatory approval of one of the HPV vaccines in June 2006, and the fact that the women had relatively high levels of education within the Brazilian context. Only 19 percent and seven percent of the women, respectively, knew that HPV is a sexually transmitted infection (STI) and that it can cause cervical cancer.

Awareness regarding HPV vaccines was high, with 74 percent of the women mentioning their preventative aspect, and 57 percent of women could identify at least one of the vaccines they had received; that is, they could name the vaccine or the disease which it was intended to prevent.

Despite the possibility to provide a large number of information to mothers during the prenatal and postpartum periods, this group of women had low levels of knowledge of HPV and cervical cancer development and prevention. “Thus, these women could benefit greatly from educational interventions to encourage participation in primary and secondary cervical cancer prevention programs,” the study concluded.

1. Rama CH, Villa LL, Pagliusi S. Awareness and knowledge of HPV, cervical cancer, and vaccines in young women after first delivery in São Paulo, Brazil–a cross-sectional study. BMC Women’s Health 2010; 10: 35. (open access)

Better diabetes training for primary care providers needed in Brazil

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Primary health care providers in Brazil reported in a study that they felt insufficiently prepared to conduct educational practices for people with diabetes, pointing to gaps in their knowledge on the disease and the importance of diabetes self-management. The study findings indicate that the health professionals are aware and want to modify their behavior in patient education and complain of a lack of training for such change, specifically in relation to patient education in diabetes.

The current patient education process is based on health professionals “transferring” information on diabetes, rather than a more comprehensive and effective educational approach. The study suggests that the more appropriate approach should focus on the need to establish a dialogue between the provider and the patient and thus on the capacity to hear the needs and demands of the patient.

1. Torres HC, Rozemberg B, Amaral MA, Bodstein RCA. Perceptions of primary healthcare professionals towards their role in type 2 diabetes mellitus patient education in Brazil. BMC Public Health 2010; 10: 583. (open access)