Desenvolvimento sustentável e a distribuição estadual do serviço de saúde na Paraíba

Abstract

This paper proposes to analyze the spatial distribution of health services in Paraíba regarding the network of public and private health facilities, the level of technological complexity of hospitals and the number of doctors per thousand inhabitants, based on Paraíba's mesoregions and intra-state socioeconomic differentiations. As theoretical support, the study is based on the analytical discussions that show the relations between development and health. Under this perspective, will also discuss the relevance of Agenda 2030 as a guide for public health policies in the country, the challenges of universal health care and the proposals of the State Health Plan in Paraíba. As for the methodology, the research is applied, descriptive and exploratory. The main sources of secondary data were obtained from the official platforms of public research institutions. Among the main results of the study, it was observed that there is a significant spatial concentration of production in the mesoregions of Mata Paraibana and Agreste Paraibano, which causes great asymmetries in the social and economic conditions of the state population. It was also evident that the access to piped water and to sewage and sanitation systems is unequal among the mesoregions to the disadvantage of the populations located in the Sertão and Borborema mesoregions. The analysis of the geographical distribution of health services revealed that changes have occurred in the spatial distribution of per capita spending on health and sanitation by the state government in favor of the Borborema mesoregion. However, the Sertão of Paraiba, which displayed worrisome social indicators, did not have access to a more expressive proportion of public resources in the health area compared to the other mesoregions. In the historical period studied, there was an increase in the quantity of public and private health establishments, but this expansion was concentrated in the most economically dynamic areas of the state. The number of doctors and the number of beds in Intensive Care Units also grew in Paraíba, however, the areas that presented the most precarious indicators of income and poverty, the Sertão Paraibano and Borborema, did not have a satisfactory expansion of these indicators. From these analyses, it is concluded that the spatial distribution of the health service in Paraíba faces some challenges in overcoming intra-state differentiations.