Marcolino MS, Alkmim MB, Santos TADQ, Ribeiro AL. The telehealth network of Minas Gerais: a large-scale Brazilian public telehealth service improving access to specialised health care. Policy in Focus 2016; 13 (1): 59-61.
Brazil’s Constitution established the public health system (Sistema Único de Saúde— SUS) in 1988, ensuring health as a right of all citizens and a government responsibility (Brazil 1988). Primary health care (PHC) provides basic services to the population via multidisciplinary health teams, in a decentralised manner, across all Brazilian cities (Macinko and Harris 2015). Despite the improvement in health indicators, major problems remain, such as difficulty in accessing health services, poor PHC problem-solving capacity, a shortage of qualified human resources and a high turnover of PHC professionals, especially in remote cities. Brazil’s economic, social and political discrepancies, associated with the concentration of financial, human and health services in large urban centres, have led to precarious access to specialised services in small and remote cities. In Minas Gerais, the fourth largest state in Brazil (586,528 km2 ), the second most populous and the third largest state economy, access to health care is no different from the rest of the country. There are around 21 million people living in the state, distributed over its 853 towns, 70 per cent of which have fewer than 14,000 inhabitants (IBGE 2016). In Minas Gerais, nearly 50 per cent of all doctors are concentrated in the metropolitan region of the state capital, Belo Horizonte (Conselho Regional de Medecina 2013).
