Equity in the territorial allocation of health projects in Brazil
1
Social Impact Directorate, Hospital Sírio-Libanês, São Paulo, Brazil
2
School of Public Health, University of São Paulo, São Paulo, Brazil
3
Sírio-Libanês School, Hospital Sírio-Libanês, São Paulo, Brazil
4
São Paulo School of Politics, Economics and Business, Federal University of São Paulo, Osasco, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
The Programme for Institutional Development Support of Brazil’s Unified Health System (PROADI-SUS) is a partnership between the Brazilian Ministry of Health and seven philanthropic hospitals of excellence1. Through financial resources derived from tax exemption mechanisms, the programme supports triennial projects developed across strategic areas aligned with the goals of the National Health Plan2. These projects aim to strengthen health services, workforce capacity, research, and management throughout the national territory. This study reports the experience of one philanthropic hospital regarding the territorial distribution of its health projects.
METHODS:
This study analyses projects implemented by Hospital Sírio-Libanês (HSL) within PROADI-SUS during the 2024–2026 triennium. Data were obtained from institutional management reports. The analysis included all Brazilian municipalities that had contact with at least one project. Included were health services units, health professionals, patients, research participants, and individuals enrolled in training courses and workshops. Municipal Human Development Index (MHDI) data were based on the 2010 Brazilian Institute of Geography and Statistics classification, the most recent version available3.
RESULTS:
The HSL implemented projects in all five regions of Brazil, reaching 27 states and 312 municipalities. An institutional target was to allocate at least 50% of projects to municipalities classified as having medium or low MHDI. Among the municipalities analysed, 6.4% were classified as very high MHDI, 36.5% as high MHDI, 51.0% as medium MHDI, and 6.1% as low MHDI. The predefined target was achieved, with 57.1% of projects allocated to municipalities with medium or low MHDI, representing the territorial equity indicator.
CONCLUSIONS:
The findings indicate territorial coverage but reveal challenges in implementing projects in municipalities with low MHDI. Limited local infrastructure may constrain the capacity of vulnerable territories to receive projects, indicating the need for future coordinated strategies with the Ministry of Health to enable implementation in underserved areas.
The Programme for Institutional Development Support of Brazil’s Unified Health System (PROADI-SUS) is a partnership between the Brazilian Ministry of Health and seven philanthropic hospitals of excellence1. Through financial resources derived from tax exemption mechanisms, the programme supports triennial projects developed across strategic areas aligned with the goals of the National Health Plan2. These projects aim to strengthen health services, workforce capacity, research, and management throughout the national territory. This study reports the experience of one philanthropic hospital regarding the territorial distribution of its health projects.
METHODS:
This study analyses projects implemented by Hospital Sírio-Libanês (HSL) within PROADI-SUS during the 2024–2026 triennium. Data were obtained from institutional management reports. The analysis included all Brazilian municipalities that had contact with at least one project. Included were health services units, health professionals, patients, research participants, and individuals enrolled in training courses and workshops. Municipal Human Development Index (MHDI) data were based on the 2010 Brazilian Institute of Geography and Statistics classification, the most recent version available3.
RESULTS:
The HSL implemented projects in all five regions of Brazil, reaching 27 states and 312 municipalities. An institutional target was to allocate at least 50% of projects to municipalities classified as having medium or low MHDI. Among the municipalities analysed, 6.4% were classified as very high MHDI, 36.5% as high MHDI, 51.0% as medium MHDI, and 6.1% as low MHDI. The predefined target was achieved, with 57.1% of projects allocated to municipalities with medium or low MHDI, representing the territorial equity indicator.
CONCLUSIONS:
The findings indicate territorial coverage but reveal challenges in implementing projects in municipalities with low MHDI. Limited local infrastructure may constrain the capacity of vulnerable territories to receive projects, indicating the need for future coordinated strategies with the Ministry of Health to enable implementation in underserved areas.
| eISSN: | 2654-1459 |
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