Rio 2016: Primary Health Care as a legacy

Rio de Janeiro addressed the challenge of the 2016 Olympic Games as an opportunity to transform the city based on 3 principles: 1. To leave a legacy to the city and its citizens beyond the infrastructure. 2. To take care of public money, making sure the work costs what is indicated in the initial contracts. 3. No white elephants, that everything that is built can be used after the event.
The city government decided that one of the main legacies of the Olympics for their citizenship should be a health reform in primary care, which they called Family Health Strategy (ESF). With it they aspired to overcome bad health indicators that the city had in 2008, the worst among Brazilian cities.

The Family Health Strategy in 2015 has achieved coverage of 45.5% thanks to the work of 845 family health teams, 320 oral health teams and 47 support centers for Family Health (NASF). For 2017 they want to reach coverage of 70% of its population.

The municipal government provides, coordinates, and strives to achieve a better collective and personal health, with the support from the private sector and with the leadership of Health. 

Meets the criteria established under Health in All Policies:

• Political commitment. The increased political commitment comes from the municipal government that puts the health reform as a major legacy of the Olympics for its people, and this is reflected in their strategic plans. This decision is in accordance with Brazilian law.
• Structure. It does not have its own structure, rather it was included to the Department of Health of the City as a program, and from here it is coordinated and executed.
• Participation of other sectors. The sector highlighted in the health reform, sets the indicators and the achievements of the Strategy in the municipal administration budget. The Health Department of the City, gave the technical criteria on the health needs and providing of services in the health care network; the RioUrbe (Municipal Urbanization company), the Department of Environment and the Department of Finance of the City contributed in city planning, feasibility analysis and accessibility, availability of financial resources, etc. Other sectors, such as Education, Sport and Social Development, coordinated with national programs, such as Healthy Schools, Health Academy and Bolsa Familia (Family Grant Program). At the local level, according to the health needs other sectors are involved such as the Department of Culture, Special Secretariat for Healthy Aging, Municipal Urban Cleaning and Rain Water Collection Company (in charge of maintenance of city canals, sewage networks and electromechanical sewerage systems), among others.
• Separate Budget. It has its own financing. The financing of primary health care in Brazil is the sum of resources from federal, state and municipal governments. In the city of Rio de Janeiro, the majority of funding comes from the municipal level.
• Seeks to reduce inequity. Aims to reduce inequity because while it seeks universality, it prioritizes the poorest people , reducing inequalities and providing the guarantee of social rights. The health unit in the territory is seen as a tool to assist public health and as an important development strategy of positive interventions in the community since agents live in the area and are involved daily with issues related to it.
• Intersectoral action. It is based on intersectoral work, especially when converting health outcomes into the major legacy of the Olympics, that is, in a common goal of the city and its various sectors.
• Evidence of results. The strategy uses scientific evidence to prove the achievement of results and to redirect its decisions. So far, the Municipal Health Secretariat of Rio de Janeiro uses information systems that are supplied by other municipal or federal agencies, such as the " Single Registry for Social Programs of the Federal Government " and the "Integrated Supervision, Execution and Control System ( SIMEC) " which is related to the Bolsa Familia and local schools respectively .
• Social Participation. In terms of social participation, health decisions pass through the Municipal Health Council, a consultative and deliberative space with equal participation from users of the Unified Health System ( SUS) , health professionals and managers . The Health Conferences are held every four years with the representation of various social groups , to assess the health situation and propose guidelines for the formulation of health policies at the appropriate levels.