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São Paulo state to receive $270 million IDB loan to strengthen health care management

Program to implement a model for Brazil’s regional networks 

Brazil’s São Paulo state will receive a loan for $270 million from the Inter-American Development Bank (IDB) to strengthen health care management and implement a regional networks model for the country’s Unified Health System. 

Along with other Brazilian states, São Paulo has been experiencing a sharp rise in chronic illnesses among its population. The program will address this problem by strengthening health promotion and prevention through an integrated model of service networks to ensure continuous, integrated, and successful patient care. 

The integration of service networks will be tested in two different scenarios: in small towns that are part of micro-regions and which presently receive inadequate health service coverage, such as Vale do Ribeira, Itapeva, Vale Jurumirim, and the North Coast; and in the metropolitan region of Campinas, especially in districts with vulnerable populations. 

Areas benefiting from the program will receive strategic investments in infrastructure, including the construction and remodeling of basic health care units, counseling centers, a medical specialties clinic, and two regional hospitals. In addition, the program will finance the implementation of regional regulation centers and training for health care professionals. 

The program will finance the increased level of management needed for carrying out the network model by providing support to the Health Department of the State of São Paulo for consulting services and studies, modernization of equipment, and development of a strategy for ongoing training for Unified Health System managers. Subjects will include the use of clinical protocols and lines of care in maternal and child health, diabetes, hypertension, mental health, geriatric care, and men’s heath. 

The IDB’s project team leader, Rita Sório, described the importance of the activities to be carried out in the program. "The consolidation of integrated health networks is an important step for effectively addressing the ongoing demographic and epidemiological transition that is characterized by an aging population and an increase in chronic diseases,” she said. “Providing network-based services allows states to better coordinate the provision of health services, which will result in better quality of care and therefore better use of available resources.” 

It is expected that the program will reduce premature deaths from diabetes and cardiovascular conditions; improve the quality of first-level services and thereby reduce the rate of hospital admissions due to situations that could have been addressed by primary health services; and increase regular access to health checkups and specialized services, when necessary. 

In addition to the IDB loan, the state is contributing $110 million to the program, for a total investment of $380 million. The IDB financing has a term of 25 years, a grace period of 5-1/2 years, and an interest rate based on LIBOR.