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Brazilian state of Bahia to strengthen health care sector with $200 million loan from IDB

Program aims to set up an integrated services network with focus on primary care

The Inter-American Development Bank (IDB) has approved a $200 million loan designed to strengthen the health care system in the Brazilian state of Bahia, with a special focus on the Salvador metropolitan region and reducing the prevalence of chronic diseases affecting the most vulnerable segments of its population.

That metropolitan area is home to nearly four million people and in recent years it has confronted problems associated with demographic and epidemiological change. The population is aging quickly; the number of people over the age of 50 has doubled between 1980 and 2012.

Doctors have also observed a rise in risk factors associated with chronic diseases and the incidence of them. In 2010, 40 percent of the population of Salvador was overweight, and in 2012, 42 percent of deaths in the metropolitan region were caused by cardiovascular illnesses or cancer. The poorest people were particularly hard hit.

In order for the structure of the health care system to be in a stronger position to address these challenges, the program will finance the creation of an integrated services network with a focus on primary care as the gateway to broadening access to and the quality, continuity and efficiency of the network’s services. The program will finance investment to boost management and enhance access to and quality of all the phases of the health care services chain.

With an eye to prevention and primary care, the plan calls for building 13 public gymnasiums (so-called health academies), nine social and mental health care centers, 11 basic health care clinics and a facility specializing in the health of workers. As for specialized care, seven new integrated health care centers will be built, and the existing network of hemotherapy—the use of blood or blood derivatives—will be boosted so as to improve emergency care.

The program will also finance the construction and equipping of the region’s Hospital Metropolitano. It will provide Bahia with cutting-edge services for intermediate care and long-term patients with chronic diseases. At least three hospitals that are part of the network dealing with chronic disorders, maternal and child health and emergencies will be upgraded.

The loan is over 25 years, with a grace period of 5.5 years and an interest rate pegged to the LIBOR. The local contribution is $85 million. The state of Bahia will execute the loan through its Secretariat of Health, and the guarantor is the Brazilian federal government.