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0049/2025 - Advances, challenges, and future perspectives to the Unified Health System (SUS) resilience
Avanços, desafios e perspectivas futuras para a resiliência do SUS

Author:

• Marco Antonio Catussi Paschoalotto - Paschoalotto, M.A.C - <marcocatussi@eeg.uminho.pt>
ORCID: https://orcid.org/0000-0003-2276-8531

Co-author(s):

• Eduardo Alves Lazzari - Lazzari, E.A - <eduardo.alazzari@gmail.com>
ORCID: https://orcid.org/0000-0002-4515-3655)
• Marcia C. Castro - Castro, M.C - <mcastro@hsph.harvard.edu>
ORCID: https://orcid.org/0000-0003-4606-2795
• Rudi Rocha - Rocha, R. - <rudi.rocha@fgv.br>
ORCID: https://orcid.org/0000-0003-0689-6963
• Adriano Massuda - Massuda. A - <adriano.massuda@fgv.br>
ORCID: https://orcid.org/0000-0002-3928-136X


Abstract:

This study aims to present and discuss the advancements, challenges, and future perspectives of Brazilian UHS resilience. To achieve this objective, an exploratory and qualitative study was conducted involving 30 interviews with academic experts and practitioners in the health system resilience analysis dimensions. The collected data were analyzed through inductive content analysis. The results present 32 advancements, 40 challenges, and 32 future perspectives of the SUS resilience divided into the following dimensions and subdimensions: Governance - leadership, politics, and regulatory complex; Financing - generation and allocation; Resources - workforce, infrastructure, medicines, and information technology; Service delivery - primary care and specialized care; and Context - social determinants of health. Therefore, these results demonstrate the SUS resilience in the last two major external shocks – political and COVID-19 pandemic - and point out aspects to be implemented, monitored, and evaluated by public health managers in the future.

Keywords:

Resilience, UHS, Health System Resilience, COVID-19, Health Systems.

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Paschoalotto, M.A.C, Lazzari, E.A, Castro, M.C, Rocha, R., Massuda. A. Advances, challenges, and future perspectives to the Unified Health System (SUS) resilience. Cien Saude Colet [periódico na internet] (2025/Feb). [Citado em 07/07/2025]. Está disponível em: http://cienciaesaudecoletiva.com.br/en/articles/advances-challenges-and-future-perspectives-to-the-unified-health-system-sus-resilience/19525?id=19525



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