How Brazil Manages Major Healthcare Challenges

Posted on 2 May 2017

Dr João Nunes and Dr Alexander Medcalf are exploring the importance of Brazil's Community Health Workers as part of a Wellcome Trust Seed Award project

Dr João Nunes (Lecturer in the Department of Politics) and Dr Alexander Medcalf (CGHH Research Fellow and Deputy Director) have been working with communities across Brazil to understand how the country manages major health challenges, including the recent outbreak of Zika virus. 

Focusing on Brazil's Community Health Workers (CHW's), Dr Nunes and Dr Medcalf highlight the enduring contemporary and historical importance of CHW's with regard to health work. As Brazil's Health-related problems are not just medical but rooted in political and cultural issues linked to poverty, society and lack of investment in basic infrastructure such as sanitation, its CHW's have played a key role in helping tackle its health problems which are often related to these wider political and infrastructure issues. However, the project finds that economic difficulties and political upheaval in Brazil has meant that politicians and policy makers are now questioning the value of the CHW programme and the public health system. A full report on their project ‘Community health workers in Brazil and the global movement for universal health coverage’ (funded by the Wellcome Trust) so far is available on the University of York's website.

Dr João Nunes's research interests lie in the politics of health and security studies. Now, following further funding for his work, Dr Nunes is collaborating with researchers at the Fiocruz scientific foundation and the João Pinheiro Foundation in Brazil to develop support programmes and training to help CHWs working in the Minas Gerais state in south-eastern Brazil. Training films are planned in partnership with a regional TV company. Dr Nunes is also collaborating with regional government and scientific institutions to draw up policy recommendations. Read more about Dr Nunes' work on his University of York Profile page.

Dr Alexander Medcalf has interests in visual culture, specialising in public health and medicine, marketing, and transport in the twentieth century. As part of the project with Dr Nunes, he is currently studying how Brazil's CHWs were represented by the World Health Organization (WHO) through film and photographs in the run up to Alma Ata and afterwards. His focus is the period leading up to and immediately after the 1978 International Conference on Primary Health Care when the World Health Organisation (WHO) sought to put CHWs at the centre of delivering health for all. WHO officials recommended the creation of more national CHW programmes and the expansion of others, but they also identified many weaknesses and challenges to overcome. Dr Medcalf’s research tracks strategies for action, including the use of extensive media campaigns to garner support for the programmes. Read more about Dr Medcalf's work on his University of York's profile page.