A Case Study of a São Paulo Health Clinic: Accessibility to Health Services by Patients Who Do Not Speak Portuguese as a First Language Open Access

Cikopana, Doris (Spring 2018)

Permanent URL: https://etd.library.emory.edu/concern/etds/k643b1186?locale=en


This honors thesis explores the topic of accessibility to health services in Brazil. The

thesis is a case study of the UBS Bom Retiro, a health post/clinic in the neighborhood of Bom

Retiro located in São Paulo, Brazil. The neighborhood is home to multiple immigrant groups

such as the Bolivians, Koreans and Paraguayans. This thesis aims to better understand how

accessibility barriers work in this neighborhood and what initiatives has the staff taken to

reduce these barriers. Another aim of this thesis is to analyze the level of access to health

services by patients who do not speak Portuguese as a first language. Lastly, this thesis contains

possible health policy suggestions that could provide solutions to accessibility barriers in UBSs

that are located in neighborhoods with a similar demographic profile as Bom Retiro.

Table of Contents

Table of Contents

Introduction (1-11)

Chapter 1: (12-33)

Section 1: Accessibility in Brazil (12-21)

Section 2: Demography of Brazil (21-24)

Section 3: São Paulo (25-28)

Section 4: Bom Retiro (28-32)

Section 5: The Creation of SUS (31-33)

Chapter 2: (34-70)

Section 1: SUS policies on accessibility to healthcare and reality of access (34-36)

Section 2: Functioning/Operation of SUS (36-44)

Section 3 Observations from UBS and AMA visits (44-51)

Section 4: Current Perspectives on SUS: Interviews with Community Agents and Doctors


Section 5: Communication Barriers in the UBS Bom Retiro (55-67)

Section 6: Proposed Solutions to Minimize Accessibility Problems (67-70)

Conclusion (71-75)

Bibliography (76-79)

Appendix I: Table of Individuals (80)

Appendix II: Tables and Charts (81-85)

Appendix III: Bom Retiro - Demographics of Patients (86-91)

Appendix IV: Extended Methodology (92-98)

Appendix V: Communication Guides (99)

About this Honors Thesis

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