Brazilian Public Healthcare System Actions to Care For Children With Microcephaly

OBJECTIVES: There has been an increase in the number of microcephaly cases reported in Brazil (3,530 suspected cases in January/2016) in infants born to women affected by the zika outbreak. Microcephaly is associated with intellectual deficit, epilepsy, cerebral palsy, delayed language and/or motor development, ophthalmologic, cardiac and renal disorders. Affected children require specialized care indefinitely, depending on the severity of each case. The objective of this study was to assess what the public healthcare system offers for the treatment of children born with microcephaly during the zika outbreak in 2015/2016. METHODS: We used data from Live Birth Information System (Sistema de Informacoes sobre Nascidos Vivos - SINASC) on microcephaly, defined as head circumference >3 standard deviations (SDs) below the mean for age and sex. We performed a literature review of published articles, gray literature and non-scientific literature focusing on government actions to care for children with microcephaly. RESULTS: The Ministries of Health and Social Development and Fight Against Hunger implemented the Rapid Action Strategy for Strengthening Attention to Health and Social Protection of Children with Microcephaly, making the public healthcare system (SUS) responsible for identifying, locating and confirming the diagnosis of microcephaly. For the confirmed cases, SUS must provide complete pediatric, neurological, ophthalmologic, auditory and other necessary assessments and the detailed medical report to instruct the process of granting the Continuous Provision Benefit (Beneficio de Prestacao Continuada - BPC) - an aid corresponding to R$ 220.00 paid to families with financial difficulties. This strategy intended to invest at least R$ 10.9 million overall or R$ 2,200.00 per child, but 1 year after the program's launch many many still do not have access to this benefit. CONCLUSIONS: There are still many challenges in accessing appropriate treatment for these children with microcephaly, and the government has failed to meet all the promised goals.