Lipodistrophy treatment: Brazilian policies in the public health system
K. Abreu1, M. Freitas1, M. Serra2, R. Burgos3
1Ministry of Health, National AIDS Department, Brasilia, Brazil, 2Univesity of Rio de Janeiro, Dermatology, Rio de Janeiro, Brazil, 3Ministry of Health, STD/AIDS and Viral Hepatitis Department, Brasilia, Brazil
Issues: Brazilian National AIDS Department training project on facial lipoatrophy treatment and governmental decree to establish treatment for lipodystrophy on public heath system.
Description: Brazilian National AIDS Program actions on lipodystrophy treatment started in 2003 with a physicians and researchers working group for determining the more indicated product to be nationally used in facial lipoatrophy, in terms of best results, cost/benefits and large scale use.
In 2005 a national training project has started. However, more than qualifying physicians on facial lipoatrophy treatment on public services, the project induced many discussions about lipodystrophy that mobilized distinct characters of the health system, such as health managers, health workers and PLWH. Six workshops were done in 5 macro regions for 225 participants. From 2006 to 2009, 30 training and supervising workshops were done exclusively for doctors.In 2007, Ministry of Health established a governmental decree with norms for lipodystrophy treatment on public hospitals, offering two types of interventions: facial and butt lipoatrophy treatments and repairing plastic surgeries for fat accumulation in the belly, breasts and dorsum cervical.In 2009, “Guideline for facial lipoatrophy treatment” was published with by MOH.
Lessons learned: The training project resulted in 210 qualifying dermatologists and plastic surgeons, who performed 8.652 procedures of facial lipoatrophy treatment between 2006 and 2009, offered now regularly in 68 public services, in 20 states. As result of the decree, 10 public hospitals are registered for lipodystrophy repairing plastic surgeries and made over 500 procedures in the last two years. However, the government's aim is to triple this amount.
Next steps: For 2010, six supervising workshops are planned objecting so that facial lipoatrophy treatment may be offered to the 27 states, in 20 new services. In terms of establishing a national response for lipodystrophy treatment, is expected to qualify 10 more public hospitals for repairing surgeries.
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