title: [Birth defects in Brazil and health care: proposals for public policies in clinical genetics].
abstract: The impact of birth defects in Brazil has increased steadily, indicating the need for specific health policy strategies. Despite the close relationship between clinical genetics and management of birth defects, less than 30% of the total demand is currently met by existing genetic services. The main problems are: difficult access to genetic services, services highly concentrated in the South and Southeast regions of the country, and insufficient laboratory support. With the aim of improving management of birth defects, a specific national policy coordinated by the Ministry of Health needs to be developed. The main goal of such a policy should be the organization of a functional integrated genetics network, in addition to rational use of resources and enhanced coverage. In order to formalize a national laboratory network, sample shipping and billing mechanisms must be created. Birth defect prevention, education for the medical community and general population, and solid epidemiological data collection are strongly recommended as complementary measures. If such recommendations are implemented, it could be possible to organize a network for management of birth defects in Brazil that is regionalized, hierarchical, functional, and democratic as well.
authors.affiliation: Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. dafne@ceresgenetica.com.br
authors.forename: Dafne Dain Gandelman
authors.initials: DD
authors.lastname: Horovitz
authors.forename: Maria Helena Cabral de Almeida
authors.initials: MH
authors.lastname: Cardoso
authors.forename: Juan Clinton
authors.initials: JC
authors.lastname: Llerena
authors.forename: Ruben Araújo
authors.initials: RA
authors.lastname: de Mattos
mesh_terms: D001938:Brazil; D000013:Congenital Abnormalities / Q000517:prevention & control*; D033142:Genetic Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D006285:Health Planning; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006301:Health Services Needs and Demand / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007753:Laboratories / Q000458:organization & administration / Q000706:statistics & numerical data; D011640:Public Policy; D011795:Surveys and Questionnaires