Implementation of the Brazilian National Health Policy for Persons with Disabilities in Rio de Janeiro, Brazil: evaluation of access to oral health

07/08/2026

AI Summary

Implementation of oral health policy for persons with disabilities remains incipient, with barriers exceeding facilitators across primary, specialised and hospital care.
Critical gaps include inadequate professional training, limited matrix support, low oral health coverage in primary care and scarce provision for general anaesthesia.
Structural barriers such as long distances, poor public transport integration, urban violence and lacking architectural accessibility hinder access to services.

AI Summary

This case study evaluated the access of people with disabilities (PwD) to public health network services in Rio de Janeiro, Brazil in the primary health (PHC), specialized, and hospital care levels.

Access dimensions (accessibility, availability, and adequacy) constituted the criteria to judge the degree of implementation of oral health care within the Brazilian National Health Policy for Persons with Disabilities.

The former included long distances from reference hospitals to certain regions of the city, low quality and little integration between public transport modes, urban violence and inadequacy of public roads, insecurity of PHC dentists in assisting PwD, few opportunities for professional training, low frequency of matrix support from the Dental Specialties Centers to PHC, low oral health coverage in PHC, and limited offer of dental care under general anesthesia.

Basic summary

Cad Saude Publica. 2026 Jul 31;42:e00219725. doi: 10.1590/0102-311XPT219725. eCollection 2026.

ABSTRACT

This case study evaluated the access of people with disabilities (PwD) to public health network services in Rio de Janeiro, Brazil in the primary health (PHC), specialized, and hospital care levels. Access dimensions (accessibility, availability, and adequacy) constituted the criteria to judge the degree of implementation of oral health care within the Brazilian National Health Policy for Persons with Disabilities. Quantitative and qualitative approaches and multiple sources and data collection techniques were used. This study considered the access of PwD to oral health services as “incipient”, with the most critical points of implementation being professional training, shared construction of care, human and material resources, architectural accessibility, and provision of services. Barriers outnumbered facilitators. The former included long distances from reference hospitals to certain regions of the city, low quality and little integration between public transport modes, urban violence and inadequacy of public roads, insecurity of PHC dentists in assisting PwD, few opportunities for professional training, low frequency of matrix support from the Dental Specialties Centers to PHC, low oral health coverage in PHC, and limited offer of dental care under general anesthesia. The implementation of the policy has been taking place gradually without consistently considering PWD’s health needs. The recommendations in this study can contribute to the comprehensive care of PWD by improving the components of the network in Rio de Janeiro.

PMID:42561298 | DOI:10.1590/0102-311XPT219725

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