In the late 1980s it was recognized that Brazil's system of specialized, urban-centered, hospital-based medical care was failing to meet the needs of the many families who could not afford, or could not access, services.
En la década de los ochenta se reconoció en Brasil que su sistema de servicios médicos especializados, centrado en los hospitales urbanos, fallaba en satisfacer las necesidades de muchas familias que no podían pagar para acceder a los servicios.