Study title

This dataset comprises interviews conducted between 2016 and 2018 with health service users, health professionals and health system managers in the Rio Negro Indigenous Health District, Amazonas State, Brazil. It focuses in particular on the primary health care services covering approximately 30 communities in the Middle Tiquié region. The Unequal Voices project – Vozes Desiguais in Portuguese – aimed to strengthen the evidence base on the politics of accountability for health equity via multi-level case studies of health systems in Brazil and Mozambique. The project conducted examined the trajectories of change in the political context and in patterns of health inequalities in Brazil and Mozambique, and carried out four cases studies to compare the operation of different accountability regimes across the two countries and between different areas within each country. The case studies tracked shifts in accountability relationships among managers, providers and citizens and changes in health system performance, in order to arrive at a better understanding of what works for different poor and marginalised groups in different contexts. In each country the research team studied one urban location with competitive politics and a high level of economic inequality and one rural location where the population as a whole has been politically marginalised and under-provided with services.Health inequities - that is, inequalities in health which result from social, economic or political factors and unfairly disadvantage the poor and marginalised - are trapping millions of people in poverty. Unless they are tackled, the effort to fulfill the promise of universal health coverage as part of the fairer world envisaged in the post-2015 Sustainable Development Goals may lead to more waste and unfairness, because new health services and resources will fail to reach the people who need them most. In Mozambique, for example, the gap in infant mortality between the best-performing and...