DESK REVIEWS | Is access to care restricted through eligibility criteria? What are these criteria?

DESK REVIEW | Is access to care restricted through eligibility criteria? What are these criteria?

Healthcare service is a constitutional right in Brazil, and everyone should have access to it regardless of their age, gender, ethnicity, socioeconomic class, or geographic location. Social care, however, is provided depending on the individual needs identified by social care workers jointly with healthcare staff, as well as the socioeconomic condition of the family/person in need. There are only a few public care homes nationally, and access to such facilities is limited to very poor people. Formal day-to-day home care is not provided by the public sector, and is usually taken over by the family.

The criteria to be eligible for PUSAKA support are:

  • Aged 60 and over,
  • Widowed and from a poor family,
  • Holding a residence card (KTP/national ID) and a letter of recommendation from the Head of Neighbourhood Association (RT/RW) and the Head of the Village (Lurah),
  • Living within walking distance from the caregiver’s home.

However, in practice the programme was also open to the elderly who do not fulfil all the criteria (Do-Le & Raharjo, 2002).


Do-Le, K. D., & Raharjo, Y. (2002). Community-Based Support for the Elderly in Indonesia: The Case of PUSAKA. “Southeast Asia’s Population In A Changing Asian Context,” June, 10–14.

Most residential homes do not have a clear admission policy except the ability to pay for the services (National Gender and Equality Commission, 2016).


National Gender and Equality Commission. (2016). Audit of Residential Institutions of Older Members of Society in Selected Counties of Kenya. Nairobi, Kenya.

Care home services in general are available through private services for those who can afford them and through 10 public institutions that provide services for those who are destitute or have no family members to take care of them. This leaves a possible large group of older adults with no access to long-term care services.