Ciencia & saude coletiva最新文献

[This corrects the article doi: 10.1590/1413-81232025309.02562024] [This corrects the article doi: 10.1590/1413-81232025309.02562024EN].

Currently, more than 53,000 Family Health teams are responsible for implementing Primary Health Care (PHC) in Brazil, developing coordinated actions for health promotion, prevention, treatment, recovery, and rehabilitation, with an approach centered on the family and community, the territory, and comprehensive care. The moment of reestablishment of Family Health as a priority strategy of the Unified Health System (SUS) was enacted by Ordinance GM/MS No. 3,493/2024, which establishes the new federal co-financing methodology and represents a milestone in its redesign. This article aims to discuss the resumption of Family Health as a central strategy for rebuilding PHC. Among the main advances are increased funding, with a reduced number of team members, the encouragement of expanded team coverage, the reactivation of the Mais Médicos Program and multidisciplinary and oral health teams, and the expansion of other access strategies, especially for vulnerable populations, such as the Riverside Family Health, Prison, and Street Clinic teams. This highlights that only with a strengthened PHC system can new milestones be envisioned in this significant civilizing policy that is the Unified Health System (SUS).

This study aimed to identify the factors associated with the provision of integrative and complementary practices used by multidisciplinary teams (MT) in the state of Bahia - Brazil. This is an exploratory, cross-sectional, quantitative, and descriptive study, based on the results of the external evaluation of the third cycle of the 2017 Primary Care Quality Improvement and Assessment Program (PMAQ) held in 171 municipalities in the state. To identify the factors associated with the outcome variable (the offering of ICHP), two levels of independent variables were used: distal level (clinical-care subdimension) and proximal level (technical-pedagogical subdimension). The most frequently ICHP offered in the state were music therapy and shantala massage. In the technical-pedagogical subdimension, it could be observed that the offering of ICHP had statistical significance in the following variables: pedagogical activities offered; the MT carried out monitoring and analysis of indicators related to their work process; and the MT that supported and developed strategies to promote body practices and physical activities in the territory. It can be concluded that the offering of ICHP was identified in teams that best organized and qualified their health work processes.

This article is a literature review on the impacts of the Family Health Strategy (FHS) on the health status of the Brazilian population over the past 30 years. The search for studies in the PubMed database identified 882 scientific articles. After having applied both inclusion and exclusion criteria, 43 articles remained for analysis of the findings. The implementation of the FHS was associated with relevant effects on the reduction of infant and under-5 mortality, especially in the postnatal period and for infectious diseases, as well as on mortality and hospitalizations for the general population and specific age groups, with emphasis on preventable causes by PHC actions and services, even though the association of FHS with a decline in hospitalizations and some causes of mortality in the adult population has not been observed in some studies. The effects of FHS were more expressive in vulnerable social groups or in poorer regions and with less structuring of the healthcare network, demonstrating its impacts on reducing health inequities in Brazil. The studies focused on the period prior to 2017, limiting knowledge about the impacts over the 30 years of FHS. Public investment is recommended for the institutionalization of evaluation to support the decision-making process of this relevant health policy in Brazil.

This article addresses the structural elements of the experiences of eight adult women who have lived on the streets in Belo Horizonte, Brazil, in 2021 and 2022. Focus groups and semi-structured interviews were conducted and analyzed using content analysis, focusing on three aspects of their life trajectories: the process of taking to the streets, their experiences on the streets, and prospects. The respondent's profile is, in general, of a Black woman, with several reasons for taking to the streets, including gender violence. Survival strategies based on the dynamics of social assistance services and access to emergency health services were reported, and prospects were mainly linked to structural issues such as housing and work. The life trajectories of these women revealed the incidence of different forms of oppression that deprive them of social rights, consequently affecting the health-illness-care process. Therefore, for public policies based on integrality and social justice, we should consider issues that affect these women's trajectories, such as the fragility of their social support network, barriers to access to health care, lack of leisure activities, and reduced autonomy.

Health campaigns have been carried out for a century in Brazil to prevent diseases, including HIV and AIDS. But what approaches and technologies are used in these actions? Our aim was to identify and discuss prevention strategies in HIV and AIDS campaigns run by the Ministry of Health between 2012 and 2022. This is a qualitative-quantitative exploratory study based on thematic content analysis and descriptive statistics. The primary, secondary, tertiary and quaternary categories of prevention were discussed in the light of the relevant literature. It was observed that the campaigns use approaches and technologies from the primary (81%) and secondary (93%) levels in the pieces analysed. The tertiary and quaternary levels only appear in 8% and 32%. The campaigns mention prevention methods without explicit information about each one and mostly deal with biomedical interventions. There is positive action to encourage barrier methods and mass testing, and information gaps regarding treatment as prevention, the response to social determinants and combination prevention. The campaigns need to be evaluated and improved as a health communication strategy adopted with the aim of providing information for HIV and AIDS prevention, especially among key and priority populations.

This study aims to analyze the trend in cigarette consumption among the adult population in Brazilian capitals from 2006 to 2023 and estimate the projections of this trend through 2030. This time trend study used data from Vigitel. The prevalence of cigarette use was calculated for the total population and stratified by sociodemographic variables. Trend analysis was performed using the joinpoint regression model. The exponential smoothing model was applied to estimate the prevalence projections, considering prevalence from 2015 to 2023. Overall, cigarette use decreased from 15.7% in 2006 to 9.3% in 2023 (AAPC: -3.3). This trend was observed across all sociodemographic strata. However, in the capitals, Goiânia was the only one with a stable prevalence. The trend analysis revealed a slowdown in the decline or even stagnation of prevalence after 2015. The projections indicate that the target of a 40% reduction by 2030 will not be achieved, as the projected prevalence is 7.96%, higher than the expected prevalence of 6.24%. These results point to setbacks in anti-tobacco policies in the country. Therefore, it is urgent to resume and expand several actions, considering the changes in context and the weaknesses of the policies, in order to reverse this situation.

This article analyzes the integration between Health Surveillance (HS) and Primary Health Care (PHC) in the Unified Health System (SUS), focusing on the fight against dengue and the challenges faced over the past 30 years of the Family Health Strategy (FHS). This work is an exploratory-descriptive study, developed in three stages: 1) a documentary review of SUS regulations to identify convergences and divergences in the guidelines for integrating health services and PHC; 2) a scoping review to map Brazilian experiences of articulation between the two; and 3) an analysis of secondary data from the Arbovirus Monitoring Panel and the National Census of PHC units, using dengue as a tracer condition. Between 2016 and 2022, Brazil witnessed a worsening of health indicators, exacerbated by the COVID-19 pandemic, resulting in an increase in the incidence of dengue. The results highlight the need for intersectoral policies and coordinated actions between FHS and HS teams. Despite progress, obstacles to integration persist, such as the fragmentation of actions and the scarcity of resources. The conclusion is that integration requires structural changes to strengthen local governance and social participation, allowing dengue and health emergencies to be tackled more effectively.

The pioneering experience of Health Agents (HA) has significantly reduced infant mortality and became a national reference, leading to the creation of the Community Health Workers Program (PACS) across the country and, subsequently, serving as the foundation for establishing the Family Health Program (PSF), currently known as the Family Health Strategy (ESF), consolidated as the main Primary Health Care model within the Unified Health System (SUS). Carlile Lavor, a Public Health physician who served as Secretary of Health of the State of Ceará in 1987, was responsible for establishing Health Agents and came to be popularly and affectionately known as the "father of the ACS". In an interview granted to researcher Anya Vieira-Meyer, Lavor reflects on the historical trajectory and contemporary challenges of Community Health Workers (ACS) in Brazil.

This theoretical essay examines the challenges and achievements of the Unified Health System (SUS) regarding teamwork over the past30 years of the Family Health Strategy (FHS) in Brazil. The aim is to critically analyze the literature as regards conceptions, structuring elements of collaborative work between FHS teams and other implemented models; achievements and challenges over the past 30 years; and proposals for overcoming them in the coming decades. The analysis was based on a review of publications from 1994 to 2024, obtained from databases, such as PubMed, LILACS, SciELO, BDENF, and Cochrane Library, resulting in the analysis of 34 articles on fundamental concepts, nature/model, and configuration of collaborative work, as well as the challenges and recommendations for the interprofessional logic of the teams. Divergences were identified in the organization of interprofessional work in different Primary Health Care (PHC) territories, with challenges related to team composition and the definition of new scopes of practice due to technological inclusion. These reflections generated recommendations to broaden the debate on the subject.