[Care regulation and regional governance in viral hepatitis microelimination strategies].

Abstract

This study aimed to evaluate the management of care regulation in the health care network and the process of elaboration and consensus of strategic actions to cope with viral hepatitis based on regional governance. This qualitative action research was carried out in a Mato Grosso Health Region, Brazil, with 45 professionals working in surveillance, care, regulation, management, and social control. The focus group enabled the joint analysis of coping strategies and the formulation of regional consensus and collegiate agreement. The results show the political-institutional absence of strategies to address care gaps, the centralization of regulation, and the fragility of computerization processes. Organizational difficulties in horizontal integration stand out, including a fragmented network and limited capacity for decentralized clinical support. Practices still show failures in intersectoral articulation, informality in care flows, and frail primary health care (PHC) in post-diagnosis monitoring. The consensual action plan included four strategic lines: expanding access to prevention actions, strengthening specialized care articulated with PHC, expanding laboratory diagnostic capacity, and consolidating health surveillance by inter-institutional agreements. Eliminating viral hepatitis requires systemic actions guided by social justice and the construction of collective solutions that meet regional needs and produce continuous monitoring to achieve the global goals by 2030.