National Policy on Congenital Heart Disease: Reflections and Proposals for Strengthening Care in Brazil.

Abstract

Background: In Brazil, more than 20,000 children are born annually with congenital heart disease, and a significant proportion require surgical or interventional treatment within the first year of life. Despite advances in medical care, substantial inequalities persist in access to timely diagnosis and treatment.

Objectives: To describe the evolution of national policies related to congenital heart disease care in Brazil and to discuss strategies for improving the organization and delivery of care within the national public health system.

Methods: This is a narrative and documental review based on the analysis of publicly available data, official health policies, and previously published literature addressing congenital heart disease care and health system organization in Brazil.

Results: The analysis identified that although multiple national initiatives have been implemented over time, they remain fragmented and have not fully addressed disparities in access to care. Key gaps include deficiencies in regionalization, data collection, workforce training, and system coordination.

Conclusions: Congenital heart disease care in Brazil remains marked by structural inequalities and fragmentation of health policies. Strengthening regionalized networks, improving financing strategies, enhancing data systems, and optimizing referral pathways are essential to ensure timely and equitable access to diagnosis and treatment.