Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2025-02-13DOI: 10.1590/1413-81232025307.18832024
Gislani Mateus Oliveira Aguilar, Luciana Freire de Carvalho, Caio Luiz Pereira Ribeiro, João Roberto Cavalcante, Raquel Proença, Gerson Oliveira Penna, Márcio Henrique de Oliveira Garcia, Daniel Soranz
{"title":"Preparedness, Surveillance, and Response to Public Health Emergencies in the City of Rio de Janeiro, Brazil, from 2021 to 2024.","authors":"Gislani Mateus Oliveira Aguilar, Luciana Freire de Carvalho, Caio Luiz Pereira Ribeiro, João Roberto Cavalcante, Raquel Proença, Gerson Oliveira Penna, Márcio Henrique de Oliveira Garcia, Daniel Soranz","doi":"10.1590/1413-81232025307.18832024","DOIUrl":"10.1590/1413-81232025307.18832024","url":null,"abstract":"<p><p>This article describes the trajectory of the city of Rio de Janeiro in facing public health emergencies between 2021 and 2024, based on three axes of action proposed by the World Health Organization (WHO): preparedness, surveillance, and response. Innovation in timely data analysis from non-conventional information sources has enabled an early detection of events, promoting reorientation in health surveillance practices. The construction of a strong institutional identity, as well as the coordination of response actions in Emergency Operations Centers, contributed to the consolidation of a culture of rapid response and networking. The integration of primary health care (PHC) and surveillance networks guaranteed a continuity of care and coordinated risk management, highlighting the importance of a decentralized health system that seeks intersectorality in responding to emergencies. The advances observed in combating the COVID-19 and dengue epidemics during this period in the city were driven by adequate investments in structure and human resources, emphasizing the importance of continuous financing and strategic planning aimed at this model of care.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e18832024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2024-06-16DOI: 10.1590/1413-81232025307.17062023
Marilene Gonçalves França, Adriana Ilha da Silva, Robson Zuccolotto
{"title":"Public health expenditures in Vitória/ES: priority for primary care.","authors":"Marilene Gonçalves França, Adriana Ilha da Silva, Robson Zuccolotto","doi":"10.1590/1413-81232025307.17062023","DOIUrl":"10.1590/1413-81232025307.17062023","url":null,"abstract":"<p><p>This study analyzed public spending on health actions and services, especially on primary care, in the municipality of Vitória/ES from 2009 to 2019. It is a quantitative and documentary study that analyzed health expenditure data, based on indicators from the Public Health Budget Information System. The average total expenditure per capita in Vitória corresponded to R$ 1,091.84 per inhabitant per year, with a reduction of 7.83%, caused by the decrease in available revenue. The per capita expenditure on own resources corresponded to an average of R$ 811.02 per inhabitant per year, which represented 74.28% of the total per capita expenditure and was the main source of financing of the system. In terms of the direction of expenditure, there was a predominance of current expenditure to the detriment of capital expenditure. In terms of spending per level of health care, basic care suffered a drastic lowering in per capita spending per year (43.47%), representing 8.52% of total per capita health spending. This scenario is linked to the fiscal austerity policy of the Union, characterized by a reduction in resources for primary care and the lack of priority given to this sub-function by the municipal management.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e17062023"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[The importance of integrating epidemiological surveillance into primary health care to mitigate hospitalizations for congenital syphilis].","authors":"Guilherme Almeida Elidio, Janaina Sallas, Dirce Bellezi Guilhem","doi":"10.1590/1413-81232025307.00142025","DOIUrl":"10.1590/1413-81232025307.00142025","url":null,"abstract":"","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e00142025"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luiz Felipe Pinto, Gerson Oliveira Penna, José Agenor Alvares da Silva, Luis Augusto Pisco
{"title":"Rio 460 years: Five million Rio residents have access to primary health care services.","authors":"Luiz Felipe Pinto, Gerson Oliveira Penna, José Agenor Alvares da Silva, Luis Augusto Pisco","doi":"10.1590/1413-81232025307.04092025","DOIUrl":"10.1590/1413-81232025307.04092025","url":null,"abstract":"","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e04092025"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2025-02-26DOI: 10.1590/1413-81232025307.21562024
Eunice Isabel do Nascimento Carrapiço, Ana Rita Semedo Correia, Baltazar Ricardo Monteiro
{"title":"Development of Clinical and Health Governance: Primary Health Care in the Lisbon and Tagus Valley Region.","authors":"Eunice Isabel do Nascimento Carrapiço, Ana Rita Semedo Correia, Baltazar Ricardo Monteiro","doi":"10.1590/1413-81232025307.21562024","DOIUrl":"10.1590/1413-81232025307.21562024","url":null,"abstract":"<p><p>The Clinical and Health Councils (Conselhos Clínicos e de Saúde - CCS) became responsible for implementing Clinical and Health Governance (Governação Clínica e de Saúde - GCS) in primary health care (PHC) in Portugal. However, this project suffered political abandonment, although there are cases of continuity due to the dedication of CCS professionals. Considering the lack of evidence on the impact of GCS concerning the horizontal integration of the Functional Units of Health Center Groups (Agrupamentos de Centros de Saúde - ACES), the present study sought to identify micropolitical elements that could enhance this horizontal integration. The modified Delphi technique (Policy Delphi) was used as a methodology involving a group of ten experts with experience in academia, in administrative structures, and in the CCS, who shared their experiences to answer the research questions. The results revealed, on the one hand, a general tendency, on the part of the experts to accept that the CCS fulfilled the competences that were assigned. On the other hand, they identified economic and social limitations in the development of the project, as well as the fragmentation of care and tensions generated by disparities between the Functional Units. This study also made it possible to suggest a set of micropolicies capable of promoting the integration of GCS in PHC.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e21562024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2024-06-27DOI: 10.1590/1413-81232025307.09362023
Maria Izabel Siqueira de Andrade, Berilany Dos Santos Sena, Juliana Souza Oliveira, Vanessa Sá Leal, Poliana Coelho Cabral, Pedro Israel Cabral de Lira
{"title":"Energy-adjusted antioxidant micronutrient intake is correlated with HOMA-IR and anthropometric variables.","authors":"Maria Izabel Siqueira de Andrade, Berilany Dos Santos Sena, Juliana Souza Oliveira, Vanessa Sá Leal, Poliana Coelho Cabral, Pedro Israel Cabral de Lira","doi":"10.1590/1413-81232025307.09362023","DOIUrl":"10.1590/1413-81232025307.09362023","url":null,"abstract":"<p><p>Evidence suggests that the consumption of foods rich in antioxidant nutrients is capable of modulating oxidative stress and assisting in the prevention of chronic diseases. The aim of the present study was to estimate the dietary intake of antioxidant nutrients among Brazilian adolescents and investigate correlations with anthropometric variables and the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). It is hypothesized that the dietary intake of antioxidant micronutrients among Brazilian adolescents is inversely associated with insulin resistance. A cross-sectional study was conducted with data from 37,023 adolescents who participated in the Study of Cardiovascular Risk in Adolescents (ERICA/Brazil). Spearman's correlation test was used to analyse the relation between HOMA-IR and energy-adjusted vitamins A, C, and E, zinc and selenium. Crude and adjusted analyzes were performed using linear regression. An inverse correlation was found between antioxidant vitamin and mineral intake and HOMA-IR among boys and girls with overweight and obesity in the different age groups (p < 0.05). In addition, low intake of the antioxidant micronutrients selenium and vitamin C were significantly associated with insulin resistance.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e09362023"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2024-07-20DOI: 10.1590/1413-81232025307.01882024
Ana Beatriz Macêdo Venâncio Dos Santos, Poliana de Araújo Palmeira, Angelo Giuseppe Roncalli da Costa Oliveira
{"title":"[Protection network for the human right to adequate food and the food insecurity: a cohort in the semi-arid Northeast].","authors":"Ana Beatriz Macêdo Venâncio Dos Santos, Poliana de Araújo Palmeira, Angelo Giuseppe Roncalli da Costa Oliveira","doi":"10.1590/1413-81232025307.01882024","DOIUrl":"10.1590/1413-81232025307.01882024","url":null,"abstract":"<p><p>This study analyzes the length of time living with Food Insecurity (AI) and access to government programs, identifying the protection network for the human right to adequate food (DHAA) accessed by families in the Brazilian semi-arid region between 2011 and 2019. It is about a cohort in Cuité, Paraíba, with collections in 2011, 2014, and 2019. The time of coexistence with AI was analyzed with the classification into persistent food safety, one-time AI, two-time AI, and persistent AI, based on the definition of security and insecurity in the Brazilian Food Insecurity Scale. Changes in access to 25 programs and the sociodemographic characteristics of families were verified using the Cochran Q test and Pearson's chi-square to verify the association between access and time spent living with AI. Note the coexistence of chronic AI, persistent sociodemographic vulnerability, and a diverse and little-accessed network of programs. Strengthening this network must aim at structural transformations through a socioeconomic development plan that promotes equal opportunities and articulates economy and social well-being.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e01882024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2025-03-23DOI: 10.1590/1413-81232025307.04112025
Luiz Felipe Pinto, Ana Luiza Ferreira Rodrigues Caldas
{"title":"Fifteen years of the Primary Health Care Reform (RCAPS) in Rio de Janeiro, Brazil.","authors":"Luiz Felipe Pinto, Ana Luiza Ferreira Rodrigues Caldas","doi":"10.1590/1413-81232025307.04112025","DOIUrl":"10.1590/1413-81232025307.04112025","url":null,"abstract":"<p><p>Rio de Janeiro has become a paradigm for Brazilian Primary Health Care (PHC). How did the city, which until 2008 was the capital city of the country with the lowest coverage of complete Family Health Strategy (FHS) teams, with 3.5% of its population, manage to give access to more than 70% of cariocas (residents of the city of Rio de Janeiro) by 2024? The present study analyzes the main axes and results of the Primary Health Care Reform (Reforma dos Cuidados em Atenção Primária à Saúde - RCAPS) over a 15-year period, inspired by PHC in Lisbon, Portugal. Limits, challenges, and advances are discussed. Our study highlights changes in the organizational chart, the management model, health care by results, and the strengthening of PHC as a network organizer and care coordinator. The feasibility of RCAPS for a large city is demonstrated, with the following limitations: (i) the need to reorganize continuing education processes, (ii) improved communication with the SUS user population, and (iii) insufficient tripartite funding, especially from the state government. Digital Health as an axis for improving communication, expanding access, and greater resolutiveness is today consolidated as management's greatest challenge.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e04112025"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2025-02-20DOI: 10.1590/1413-81232025307.21552024
Paula Travassos, Ana Karinny Clímaco de Oliveira Grego, Mariana Monteiro de Castro E Castro, Vinícius Borges de Oliveira Ribeiro, Janessa Vieira Santos, André Luiz Carneiro de Vasconcellos
{"title":"Public-Private Partnership in healthcare: the experience of Latin America's largest public emergency room.","authors":"Paula Travassos, Ana Karinny Clímaco de Oliveira Grego, Mariana Monteiro de Castro E Castro, Vinícius Borges de Oliveira Ribeiro, Janessa Vieira Santos, André Luiz Carneiro de Vasconcellos","doi":"10.1590/1413-81232025307.21552024","DOIUrl":"10.1590/1413-81232025307.21552024","url":null,"abstract":"<p><p>Brazilian scientific production on the subject of Public-Private Partnerships (PPP) in health is still scarce. In the state of Rio de Janeiro, the first PPP initiative was launched in 2023 for the Souza Aguiar Municipal Hospital Complex (Complexo Hospitalar Municipal Souza Aguiar - CHMSA) involving three SUS units in the capital: a maternity hospital, a general emergency hospital operating 24/7, and a regional emergency center (Centro de Emergência Regional - CER). We sought to characterize the unit, analyze the decision-making processes of the PPP implemented in this Complex, based on the experience of its key players during its formulation, implementation, and follow-up. Our study also highlighted the fundamental role of the permanent health education (Educação Permanente em Saúde - EPS) process, which was key to sustaining the change in the adopted management model. The results show that after the first year of the PPP's implementation, several adjustments have been necessary to make it possible to measure the indicators agreed upon with the concessionaire. By contrast, the Souza Aguiar OTICS Station has stood out as a major training center for Rio de Janeiro's SUS, with more than 2,500 workers trained in its first year of implementation by the SMS-RJ.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e21552024"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ciencia & saude coletivaPub Date : 2025-07-01Epub Date: 2024-06-27DOI: 10.1590/1413-81232025307.19882023
Claudia Cristina Gonçalves Pastorello, Caroline Dos Santos Costa, Rafael Moreira Claro, Maria Laura da Costa Louzada
{"title":"Shifting trends in obesity growth rates in Brazilian adults between 2006 and 2021.","authors":"Claudia Cristina Gonçalves Pastorello, Caroline Dos Santos Costa, Rafael Moreira Claro, Maria Laura da Costa Louzada","doi":"10.1590/1413-81232025307.19882023","DOIUrl":"10.1590/1413-81232025307.19882023","url":null,"abstract":"<p><p>The aim of this article is to analyze and quantify changes in acceleration and/or deceleration in temporal trends in the prevalence of overweight and obesity in adults in Brazilian capitals and the Federal District between 2006 and 2021. Using data from Risk and Protective Factors Surveillance System for Chronic Diseases by Telephone Interviews (Vigitel), joinpoint regression analyses were performed to identify potential inflection points in trends and to estimate the annual percentage change (VPA) of overweight and obesity prevalence. Obesity prevalence increased from 11.9% in 2006 to 22.4% in 2021, and that of overweight from 37.3% in 2006 to 58.8% in 2021. The increase in obesity suggests an annual growth rate of 5.8% (95%CI 4.7; 7.0) in the period from 2006 to 2012, and after that, a slower annual rate of 2.7% (95%CI 2.1; 3.3) between 2012 and 2021. The same trend pattern occurs for overweight prevalence, which grew by 2.9% (95%CI 2.7; 3.2) from 2006 to 2013, and by 1.3% (95%CI 1.1; 1.5) from 2013 to 2021. Reductions in the growth rates were more intense for women with less than 8 years of schooling. The results indicate a likely deceleration in the growth rates of the prevalence of overweight and obesity from 2012/2013 among Brazilian adults.</p>","PeriodicalId":10195,"journal":{"name":"Ciencia & saude coletiva","volume":"30 7","pages":"e19882023"},"PeriodicalIF":1.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}