Previne Brasil: análise dos indicadores de saúde da mulher

Abstract

This study aims to analyze the coverage of women's health indicators in Primary Health Care under the Previne Brasil program from 2018 to 2023 in Brazil. For this purpose, an ecological study was used as the method, whose units of analysis were the different geographic regions of the country, using aggregated data extracted from public health information databases on the program's women's health performance indicators. No region in Brazil reached the 40% target for cytology collection coverage in Primary Health Care. However, an increase in coverage was demonstrated at the national level, from 10% to 27%. Although all states presented coverage below 40% in all years of the study period, it was observed that the states of Alagoas and Amazonas reached values close to the target, with coverage of up to 39%. Significant variability was observed in the coverage of pregnant women with at least 6 consultations, the first being up to the twelfth week of pregnancy among Brazilian states. Acre, Amapá, Pará, and Roraima remained below 45% coverage. Alagoas stood out for its best performance, increasing from 29% to 65%. On the other hand, Amapá had the worst performance, rising from 5% to just 32%. The Federal District also stood out, with a significant increase in the coverage rate, going from 1% to 57%. There was an increase in the indicator of “proportion of pregnant women who underwent syphilis and HIV tests” at the national level, going from 17% to 68%, exceeding the established target, which was reached in the second four months of 2022 (63%). During the pandemic period, from 2020 to 2021, this indicator remained in constant growth in the country. These data reflect continuous progress in the monitored metrics. At the regional level, the indicator also showed a constant increase in the data analyzed during the period analyzed, and all regions achieved the proposed target, demonstrating good performance by teams in this indicator, including during the pandemic. All Brazilian states managed to achieve the 60% target, and the pandemic did not have a significant impact on the indicator. It is concluded that the analysis revealed important advances in the consolidation of Primary Health Care. The indicator with the best performance over the period was the proportion of pregnant women who underwent syphilis and HIV tests, whose national coverage exceeded the established target, even during the pandemic context. On the other hand, the indicator with the worst performance was the coverage of cytopathological test collection, which, although it showed growth, remained far from the target in all regions. The regional inequalities identified highlight the need for more equitable public policies and strategies aimed at strengthening PHC in territories with greater social and health vulnerability. It is also recommended that future research deepen the analysis of contextual and structural factors that influence the coverage of indicators, in order to support more effective, sustainable interventions aligned with local realities.