Silva José Agenor Alvares da, Costa Ediná Alves, Lucchese Geraldo
Escola Fiocruz de Governo, Fiocruz. Av. L3 Norte s/n, Campus Universitário Darcy Ribeiro Gleba A. 70904-130 Brasília DF Brasil.
Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil.
Cien Saude Colet. 2018 Jun;23(6):1953-1961. doi: 10.1590/1413-81232018236.04972018.
This article presents an overview of the nature, functions and history of health surveillance in the structure of the Brazilian Unified Health System (SUS). Bibliographical sources and official documents were used, with references from the careers of the authors, who have worked in health surveillance. Extremely serious adverse events in the mid-1990s gave political visibility to the fragility of Brazilian health surveillance, and were reflected in serious problems for the SUS. The creation of Anvisa and the SNVS surveillance system, and the support for bodies in individual states and municipalities, resulted in improvement in the structure and functioning of health surveillance, and improved recognition of the area as an emerging theme in research and education in public health. Several problems hamper the effective structuring of the SNVS. A change in the conception/design of health promotion is postulated, in which the large corporations, whose activities have strong connections with risk factors related to the current epidemic of chronic diseases, would be given a social responsibility. A set of challenges for better structuring of health surveillance in the SUS is also put forward.
本文概述了巴西统一卫生系统(SUS)架构中健康监测的性质、功能和历史。使用了文献来源和官方文件,并参考了从事健康监测工作的作者的经历。20世纪90年代中期极其严重的不良事件使巴西健康监测的脆弱性在政治层面上暴露无遗,并在SUS中反映为严重问题。国家卫生监督局(Anvisa)和全国卫生监测系统(SNVS)的创建,以及对各州和各市相关机构的支持,使健康监测的结构和运作得到改善,并提高了该领域在公共卫生研究和教育中作为新兴主题的认可度。若干问题阻碍了SNVS的有效构建。假定健康促进的概念/设计发生变化,即与当前慢性病流行相关风险因素有紧密联系的大公司应承担社会责任。还提出了一系列关于在SUS中更好构建健康监测的挑战。