Banca de DEFESA: ALINE PATRICIA DOS SANTOS BEZERRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : ALINE PATRICIA DOS SANTOS BEZERRA
DATE: 29/07/2026
TIME: 14:00
LOCAL: Remoto: https://meet.google.com/uso-ijsk-miv
TITLE:

Analysis of factors associated with the quality of health surveillance actions

KEY WORDS:

Public Health Surveillance; Quality, Access, and Evaluation of Health Care; Health Status Diagnosis

PAGES: 114
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

Introduction: Health Surveillance (HS) is a strategic component of the Brazilian Unified Health System (SUS), playing a fundamental role in monitoring population health conditions and supporting the formulation of public health policies. In this context, performance monitoring and evaluation are essential for strengthening management and improving the quality of health surveillance actions. Established in 2013, the Health Surveillance Actions Qualification Program (PQA-VS) was created to enhance HS performance through performance indicators and financial incentives. Objectives: To analyze the determinants associated with the qualification of Health Surveillance actions in Brazil, considering contextual, organizational, epidemiological, and socioeconomic dimensions, as well as their effects on the performance of public health surveillance policies. Methods: This ecological study employed a quantitative approach and comprised two studies using data from Brazilian municipalities. The first was a cross-sectional study including 5,514 municipalities. The dependent variable was the PQA-VS financial incentive per capita, while socioeconomic, epidemiological, and health service indicators were considered independent variables. Mahalanobis distance was used to identify multivariate outliers, followed by Pearson's correlation analysis and multiple linear regression using the backward stepwise method. The second study was a time-series analysis (2021–2024) that included PQA-VS indicators, demographic, socioeconomic, household income, and population size variables. Temporal trends were estimated using the Annual Percent Change (APC). Comparisons between groups were performed using analysis of variance (ANOVA), and spatial distribution was analyzed using QGIS software. Results: The PQA-VS financial incentive per capita was positively associated with indicators of social vulnerability and negatively associated with indicators of better living conditions, including life expectancy, income, and the Human Development Index (HDI). Higher per capita investments were observed in municipalities with higher infant mortality rates, greater income inequality, lower household income, and a higher proportion of households with inadequate water supply and sanitation. Time-series analysis showed a significant increase in PQA-VS financial incentives between 2021 and 2024, with a more pronounced growth in municipalities with greater social vulnerability. ANOVA revealed significant effects of time and contextual variables on incentive values, while spatial analysis demonstrated relative stability in territorial distribution, with the highest per capita values concentrated in the North, Northeast, and parts of the Central-West regions of Brazil. Conclusions: The performance and evolution of PQA-VS funding are strongly influenced by the socioeconomic, demographic, and health-related inequalities among Brazilian municipalities. Although the program has contributed to strengthening Health Surveillance, performance-based financing alone has proven insufficient to reduce territorial inequalities. These findings highlight the need to improve funding and evaluation mechanisms by incorporating indicators of social vulnerability, epidemiological needs, and municipal institutional capacity in order to promote greater equity, strengthen Health Surveillance, and support the improvement of public health policies within the Brazilian Unified Health System (SUS).

COMMITTEE MEMBERS:
Presidente - 1149540 - ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
Interna - ***.578.944-** - GRÁCIA MARIA DE MIRANDA GONDIM - Fiocruz - RJ
Externo ao Programa - 2580109 - EWERTON WILLIAM GOMES BRITO - UFRNExterna ao Programa - 1674688 - TATYANA MARIA SILVA DE SOUZA ROSENDO - UFRNExterna à Instituição - RENATA ALVES GOMES VILLANI
Externo à Instituição - RAPHAEL MENDONÇA GUIMARÃES