Atuação de um Centro de Informações Estratégicas em Vigilância em Saúde em uma região de fronteira internacional do Brasil

Abstract

The study aimed to analyze how Health Surveillance and the Strategic Health Surveillance Information Center respond to public health emergencies in the international tri-border region of Brazil, Colombia, and Peru. This is a single-case, descriptive study with a qualitative approach, conducted in the context of the Brazil–Colombia–Peru tri-border region, with the municipality of Tabatinga, Amazonas, Brazil, as the case. Three sources of evidence were included in the study: interviews with managers from the Municipal Health Department of Tabatinga, the Border Laboratory, and the CIEVS of the Alto Rio Solimões Indigenous Health District; documents; and non-participant direct observations. The collected data were organized and coded with the support of ATLAS.ti® software. For data analysis, theoretical propositions were used as an analytical strategy, along with the construction of evidence-based descriptions as a technique. The study was approved by the Research Ethics Committee of the Amazonas State University. The results are presented in the case report description, which situates Tabatinga within the tri-border context and in the monitoring of diseases and health conditions through the Border CIEVS, organized into three categories that describe the evidence. The first category addresses actions and strategies for responding to public health emergencies in an international border region. The second reveals the existence of interinstitutional relationships to ensure shared objectives in health surveillance in an international border. The third explains the integration of CIEVS and Health Surveillance actions within the Health Care Network and their role in organizing health care for border populations. The study concludes that the field of public health emergencies requires assertive and coordinated actions to address them. This is a complex field for public health, dependent on public policies that take into account the specificities and vulnerabilities of border regions, especially the international tri-border region of Amazonas. In the tri-border area—Tabatinga (Brazil), Leticia (Colombia), and Santa Rosa (Peru)—health surveillance for border populations presents specific arrangements for analysis, monitoring, evaluation, and responses to diseases and health conditions affecting the territory, involving joint action by the Border CIEVS, epidemiological surveillance, and the border laboratory. At the border, actions have been undertaken to strengthen the integration of health surveillance in the tri-border region through joint interinstitutional initiatives among the technical coordination bodies of the three countries, the maintenance of informal agreements, and the establishment of information flows for disease notification. To consolidate the monitoring of the health situation in the international border region, it is suggested to create a subsystem for monitoring border population health surveillance, with unified data from the three countries, supported by financial incentives from all three nations to improve and enhance the trinational health situation room, enabling data analysis and the timely standardized sharing of health information to support decision-making by managers.