A Saúde Digital na promoção do acessão à Atenção Primária à Saúde por populações ribeirinhas no contexto amazônico

Abstract

Since the creation of the Unified Health System (SUS), Brazil has made significant progress in strengthening Primary Health Care (PHC), with significant improvements in expanding access and improving the quality of services offered. However, the constitutional principle of universal access has not yet been fully realized for all Brazilians, especially for populations living in rural and riverside areas of the Amazon, where geographic, social, and health barriers persist, hindering the provision and use of timely and effective services. In this context, Digital Health emerges as a promising strategy to address inequities in access, being encouraged by international organizations and incorporated into Brazilian public policies through investments and initiatives focused on innovation. Advances in Information and Communication Technologies (ICTs) have enabled the development of new care practices and models, transforming the organization of health services and expanding coverage, resolution, and quality of care, especially in hard-to-reach areas. Thus, this research aimed to analyze the use of Digital Health solutions in promoting access to PHC services for rural riverside populations, considering their territorial and sociocultural specificities. This is a qualitative study with an exploratory character, that combines a scoping review with field research conducted in the Santa Maria Community, located in the Puranga Conquista Sustainable Development Reserve in Manaus, Amazonas. Semi-structured interviews were conducted with healthcare professionals and managers, as well as an workshop with community residents, covering their perceptions, experiences, and expectations regarding the use of digital technologies in healthcare. The results show that ICTs represent a concrete opportunity to overcome structural barriers and expand the provision of health services in regions historically marked by inequalities. They also present the advantages and challenges of their implementation, according to the participants in this research, as well as factors that affect their acceptance. However, for these technologies to fulfill their transformative role, it is essential that digital solutions be developed in partnership with professionals and users, respecting local characteristics and responding to the real needs of the population. The effectiveness of these strategies depends directly on their acceptance, which is influenced by perceived usefulness, dialogue and guidance, and perceived needs. The willingness of professionals and residents to adopt these technologies, even when faced with challenges such as poor infrastructure, limited connectivity, and the need for training, reinforces the vision of Digital Health as a tool for strengthening PHC while also highlighting challenges that must be considered in the development of new solutions. Thus, this study contributes to the debate on the development of public policies more sensitive to the realities of the Amazon, reaffirming the commitment to the principles of the Unified Health System (SUS) and the promotion of equitable, comprehensive, and effective care for vulnerable people.