Regionalized Health Surveillance in the State of Pernambuco: a case study

ABSTRACT This study aimed to evaluate the implementation of Regionalized Health Surveillance (HS) in the State of Pernambuco. It is an evaluative study carried out by means of the normative and the exploratory steps. The normative evaluation applied a quantitative approach for the structure and process dimensions, measuring the degree of HS implementation in four health regions of Pernambuco. The exploratory step consisted of semi-structured interviews with key informants so to apprehend also their perception about the HS regionalization process in Pernambuco as the factors that ease and hinder the process. HS was classified as 'partially implemented' in regions I, II and III, and 'implemented' in region IV. 'Structure' was classified as 'partially implemented' in all regions. 'Process' was classified as 'partially implemented' in regions I and III, and 'implemented' in regions II and IV. We concluded that HS regionalization in Pernambuco is still incomplete, despite being a process of great relevance, since the regional level is able to plan and promote strategies more appropriate for each context, given the specific characteristics of each municipality.

摘要 本研究旨在评估伯南布哥州区域化健康监测（Regionalized Health Surveillance，HS）的实施现状。本研究为评估性研究，采用规范步骤与探索步骤相结合的方式开展。其中规范评估环节针对结构与流程维度采用定量研究方法，对伯南布哥州四个卫生区域的健康监测实施程度进行量化测评。探索性环节则通过对关键信息提供者开展半结构化访谈，以了解其对伯南布哥州健康监测区域化进程的看法，以及推动和阻碍该进程的相关影响因素。研究结果显示：第一、二、三卫生区域的健康监测被评定为"部分实施"，第四卫生区域为"已实施"；所有区域的"结构"维度均被评定为"部分实施"；"流程"维度中，第一、三卫生区域为"部分实施"，第二、四卫生区域为"已实施"。本研究最终得出结论：尽管区域层级可结合各市县的具体特征，制定并推行更贴合当地实际的相关策略，健康监测区域化进程具备重要意义，但伯南布哥州的健康监测区域化仍不完善。