Desafios e oportunidades no plano de doenças e agravos não transmissíveis: implementação de políticas de saúde pública num estado da Amazônia legal

Abstract

Non-Communicable Diseases and Conditions (NCDs) represent one of the greatest challenges to Brazilian public health, with significant impacts on morbidity, mortality, and the population’s quality of life. This dissertation aimed to analyze the implementation of public health policies in a state of the Legal Amazon, focusing on the NCD Plan (2021–2030). This descriptive study, with a mixed-methods approach (qualitative and quantitative), employed methodological triangulation as an analytical strategy. Three data sources were integrated: official documents, Sustainable Development Goals (SDG) indicators, and a semi-structured interview with a health professional, using thematic categorical content analysis. The results reveal specific advances, such as access to safe drinking water for 93.3% of the population in 2023; 58 births per 1,000 girls aged 15–19 in 2023, compared to 69 in 2020; and coverage of births attended by skilled professionals at 98.7% in 2023, compared to 92.2% in 2020. However, critical challenges persist, including high mortality from NCDs and violence, and a maternal mortality ratio of 86 per 100,000 live births in 2023, above the SDG target (≤70 per 100,000). There are challenges in coordination among surveillance, primary health care, and intersectoral policies, which are essential to achieving the targets of the NCD Plan and the SDGs, as outlined in the state NCD plan and observed by the informant. The need to strengthen intersectoral coordination among surveillance, primary care, and regional management was evident. The study contributes to improving health strategies, reinforcing the relationship between the goals of the NCD Plan and the SDGs.