Analysis of the implementation on National Policy of Comprehensive Health for the Black Population based on state and municipal basic information surveys and its relationship with Primary Health Care

Bibliographic Data

ID23309149
AuthorsJulyane Cristina dos Santos Felício (0009-0006-9609-783X, Escola Nacional de Saúde Pública), Ana Paula Da Cunha (0000-0002-1400-1472, Fundação Oswaldo Cruz), Márcia Pereira Alves Dos Santos (0000-0003-0349-8521, Fundação Oswaldo Cruz), Marly Marques Da Cruz (0000-0002-4061-474X, Escola Nacional de Saúde Pública)
Year2026
Volume35
Issue2
Publication date2026-01-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSaúde e Sociedade (JOURNAL)
Journal identifiersISSN: 0104-1290 • E-ISSN: 1984-0470
PublisherFapUNIFESP (SciELO) (PUBLISHER)
DOI10.1590/s0104-12902026250531en
OpenAlexW7171472419
SCIELO_PIDS0104-12902026000201004
LanguageEN
References cited14

This study analyzed the implementation of the National Policy for Comprehensive Health Care for the Black Population (PNSIPN) across Brazilian states and municipalities, examining its association with Primary Health Care (PHC) coverage and the proportion of the Black population using secondary data from the ESTADIC-MUNIC survey (2021). In the state-level analysis, we adopted the K-means cluster analysis to identify implementation profiles. At the municipal level, a fractional logit regression model suitable for proportional outcomes was applied, incorporating all explanatory variables simultaneously. The findings revealed significant regional disparities, with states exhibiting varied combinations of PHC coverage, Black population proportions, and policy implementation levels. At the municipal level, both health plans showed low institutionalization of the PNSIPN. Greater PHC coverage was associated with lower policy implementation levels, regardless of the proportion of the Black population. The PNSIPN remains weakly institutionalized at both state and municipal levels, with actions concentrated in a limited number of territories. A notable gap persists between normative commitments, such as plans and councils, and the effective implementation of actions aimed at racial equity. While PHC expansion may support PNSIPN implementation, structural barriers continue to hinder sustained progress, particularly in areas with a higher proportion of Black residents.

Health care · Institutionalisation · Logistic regression · Normative · Population · Primary care · State (computer science) · State policy · Health, Nursing, Elderly Care · Maternal and Neonatal Healthcare · Public Health in Brazil · Health Policy

Tools

Open DOIOpen Access