"From the territorial grounds": an interview with Weibe Tapeba, secretary of Indigenous Health at the Ministry of Health.

In this interview, Weibe Tapeba, secretary of Indigenous Health at the Ministry of Health in the Lula Government, discusses the process of reorganizing the Secretariat of Indigenous Health (SESAI) and Indigenous protagonism in the new administration. Among the points highlighted by the interviewee are the assessment of the Indigenous health scenario within the current political context of the Ministry of Health, dialogues with Indigenous movement organizations, as well as collaboration with research and educational institutions. The interview highlights the importance of developing strategies aimed at restructuring SESAI and improving Indigenous health public policy in Brazil through extensive coordination, involving planning, management, funding, and Indigenous social participation with Social Control.

Implementation of the Indigenous Health Policy: an ethnographic analysis of healthcare practices in the Upper Solimões River.

This study analyzes the implementation of the Indigenous Health Policy, focusing on the care practices of health teams of the Indigenous Health Care Subsystem in the Upper Solimões River in the Amazon region. Using ethnography as a methodological resource, the dynamics among participants, discourses, and power in the implementation of the policy are investigated, revealing a complex interconnection between practices and other contextual realities. Three phenomena emerge as critical influences on care practices: the medical-care model, the sanitation model, and the culture of performance.

Living conditions, nutrition, and maternal and child health in the Baniwa Indigenous people, Northwest Amazon, Brazil.

Epidemiological surveys by ethnic groups are scarce in Brazil. The health and nutrition conditions of indigenous peoples who face situations of social inequities and inequalities, negatively influence their health indicators. This study is the widest investigation on the subject ever carried out on the Baniwa ethnic group, one of the most numerous in the country.

Utilization of dental services by rural riverside populations covered by a Fluvial Family Health Team in Brazil.

Introduction: Rural riverside populations of Brazil face several difficulties to access health services. The Brazilian National Primary Care Policy implemented the Fluvial Family Health Teams (FFHT), which is a specific primary care team arrangement for these territories. The aim of the study was to assess the use of dental services by adults living in rural riverside areas covered by a FFHT.

Prevalence of concomitant hypertension and diabetes among adults and elderly living in rural riverside areas in the Amazon.

Introduction: Considering the scarcity of information on the assessment of chronic diseases in traditional Amazonian populations, as well as public health policies focused on their specificities, this study aimed to estimate the prevalence of at least one of the chronic diseases (systemic arterial hypertension (SAH) or diabetes mellitus (DM)) and their concomitant occurrence in a rural riverside population of the Amazon, and determine the associated factors.

Methods: A household-based cross-sectional survey was conducted with a sample of adults and elderly people living in rural riverside locations along the left bank of the Negro River, in the municipality of Manaus, Amazonas, Brazil. The outcomes evaluated were the presence of at least one of the evaluated chronic diseases and the concomitant occurrence, based on the self-reported medical diagnosis of SAH and DM.

Pre- and post-surgical evaluation of the impact on Hansen disease sequealae patients' quality of life submitted to orthopedic surgery for closure of chronic plantar ulcers.

Introduction: Leprosy is a chronic infectious disease that still persists as a public health problem in Brazil. Plantar ulcers are serious complications due to leprosy neuropathy and intensify the isolation and stigma of these individuals. The difficulty in closing these lesions associated with the fetid odor negatively impact the quality of life of people with these lesions.

Association of physical performance and sarcopenia with use of health services in elderly people living in rural riverside areas in the Amazon: a cross-sectional study.

Introduction: Access is considered one of the necessary conditions for achieving effectiveness and quality in health services. However, it represents a complex construct, with several interpretations, and can be understood as the ease or degree of difficulty with which people obtain effective and timely care. Barriers to access can be related to individual characteristics and those of health systems and services.

Contextual and individual factors associated with self-reported tooth loss among adults and elderly residents in rural riverside areas: A cross-sectional household-based survey.

Background: Tooth loss is an oral health condition with high prevalence and negative impact on quality of life. It is the result of the history of oral diseases and their treatment as well as provision of dental care and access to dental services. Socioeconomic characteristics are determinants of tooth loss and living in rural areas is also a risk factor for its incidence.

Barriers to Access the Pap Smear Test for Cervical Cancer Screening in Rural Riverside Populations Covered by a Fluvial Primary Healthcare Team in the Amazon.

Cervical cancer is a major public health problem, especially in the north region of Brazil. The aim of the study was to identify the factors associated with not undergoing the cervical cancer screening test in rural riverside populations in the Amazon. A cross-sectional home-based survey was carried out in 38 locations covered by a fluvial primary healthcare team, and the administrative records of the screening tests from January 2016 to May 2019 were analyzed.

Self-reported chronic back pain in the elderly living in rural riverine areas in the Amazon.

Introduction: The present study aimed to estimate the prevalence of self-reported chronic low back pain and to identify the associated factors in elderly people living in rural riverside areas in the Amazon.

Methods: Data from a cross-sectional home-based survey performed in 38 riverside rural locations along the left bank of the Negro River, in the municipality of Manaus, Amazonas, Brazil, were analyzed. The selected elderly people answered a questionnaire comprising items related to the living conditions, socioeconomic and demographic characteristics, health status and utilization of health services.

Providing Antivenom Treatment Access to All Brazilian Amazon Indigenous Areas: 'Every Life Has Equal Value'.

Snakebites are more frequent in the Brazilian Amazon than in other parts of Brazil, representing a high cost for the health system since antivenoms are only available through medical prescription from central municipal hospitals in most cases. The need for a cold chain and physicians usually restricts access to the only effective treatment of a snakebite, the antivenom. The complex topography of the rivers contributes to delays in treatment, and consequently increases the risk of severe complications, chronic sequelae and death.

Barriers to access and organization of primary health care services for rural riverside populations in the Amazon.

Background: The ways of life in the Amazon are diverse and not widely known. In addition, social inequities, large geographic distances and inadequate health care network noticeably limit access to health services in rural areas. Over the last decades, Brazilian health authorities have implemented fluvial mobile units (FMU) as an alternative to increase access and healthcare coverage.

[Assessment of prenatal care for indigenous women in Brazil: findings from the First National Survey of Indigenous People's Health and Nutrition].

This study assesses prenatal care for indigenous women 14-49 years of age with children under five years of age in Brazil. The First National Survey of Indigenous People's Health and Nutrition assessed 3,967 women who met these criteria, of whom 41.3% in the North, 21.

Socioenvironmental aspects of the Purus Region - Brazilian Amazon: Why relate them to the occurrence of American Tegumentary Leishmaniasis?

This study aims to analyze factors related to the occurrence of American Tegumentary Leishmaniasis in the Purus Region, based on the reporting of cases between 2001 and 2013, correlating them with livelihoods and subsistence farming in the region, and analyzing them in regards to sex, age, clinical form, occupation, diagnostic methods and seasonality. The analysis parameter which was used included all cases of American Tegumentary Leishmaniasis in each sub-region by municipality. The Purus Region, between the states of Amazonas and Acre, consists of three sub-regions: Upper, Middle, and Lower Purus.

[Access to prenatal care and quality of care in the Family Health Strategy: infrastructure, care, and management].

This study focuses on access to prenatal care and quality of care in the Family Health Strategy in Brazil as a whole and in the North region, through evaluation of infrastructure characteristics in the health units, management, and supply of care provided by the teams, from the perspective of regional and state inequalities. A cross-sectional evaluative and normative study was performed, drawing on the external evaluation component of the second round of the Program for Improvement of Access and Quality of Primary Care, in 2013-2014. The results revealed the inadequacy of the primary healthcare network's infrastructure for prenatal care, low adequacy of clinical actions for quality of care, and the teams' low management capacity to guarantee access and quality of care.

Articulation between health services and "indigenous medicine": Anthropological reflections on policies and reality in Brazil.

This paper contributes to the dialogue between the social sciences and social medicine in Latin America by exploring therapeutic pluralism in indigenous health policies and services in Brazil. It reviews recent anthropological research, concepts and current debates to critically examine Brazilian indigenous health policy and its concept of "differentiated care," which proposes articulation between official health practices and indigenous therapies. A number of contradictions and tensions are present in the structural organizational of the indigenous health subsystem at the national level and in the daily practices of health teams at the local level.

Health regionalization in Amazonas: progress and challenges.

This paper analyses the health services regionalization process in the State of Amazonas through a case study covering the health sub-region Manaus Surroundings. This is a qualitative, descriptive and analytical research, which data were collected using interviews, documents and Internet reviews, oriented by the guiding concept of health regionalization. Study findings revealed a social setting dominated by asymmetry, verticality, competitiveness and fragile multilateral relations among municipalities, associated to a bureaucratic profile of local institutions operating in the region under study.

Anemia among indigenous women in Brazil: findings from the First National Survey of Indigenous People's Health and Nutrition.

Background: Anemia is recognized as a major public health problem that disproportionately affects vulnerable populations. Indigenous women of reproductive age in Brazil are thought to be at high risk, but lack of nationwide data limits knowledge about the burden of disease and its main determinants. This study aimed to assess the prevalence of anemia and associated factors in this population using data from The First National Survey of Indigenous People's Health and Nutrition in Brazil.

[The differentiated care model in the Special Indigenous Health Districts: reflections based on Alto Rio Negro in Amazonia State, Brazil].

The implementation of the National Policy for Healthcare of Indigenous Peoples (Pnaspi) in the Alto Rio Negro Amazon region was analyzed based on the principles of the differentiated care model. This theme was investigated from three perspectives, namely the formulation of the guidelines, the therapeutic itineraries in indigenous villages, and the work routines of the Indigenous Community Health Agents (AIS). It involved qualitative research based on the anthropological perspective of Eduardo Menéndez.

[Professional education and work of indigenous health agents in the Brazilian health system].

Objective: To discuss the role of indigenous health agents in the implementation of the model of differentiated attention or intercultural health in Brazil.

Materials And Methods: We revised the scientific literature about the work and professional education of indigenous health agents in the Brazilian indigenous health system.

Results: There is a subordination of the agents to the hegemonic medical model.

The First National Survey of Indigenous People's Health and Nutrition in Brazil: rationale, methodology, and overview of results.

Background: Although case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey. Reported here for the first time, the First National Survey of Indigenous People's Health and Nutrition in Brazil was conducted in 2008-2009 to obtain baseline information based on a nationwide representative sample. This paper presents the study's rationale, design and methods, and selected results.