Analyzing a national health surveillance strategy to reduce mother-to-child transmission of syphilis: The case of Brazilian investigation committees

Abstract

Objectives: This study aimed to analyze the relevance of investigation committees in eliminating mother-to-child transmission of syphilis in Brazil.

Methods: Questionnaires and interviews were conducted with health managers of 25 Brazilian Federative Units and Brazil's Federal District. Data were analyzed using Bardin's content analysis technique and subsequently compared with the global prescriptions for syphilis response of the Pan American Health Organization, World Health Organization, and recent research publications examining the course of syphilis in Brazil, in Brazilian regions, and globally.

Results: While the investigation committees drew on the successful experience of those in reducing maternal mortality, which helped the country achieve the Millennium Development Goals, they are not demonstrated to be sufficient for preventing mother-to-child transmission of syphilis. The committees' systematic and bureaucratic agenda has not been efficient in managing avoidable factors for syphilis, nor do they operate in the scope of the integration of surveillance and care actions, as recommended by the health policy.

Conclusion: The committees' model needs to be reviewed in the context of Brazil's National Health System. The research process should be rescaled in order to remain a cornerstone for the induction of health policy that integrates surveillance and healthcare across Brazilian Federative Units. The advancement toward an automated case management model becomes relevant for the country to meet global commitments to eliminate congenital syphilis transmission and achieve the goals outlined in the 2030 Agenda.

Keywords: Congenital syphilis; Mother-to-child transmission of infectious diseases; Public health policy.

Figure 1

Existence of a committee or other institutional space for the investigation of diseases transmitted from mother to child, Brazil, 2022. Source: own authorship, 2022.

Figure 2

Status of the institutional spaces responsible for performing investigations of mother-to-child transmission of syphilis, n = 26.

Figure 3

Percentage of composition of members that are part of the place for investigation of syphilis mother-to-child transmission. n = 26. SHS, State Health Secretariats; STI, sexually transmitted infection. Source: own authorship, 2023.

Figure 4

Percentage of participation of the project supporter as a member of a place responsible for the investigation of mother-to-child transmission along the project's territorial support per region. n = 26. Source: own authorship, 2023.

Figure 5

Percentage of meeting periodicity coordinated by the institutional spaces for mother-to-child transmission of syphilis per region. n = 26. Source: own authorship, 2023.