Saúde indígena no Pará e sua interface com o Covid-19: planejamento, implementação e governança

Abstract

Faced with the global, national and state scenario, affected by the new variant of the Coronavirus, international and national authorities launched measures that needed to be planned and implemented rigorously, in order to contain the spread of the virus and the impact of more individuals, with deaths and sequelae. This need was reinforced in the pandemic situation, based on the confirmed cases and deaths reported by COVID-19 among the indigenous peoples of the state of Pará. Thus, this thesis sought to analyze the processes of planning and implementing actions and services aimed at indigenous health, during this period of pandemic due to COVID19. To conduct this process, a mixed study was adopted, with a qualitative and quantitative approach, using a specialized bibliography focused on regionalization, indigenous health, interdisciplinarity, impacts of COVID-19, care networks, with historical documentation, regulations, theses, and scientific articles. The complexity posed by this study also required different methodologies, which helped the researcher understand and analyze the facts and phenomena from different perspectives, thus enabling interdisciplinary dialogue. Thus, descriptive-exploratory qualitative research was adopted and, therefore, a documentary analysis was carried out, based on the contingency plans against Covid-19 of the Special Secretariat for Indigenous Health, of the state of Pará, of the Special Indigenous Health Districts of Pará and strategic municipalities, as well as the analysis of vaccination coverage and morbidity and mortality data of each district. As results found, it is important to mention that there was no planning linked to the municipalities as governed by legislation, the implementation of contingency plans had an impact on vaccination coverage and morbidity and mortality indicators, despite the “biases” of the route and the governance of actions and services during the pandemic they were “crossed” by macro and micropolitics that historically persist. There have been many advances, but there are still challenges to be overcome in the spaces of macro and micro politics of meetings between districts and municipalities, between districts and the Department of Public Health of the State of Pará, between districts and the Special Secretariat for Indigenous Health, in the regions and macro-regions of Pará. Seeking strategies and strengthening existing ones, such as the steering group and the interagency commissions with indigenous health, can be a path to governance.