HEALTH SURVEILLANCE IN VULNERABLE TERRITORIES: OPERATIONAL, STRUCTURAL, AND MANAGEMENT CHALLENGE

Abstract

Health surveillance in vulnerable territories is a fundamental strategy for the effectiveness of the Brazilian Unified Health System, as it articulates actions for health promotion, prevention, and control of diseases based on the concrete living conditions of the population. This study aimed to analyze the operational, structural, and managerial challenges that interfere with the organization of health surveillance in contexts marked by social inequalities. It is a narrative literature review grounded on documents from the Ministry of Health and national scientific publications, focusing on the integration between primary health care and surveillance, the social determinants of health, and the specificities of vulnerable groups. The results showed weaknesses in territorialization processes, fragmentation among surveillance sectors, insufficiency of information systems, and difficulties faced by health teams in accessing areas affected by violence. It was observed that Black populations, homeless people, and residents of peripheral areas experience greater barriers to care and worse health outcomes, revealing the persistence of inequities. The role of the Family Health Strategy, community participation initiatives, and proposals for popular surveillance with an intersectional approach were highlighted as potentialities. It is concluded that strengthening health surveillance in vulnerable territories depends on integrated management, permanent professional education, intersectoral actions, and ethical governance of information. The effectiveness of actions requires recognizing the territory as a political and social space, transforming data into interventions capable of reducing inequalities and expanding rights. Participatory empirical research is suggested to deepen the understanding of local surveillance practices and their impacts on community life.