Physical activity as part of the surveillance, monitoring, and evaluation of Primary Health Care in Brazil: a scoping review

Abstract

OBJECTIVE: Mapping how physical activity (PA) is considered in Primary Health Care (PHC) is essential for aiding planning and management of policies and programs within the Brazilian Unified Health System (SUS). The aim of this study was to map PA-related measures and indicators that are considered in the surveillance, monitoring and evaluation of services and users from the PHC/SUS.

METHOD: This is a scoping review with searches conducted in January 2024 on electronic portals related to PHC/SUS. A “snowball” strategy was used to access government documents/reports and their complementary references. Documents were eligible whether they: 1) were government materials; 2) aimed at health surveillance, monitoring/evaluation of services or users from PHC/SUS, and 3) reported PA-related measures or indicators (the behavior and their psychosocial and/or contextual correlates). The selection and extraction process were performed in pairs. A thematic synthesis (evidence map) was applied.

RESULTS: Of the 239 potentially eligible documents, 95 were included and summarized according to four groups: health surveillance (n=39), indicators of health plans/policies (n=7), monitoring/evaluation of users (n=34) and services (n =15) from PHC/SUS. A total of 69 measures and 38 different indicators were addressed in health surveillance. The monitoring/evaluation of services includes general- and specific PA programs in PHC/SUS (17 and 13 indicators, respectively). User monitoring/evaluation included indicators aimed at people from different groups (e.g., people with chronic diseases) and their application, primarily in initial examinations and therapeutic planning.

CONCLUSIONS: These findings reinforce a call for government actions aiming to qualify the acquisition and implementation of PA-related health information; this may be one the main pathways of strengthening PA promotion on the SUS agenda.