Governança e planejamento estratégico situacional na saúde indígena - polo base Guarita/RS

Abstract

Introduction: indigenous health governance requires effective articulation between the Unified Health System (SUS) and the Indigenous Health Care Subsystem (SasiSUS), especially in territories marked by high sociocultural complexity. Thus, understanding how governance is organized in each territory is essential for strengthening intercultural approaches and promoting differentiated health care for Indigenous populations. Objective: to understand the organization of health governance in the Guarita Base Pole and identify how municipalities integrate (or fail to integrate) the guidelines of the National Policy for the Health Care of Indigenous Peoples into their planning instruments and services. Method: a qualitative approach was used, including a technical field visit, analysis of Municipal Health Plans and district documents, and consideration of field observations. Results: findings revealed that, although Indigenous presence is significant in the territories, municipalities do not fully incorporate the guidelines of the National Policy for the Health Care of Indigenous Peoples—such as the roles of Indigenous Health Agents and Indigenous Sanitation Agents— into their management instruments. The study also identified positive advances in Indigenous health in the territory, including cultural mediation within a municipal health service, expansion of specialized services, and the structuring of a specialized Indigenous health clinic in the city of Tenente Portela. Conclusion: strengthening shared, territorialized, and intercultural governance is essential to ensuring integral, effective, equitable, and culturally coherent care for Kaingang and Guarani peoples of the Guarita Indigenous Land in Rio Grande do Sul.