Indigenous Health in SUS planning in Santa Catarina: a quantitative–qualitative analysis of municipal, regional, and state health plans

Abstract

This study aimed to identify the presence of references and analyze how the Indigenous population is incorporated into SUS planning instruments in Santa Catarina. It is a quantitative–qualitative study based on document and content analysis of 19 Municipal Health Plans (MHPs) 2022–2025 from municipalities with Indigenous villages, the State Health Plan (SHP) 2024–2027, and six Regional Plans (RHPs) from macro-regions where village-based Indigenous peoples live. Terms related to Indigenous issues were searched, mentions were categorized, and coherence was assessed between the Health Situation Analysis (ASIS) and the Guidelines, Objectives, Goals, and Indicators (DOMI). Eight MHPs, five RHPs, and the SHP included references to the Indigenous population, grouped into access to comprehensive and equitable care, epidemiological situation, and sociodemographic situation. The mentions were occasional and mostly generic, with limited consideration of the cultural, social, and territorial specificities of Indigenous peoples. Gaps were identified in the use of disaggregated epidemiological and demographic data, and the articulation between ASIS and DOMI was weak. Only one reference to Indigenous participation in planning processes was found. Overall, the analyzed instruments do not adequately address the specificities of village-based Indigenous peoples or the adaptations necessary to ensure comprehensive and equitable care, highlighting the need to identify inequalities, recognize socially produced vulnerabilities, and guide policies consistent with SUS principles of equity and universality.