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Sa\u00fade P\u00fablica"],"abstract":"<jats:p>O estudo objetivou avaliar a gest\u00e3o da regula\u00e7\u00e3o assistencial na rede de aten\u00e7\u00e3o \u00e0 sa\u00fade, bem como o processo de elabora\u00e7\u00e3o e consenso de a\u00e7\u00f5es estrat\u00e9gicas pactuadas para o enfrentamento das hepatites virais, na perspectiva da governan\u00e7a regional. Trata-se de pesquisa-a\u00e7\u00e3o, de abordagem qualitativa, realizada em uma Regi\u00e3o de Sa\u00fade de Mato Grosso, Brasil, com a participa\u00e7\u00e3o de 45 profissionais atuantes na vigil\u00e2ncia, cuidado, regula\u00e7\u00e3o, gest\u00e3o e controle social. A realiza\u00e7\u00e3o de grupo focal possibilitou a an\u00e1lise conjunta das estrat\u00e9gias de enfrentamento, culminando na formula\u00e7\u00e3o de consenso regional e pactua\u00e7\u00e3o colegiada. Os resultados evidenciam, no n\u00edvel pol\u00edtico-institucional, a aus\u00eancia de estrat\u00e9gias para enfrentar vazios assistenciais, a centraliza\u00e7\u00e3o da regula\u00e7\u00e3o e a fragilidade dos processos de informatiza\u00e7\u00e3o. No n\u00edvel organizacional, destacam-se dificuldades de integra\u00e7\u00e3o horizontal, com uma rede fragmentada e limitada capacidade de suporte cl\u00ednico descentralizado. No n\u00edvel das pr\u00e1ticas, persistem falhas na articula\u00e7\u00e3o intersetorial, informalidade nos fluxos de cuidado e fragilidade da aten\u00e7\u00e3o prim\u00e1ria \u00e0 sa\u00fade (APS) no monitoramento p\u00f3s-diagn\u00f3stico. O plano de a\u00e7\u00e3o consensuado contempla quatro linhas estrat\u00e9gicas: ampliar o acesso \u00e0s a\u00e7\u00f5es de preven\u00e7\u00e3o; fortalecer a aten\u00e7\u00e3o especializada articulada \u00e0 APS; expandir a capacidade diagn\u00f3stica laboratorial; e consolidar a vigil\u00e2ncia em sa\u00fade mediante pactua\u00e7\u00f5es interinstitucionais. A elimina\u00e7\u00e3o das hepatites virais demanda atua\u00e7\u00e3o sist\u00eamica, orientada pela justi\u00e7a social e pela constru\u00e7\u00e3o de solu\u00e7\u00f5es coletivas que respondam \u00e0s necessidades regionais, com monitoramento cont\u00ednuo para o alcance das metas globais at\u00e9 2030.<\/jats:p>","DOI":"10.1590\/0102-311xpt104125","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T10:45:23Z","timestamp":1782125123000},"source":"Crossref","is-referenced-by-count":0,"title":["Regula\u00e7\u00e3o assistencial e governan\u00e7a regional nas estrat\u00e9gias de microelimina\u00e7\u00e3o das hepatites virais"],"prefix":"10.1590","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5881-4945","authenticated-orcid":false,"given":"Josu\u00e9 Souza","family":"Gleriano","sequence":"first","affiliation":[{"name":"Universidade do Estado de Mato Grosso,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7781-7172","authenticated-orcid":false,"given":"Carlise","family":"Krein","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6766-3667","authenticated-orcid":false,"given":"Claudia Beatriz Cunha de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Secretaria Municipal de Sa\u00fade de Tangar\u00e1 da Serra,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0485-5724","authenticated-orcid":false,"given":"Stella","family":"Giansante","sequence":"additional","affiliation":[{"name":"Secretaria Municipal de Sa\u00fade de Tangar\u00e1 da Serra,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3353-3342","authenticated-orcid":false,"given":"Marcia Oliveira de","family":"Souza","sequence":"additional","affiliation":[{"name":"Secretaria Municipal de Sa\u00fade de Tangar\u00e1 da Serra,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1892-2412","authenticated-orcid":false,"given":"Gess\u00e9 Duque Ferreira de","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Secretaria Municipal de Sa\u00fade de Tangar\u00e1 da Serra,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8167-1837","authenticated-orcid":false,"given":"Regina Mary da Silva","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Secretaria de Estado de Sa\u00fade de Mato Grosso,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8730-2815","authenticated-orcid":false,"given":"Lucieli Dias Pedreschi","family":"Chaves","sequence":"additional","affiliation":[{"name":"Universidade de S\u00e3o Paulo,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"key":"ref1","series-title":"Tools and methodologies to assess integrated care in Europe: report by the Expert Group on Health Systems Performance Assessment.","year":"2017"},{"key":"ref2","series-title":"Redes Integradas de Servicios de Salud: conceptos, opciones de pol\u00edtica y hoja de ruta para su implementaci\u00f3n en las Am\u00e9rica","year":"2010"},{"key":"ref3","series-title":"Decentralization in health care: strategies and outcomes","year":"2007"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1186\/s12939-021-01426-1","article-title":"Understanding 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