Avaliação do sistema de vigilância em saúde da violência autoprovocada na macrorregião de saúde leste de Minas Gerais, Brasil

Abstract

Self-inflicted violence is a severe public health issue due to the magnitude of its impact on victims, their families, and society. The evaluation of surveillance systems is an action recommended by the Centers for Disease Control and Prevention (CDC), which advocates for routine assessments of health surveillance systems. In this context, the present study aimed to evaluate the health surveillance system for self-inflicted violence in the Eastern Health Macroregion of Minas Gerais (Macro Leste). This was a mixed-methods evaluative study with distinct approaches to the self-inflicted violence surveillance system, including: a descriptive cross-sectional quantitative approach analyzing the epidemiological profile of self-inflicted violence notifications; assessment of quantitative attributes (Sensitivity, Representativeness, Timeliness) and qualitative attributes (Simplicity, Flexibility, Stability, Data Quality, and Acceptability); as well as utility and monitoring. The attributes of representativeness, timeliness, acceptability, and data quality were evaluated through self-inflicted violence notifications from Notifiable Diseases Information System (SINAN). Simplicity, flexibility, stability, utility, and monitoring were assessed using a data collection instrument with a Likert scale ranging from "strongly agree" (5 points) to "strongly disagree" (1 point). Sensitivity was evaluated by analyzing the temporal trends of notification, hospitalization, and mortality data related to self-inflicted injuries. The instrument was completed by 24 health professionals working in the Macro Leste. The responses were assessed for internal consistency using McDonald's Omega (ω), classified as low (0–0.39), moderate (0.40–0.79), or excellent (≥0.80). Due to the large volume of data, the study results were presented in two scientific articles. Following the evaluation, the system was classified as having good data quality, moderate representativeness, untimely reporting, poor acceptability, simplicity, sensitivity, inflexibility, instability, and low utility, considering the identification and reporting of cases within 24 hours, along with low monitoring by municipal health surveillance professionals. Thus, it was concluded that, despite the current relevance of the issue, there are still weaknesses in the macro-regional surveillance system. Investments in public policies focusing on improving epidemiological surveillance and victim care are necessary to prevent suicide deaths.