Responses of the Brazilian health system to the emergency of the Zika virus: different strategies adopted by the states of Ceará and Rio de Janeiro

Abstract

The article analyzes the cases of health system reprogramming in response to the Zika emergency in the states of Ceará (CE) and Rio de Janeiro (RJ), from 2015 to 2017. The research was anchored in the historical and institutionalist approach and the literature on regionalization and health care networks. It involved analyzing government documents and conducting interviews with key actors mobilized in the states’ response to the epidemic. For each state, the following aspects were primarily explored: context, political-financial situation and health agenda at the time of the epidemic; and the design and implementation of responses (meanings, actors, resources, strategies and repercussions). The reprogramming of the health system in the states of CE and RJ presented different conditions and different meanings of actions, strategies, mobilized actors and developments, with a focus on care initiatives for children with Congenital Zika Virus Syndrome (SCZV). The importance of the regionalized and coordinated network was highlighted, with deconcentration of the offer of specialized services and early stimulation procedures; the coordinating and investing role of the state government; the qualification initiatives of health professionals; of the performance of research institutions in the service, production of knowledge and in the dialogue with affected families.