The Social Determinants of Health in the planning of COVID-19 testing in Amazonas, Brazil

Abstract

The COVID-19 syndemic has disproportionately affected more vulnerable populations, exposing social inequalities in health. This article analyzes whether and how Social Determinants of Health were considered during the planning of testing for COVID-19 in Amazonas. For such analysis, we conducted a qualitative case study through document analysis and semi-structured interviews with key actors involved in the planning and implementation of testing. The official documents were systematized using TIDieR-PHP. Data were analyzed using the REFLEX-ISS tool. Social Determinants of Health were not considered in the planning of testing in Amazonas. Testing was conducted primarily through centers set up in 2020 specifically for COVID-19. Testing was restricted to patients with severe symptoms and certain categories of workers in services considered essential due to occupational exposure. There was no consensus among the interviewees about the importance of considering the Social Determinants of Health in intervention planning, or prioritizing groups considered at risk. Health policy managers must know the importance of considering the SDH in the planning of population interventions to make an equitable policy.