BIREME Bulletin n° 35

Promoting the use of evidence in health locally

Developing culture and conditions for the use of scientific knowledge and evidence as an element of decision making at the local level of the health systems is still a great challenge and opportunity to face high impact problems in order to attain the sustainable development goals of the 2030 Agenda.

A recent experience is taking place with the participation and collaboration of BIREME, in the development of a synthesis of evidence for the reduction of maternal mortality in the state of PiauĂ­. In fact, the problem of maternal mortality deserves special attention due to the high rates within the state and which, for the most part, are related to preventable causes, with large quantities of strong evidence that can be considered by the state in order to reduce maternal mortality.

BIREME is collaborating with the elaboration of a synthesis of evidence, especially with identifying and analyzing evidence in terms of quality, equity and implementation of selected options according to the context and characterization of the problem within the state of PiauĂ­. The options are:

Option 1 – Tracing hypertension and pre-eclampsia during pregnancy, which consists in good quality monitoring of arterial pressure by the Family Health Team during the entire pregnancy term and in implementing the proteinuria test in Primary Care for high-risk pregnancies.

Option 2 – Perinatal regionalization and m-Health, which consists in implementing a system of text messages via cell phone between high-risk pregnant women and family health teams, for promotion and education in health, prevention of diseases and use of the services of the Regionalized Health Network.

Option 3 – Training for the health teams in Primary Health Care, which consists in implementing training actions (educational meetings, educational visits, facilitated practices, local opinion leaders, audits and feedback) which promote cognitive and behavioral changes in family health professionals.

piaui_aThese options were presented and discussed in a Deliberative Dialogue which was held in the city of SĂŁo Raimundo Nonato, on July 26 of this year, as part of the program of the I International Symposium on Women’s Health, during which decision-makers, managers of the different levels of the Brazil’s Unified Health System (SUS), health workers, researchers and representatives of organized civil society discussed strategies for the reduction of maternal mortality in the state of PiauĂ­.

The words of the representative of the legislative in this Dialogue reflect very well the importance of the initiative:

“Now I have a qualified discourse based on scientific data and evidence. This allows me to speak with authority and not merely from common sense. The problem can be interpreted as complex or requiring a large amount of financial resources to be solved, but when we know the data, the evidence, we realize that the solution comes from a simple change of attitude. Knowledge allows for empowering.”

More information on the use of evidence in PiauĂ­

For many years BIREME has been holding activities for the promotion of access and use of scientific knowledge and evidence through the Núcleo de Ensino, Pesquisa e Extensão em Educação Permanente para o SUS (NUEPES) of the Universidade Federal do Piauí (UFPI). These courses aim to develop capacities for access, analysis, systematization and application of evidence in access for health researchers and managers; and participation in events promoted by the NUEPES.

The most recent activity consists on the elaboration of a synthesis of evidence for the reduction of maternal mortality in Piauí by applying the SUPPORT methodology promoted by EVIPNet Brasil – Network for Policies Informed by Evidence and by the Department of Science and Technology (DECIT) of the Brazilian Ministry of Health.


Reference sources:

SUPPORT Methodology and EVIPNet: (in Portuguese)

I International Symposium on Women’s Health: Deliberative Dialogue discusses strategies for reducing maternal mortality in Piauí, available at: (access on August 26, 2019 – in Portuguese)

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