Participatory development and pilot implementation of self-care support groups for chagas disease in primary health care in brazil’s unified health system
1
CUIDA Chagas Project, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A1498
ABSTRACT
INTRODUCTION:
Chagas disease (CD) is a neglected chronic condition in which stigma, fragmented care pathways, and limited psychosocial support can undermine quality of life and engagement with care. Primary health care (PHC) is a strategic setting to integrate clinical care with health promotion actions that strengthen autonomy, shared knowledge, and the right to health within public health systems.1,2
METHODS:
The CUIDA Chagas project,3 through a participatory approach, developed a practical guide to support the implementation of Selfcare Support Groups (SSG) for people living with CD. The guide offers a structured adaptable package, including key concepts, operational recommendations, a proposed cycle of 10 1.5-hour sessions, and tools for planning, monitoring, and evaluation. The methodology is organized around three pillars (clinical management, lifestyle, and socio-emotional aspects), supporting an integral health promotion framework.4
RESULTS:
In 2024 and 2025, four SSG cycles were implemented in three Brazilian municipalities of the CUIDA Chagas implementation study. Eight facilitators were trained, all PHC nurses. Cycles achieved an average of eight participants per meeting, consisting of women living with CD, family members and others health workers. Reported strengths included local government and health management support, effective mobilization strategies for participants, increased self-confidence regarding selfcare in CD, and strengthened social bonds over time. A common challenge was participant's adherence and schedule compatibility. Facilitator engagement was crucial for session quality and continuity. Pilot experience informed refinements to facilitation, logistics, and session dynamics.
CONCLUSIONS:
Developing and piloting this methodology supported the implementation of an innovative, scalable health promotion strategy for CD in PHC within Brazil’s Unified Health System. As the first group-based comprehensive approach for people living with CD, its step-by-step structure and adaptability support replication across diverse territories. Sustainability and scale-up depend on continued institutional support, expanded facilitator training, and mechanisms for local adaptation.
Chagas disease (CD) is a neglected chronic condition in which stigma, fragmented care pathways, and limited psychosocial support can undermine quality of life and engagement with care. Primary health care (PHC) is a strategic setting to integrate clinical care with health promotion actions that strengthen autonomy, shared knowledge, and the right to health within public health systems.1,2
METHODS:
The CUIDA Chagas project,3 through a participatory approach, developed a practical guide to support the implementation of Selfcare Support Groups (SSG) for people living with CD. The guide offers a structured adaptable package, including key concepts, operational recommendations, a proposed cycle of 10 1.5-hour sessions, and tools for planning, monitoring, and evaluation. The methodology is organized around three pillars (clinical management, lifestyle, and socio-emotional aspects), supporting an integral health promotion framework.4
RESULTS:
In 2024 and 2025, four SSG cycles were implemented in three Brazilian municipalities of the CUIDA Chagas implementation study. Eight facilitators were trained, all PHC nurses. Cycles achieved an average of eight participants per meeting, consisting of women living with CD, family members and others health workers. Reported strengths included local government and health management support, effective mobilization strategies for participants, increased self-confidence regarding selfcare in CD, and strengthened social bonds over time. A common challenge was participant's adherence and schedule compatibility. Facilitator engagement was crucial for session quality and continuity. Pilot experience informed refinements to facilitation, logistics, and session dynamics.
CONCLUSIONS:
Developing and piloting this methodology supported the implementation of an innovative, scalable health promotion strategy for CD in PHC within Brazil’s Unified Health System. As the first group-based comprehensive approach for people living with CD, its step-by-step structure and adaptability support replication across diverse territories. Sustainability and scale-up depend on continued institutional support, expanded facilitator training, and mechanisms for local adaptation.
| eISSN: | 2654-1459 |
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