INTRODUCTION:
Systematic quality assessment in health care remains a global challenge, particularly in low- and middle-income countries where resource constraints coexist with demands for universal health coverage. Despite international commitments to people-centered care, few public health systems have successfully institutionalized comprehensive evaluation models that integrate user voice, team self-assessment, and health outcomes into routine management practice. Recife Monitora was developed by the city of Recife within Brazil's Unified Health System (SUS) as a systematic evaluation framework combining multiple quality dimensions through digital platforms. This study presents the model's design and implementation results in Primary Health Care.

METHODS:
Implemented in Recife (population of approximately 1.6 million), the model integrates three dimensions through digital platforms: satisfaction surveys conducted post-consultation via WhatsApp across all Primary Health Care facilities; team self-assessment; and performance monitoring through health indicators. Data collection occurs in four-month continuous improvement cycles, generating a classification matrix that enables comparative analysis and performance tracking. Results are systematically fed back to teams through dashboards and mentoring sessions. The methodology is institutionalized through municipal legislation and operationalized via standardized protocols.

RESULTS:
Between 2023-2025, Recife Monitora completed seven evaluation cycles, collecting more than 300000 user assessments across the municipal Primary Health Care network. Teams achieving top-tier quality classification increased three-fold from baseline. The continuous feedback loop enabled targeted improvements in patient reception protocols, provider-patient communication, and access organization. The model demonstrated feasibility for large-scale digital implementation while generating actionable intelligence for health managers.

CONCLUSIONS:
Recife Monitora demonstrates that integrating user experience, team self-assessment, and health performance indicators into a digitally-enabled quality monitoring framework is feasible and effective in large public health systems. Its standardized methodology, technological scalability, and integration with existing health information systems position it as a transferable model for cities and regions seeking to strengthen quality governance within universal health coverage frameworks.