ABSTRACT:
The Brazilian Amazon plays a critical role in global environmental sustainability, yet the well-being of the populations who inhabit and protect this territory remains largely overlooked. These populations face persistent structural inequalities in access to Primary Health Care (PHC), driven by social invisibility, geographic barriers, territorial isolation, limited state presence, and constrained public service provision. Such challenges are exacerbated by long river distances, climatic seasonality, extreme weather events related to climate change, and population dispersion across remote areas. In this context, this study examines initiatives aimed at strengthening Brazil’s Unified Health System (SUS) through the integration of PHC and digital health strategies in traditional Amazonian communities. The initiative seeks to expand access to health services by strengthening physical and digital infrastructure, organizing care pathways for both in-person and telehealth services, identifying technical gaps in the health workforce, and enhancing PHC governance. The intervention is guided by participatory approaches and by the adaptation of strategies to local sociocultural and territorial contexts, through partnerships involving civil society organizations, philanthropic institutions, health authorities, and environmental agencies. This study adopts an experience-report design based on the systematization of data from technical and managerial monitoring processes, including technical documents, monitoring reports, interinstitutional meetings, and workforce training activities. Preliminary findings indicate improvements in interinstitutional governance arrangements and strengthened social participation, with active engagement of community leaders in priority setting and contextual adaptation of strategies. Advances were also observed in the organization of PHC work processes and in territorial readiness for the integration of digital health strategies. The integration of PHC and digital health, supported by collaborative governance and community participation, demonstrates strong potential to reduce territorial health inequalities and enhance the resilience and sustainability of health systems in remote Amazonian contexts.