Primary Health Care and the Management of Noncommunicable Diseases: Challenges and Strategies for Hypertension and Diabetes in the Amazon

Abstract

Noncommunicable Diseases (NCDs), especially Systemic Arterial Hypertension and Diabetes Mellitus, constitute significant public health problems, demanding continuous strategies for care, monitoring, and prevention of complications. In the Amazonian context, particularly in riverside communities, the management of these conditions presents additional challenges related to territorial inequalities, geographical barriers, logistical limitations, and fragilities in the organization of health services. Given this scenario, Primary Health Care (PHC) plays a strategic role in care coordination, longitudinal monitoring, and the promotion of equity. This study aimed to analyze, through a narrative literature review, PHC strategies focused on the management of systemic arterial hypertension and diabetes mellitus in riverside communities in the Amazon. The methodology consisted of a narrative review of scientific publications and normative documents, selected from electronic databases and official institutional health sources. The results show a high prevalence of underdiagnosis, discontinuity of care, and a higher risk of complications associated with NCDs in these territories, while also highlighting the relevance of strategies such as active case finding, territorialization, the role of Community Health Agents, health education, and supported self-care. It is concluded that strengthening PHC, with actions adapted to the socio-territorial specificities of riverside communities, is fundamental to qualify the care for NCDs, reduce avoidable hospitalizations, and promote greater equity in access and health outcomes.