According to the National Registry of Health Institutions (CNES), there are 402,777 health agents in Brazil, including Community Health Agents (CHAs) and Endemic Disease Control Agents (ACEs). In addition, a new category is being formed: from the second half of this year, the first classes of Popular Health Agents (AgpopSUS) will begin.
For over 20 years, agents have played a key role in promoting universal and comprehensive access to healthcare, especially in hard-to-reach areas with vulnerable populations. They serve as a bridge between communities and health services, facilitating access to primary and specialized healthcare.
Through their educational activities, preventive guidance and early identification of health problems, agents contribute significantly to disease prevention and the promotion of healthy habits within communities. Therefore, their community work and proximity to the local reality are essential to enhance the service and the well-being of the population served.
Learn the differences between them below:
Community Health Agents (CHAs)
Community health agents are professionals with in-depth knowledge of the community in which they work, of which they are part. Their close work with families allows for a more humanistic and individualized approach, focused on prevention, health promotion and comprehensive monitoring of people’s health needs. They are members of the basic formation of family health teams, which form the basis of primary care in Brazil.
CHAs are assigned to work in the territory where they reside and receive specific training to carry out activities such as home visits, identifying health problems, providing guidance on health practices, referring to health services when necessary, and contributing to community organization and mobilization. “Being an agent means being a link, being a facilitator. We know the house and the characteristics of the families, so we can work to meet their real needs,” says Leuda Silva, Community Health Agent at Basic Health Unit 1 (UBS 1) in Paranoa (DF).
- Photo: Tiberio Rodriguez
According to the Primary Care Health Information System (Sisab), in the first half of 2024, 344,668,394 home visits were recorded by these agents throughout Brazil. The data also reveal that, in the same period, they were responsible for 491,224 group activities, with the participation of 8,821,486 users, which led to a significant increase in the population’s attachment to the teams. “The presence of these health professionals, who represent well the link between the Unified Health System and the people, is fundamental to achieving the good results offered by the Family Health Strategy,” says the Minister of Primary Health Care, Felipe Proinco.
In the first four months of 2024, the Ministry of Health invested R$758,800 in the training of these professionals. In addition, Decree GM/MS 3,162, issued on February 20, 2024updated the value of the federal financial incentive for monthly funding that agents receive to the minimum wage.
Anti-epidemic agents (ACEs)
The ACE, a specialist attached to the health surveillance team, is responsible for monitoring and controlling vector-borne diseases, such as dengue, Zika, chikungunya, malaria, and others, as well as actions that include promoting healthy environments and monitoring and identifying environmental hazards that may negatively impact health.
“We are aware of the environment on a broader scale. We not only monitor zoonotic and vector-borne diseases, but also environmental factors that can cause health problems. It is gratifying to identify environments that may experience a serious epidemic process and to be able to recognize them before they happen,” says Anderson Leocadio, environmental agent at the Recanto das Emas surveillance center, in the Federal District.
They work to identify and eliminate breeding sites of vectors responsible for transmitting these diseases, implement vector control measures, and promote environmental and community health education to prevent and monitor the occurrence of diseases in their areas of operation. “The work of ACEs is crucial to prevent outbreaks and epidemics of these diseases. They are agents of environmental and social change, reinforcing the principle of comprehensive care in the unified health system,” says Ranier Flavio, technical advisor to the Secretariat for Health and Environmental Surveillance (SVSA).
The integration of health and environmental surveillance and primary care greatly enhances the work of community and endemic disease agents, allowing for a more effective and coordinated approach to health care. This collaboration expands their ability to identify, prevent and treat diseases, taking into account clinical, social and environmental aspects, leading to healthier and better-served communities.
AgpopSUS (People’s Health Agents)
The renowned health education agents are volunteers who collaborate with health and strengthen the unified health system through different fronts of participation and social control actions in their areas. The training of these future professionals was launched in the midst of the Covid-19 pandemic through free courses offered by popular social movements in partnership with public universities and, in some states, by the Fiocruz organization.
They know the community’s requirements and needs regarding health conditions, access to food and water, employment, income, transportation, sanitation, SUS network, and housing conditions.
Volunteers mobilize and organize the community in which they live to ensure social rights, as well as assist in initiatives to combat hunger, such as popular food banks, agro-ecological gardens in the countryside and in the city, and solidarity kitchens. Agents face another challenge: strengthening local health councils to promote social participation in building the unified health system in their territories.
Vanessa Rodriguez
Ministry of Health
