Advances and setbacks in care with integrative practices: An ecological study in the Northern region of Brazil

Abstract

This ecological study analyzed the use of Integrative and Complementary Health Practices (ICHP) in primary health care in the Northern region of Brazil between 2019 and 2024. Data were obtained from the SISAB and DATASUS systems, and standardized attendance rates per 10,000 inhabitants were calculated. Temporal trends were assessed using segmented regression (Joinpoint), with the estimation of Annual Percent Change (APC) and Average Annual Percent Change (AAPC). During the study period, 101,255 ICHP-related consultations were recorded. The states with the highest average rates were Amazonas, Tocantins, and Acre. Significant variations in trends were observed, including notable increases in some states, declines in others, and stability in part of the series. Acupuncture and its related techniques (including auriculotherapy) were the most prevalent practices. The findings highlight territorial inequalities, weaknesses in data recording, and the low institutionalization of ICHP in certain settings. In a region characterized by sociocultural diversity and the presence of traditional knowledge, these practices play an important role as a care strategy, especially in areas with limited access to conventional health services. It is concluded that greater investment is needed, as well as improvements in data quality and the strengthening of ICHP integration into public health policies.