The therapeutic itineraries of vulnerable populations at Covid-19: a scoping review

Cualhete, Deborah Nimtzovitch; Santos-Moura, Greice Herédia dos; Castro-Silva, Carlos Roberto de

doi:10.1590/interface.220210

Deborah Nimtzovitch Cualhete cualhete.deborah@unifesp.br

Pós-graduanda no Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde (Mestrado), Departamento de Políticas Públicas e Saúde Coletiva, Instituto Saúde e Sociedade, Universidade Federal de São Paulo (Unifesp). Avenida Ana Costa, 438, Ap 71. Santos, SP, Brasil. 11060-002.

http://orcid.org/0000-0002-3531-3002

Greice Herédia dos Santos-Moura moura.santos@unifesp.br

Pós-graduanda no Programa de Pós-Graduação Interdisciplinar em Ciências da Saúde (Mestrado), Departamento de Políticas Públicas e Saúde Coletiva, Instituto Saúde e Sociedade, Universidade Federal de São Paulo (Unifesp). Avenida Ana Costa, 438, Ap 71. Santos, SP, Brasil. 11060-002.

http://orcid.org/0000-0003-0635-4478

Carlos Roberto de Castro-Silva roberto.castro@unifesp.br

Departamento de Políticas Públicas e Saúde Coletiva, Instituto Saúde e Sociedade, Unifesp. Santos, SP, Brasil.

http://orcid.org/0000-0002-8880-1042

cualhete.deborah@unifesp.br

moura.santos@unifesp.br

roberto.castro@unifesp.br

Authors’ contribution

All authors actively participated in all stages of preparing the manuscript.

Conflict of interest

The authors have no conflict of interest to declare.

Editor

Antonio Pithon Cyrino

Associated editor

Willian Fernandes Luna

Translator

Amanda Borges

PCC Strategy	Boolean descriptors and connectors
Population	#1 (“Therapeutic Itinerary” OR “therapeutic itineraries” OR “Delivery of Health Care” OR “Health Services Accessibility” OR “Health Knowledge” OR “Health Attitudes” OR “Health Practic” OR “Public Health Systems” OR “Health Services” OR “Social Support” OR “Health Resources” OR “patient Acceptance of Health Care” OR “Healthcare”)
Concept	#2 (“socioeconomic factors” OR poverty OR “Social Condition” OR “Social Inequality” OR “Health Inequality” OR “Social Inequalities” OR “Health Inequalities” OR “Social Inequity” OR “Health Inequity” OR “Social Inequities” OR “Health Inequities” OR “Social Equity” OR “Health Equity” OR “Social Equities” OR “Health Equities” OR “Social Vulnerability” OR “High Social risk” OR “Social High Risk”) AND
Context	#3 (“Coronavirus Infections” OR Covid-19 OR coronavirus) AND (brazil OR bras$) AND Brasil OR Brazil OR brasi$

Identification	Year	Método	Method	Database
E1²¹21 Santos R, Wiese ML. SUS e proteção social: desafios postos às famílias frente à pandemia da Covid-19. Humanidad Inov. 2021; 8(35):196-209.	2021	Qualitative	Portuguese	Web of Science
E2²²22 Mesquita AP, Silva GF, Leoncio AKS. A violência contra as mulheres em tempos de pandemia: reatualizando a caça às bruxas. Humanidad Inov. 2021; 8(35):181-195.	2021	Qualitative	Portuguese	Web of Science
E3²³23 Saldanha JHS, Pereira APM, Santos AOCD, Miranda BS, Carvalho HKSD, Nascimento LC, et al. Pessoas com deficiência na pandemia da Covid-19: garantia de direitos fundamentais e equidade no cuidado. Cad Saude Publica. 2021; 37(9):e00291720.	2021	Qualitative	Portuguese	Pubmed
E4²⁴24 Nunes NRA, Rodrigues A, Cinacchi GB. Health and social care inequalities: the impact of Covid-19 on people experiencing homelessness in Brazil. Int J Environ Res Public Health. 2021; 18(11):5545.	2021	Qualitative	English	Pubmed
E5²⁵25 Nunes NRA. The power that comes from within: female leaders of Rio de Janeiro’s favelas in times of pandemic. Glob Health Promot. 2021; 28(2):38-45.	2021	Qualitative	English	Pubmed
E6²⁶26 Kauss B, Polidoro M, Costa A, Canavese D. “Semente para Luta”: ativismos, direito à saúde e enfrentamentos de pessoas LGBTI na pandemia da covid-19. Saude Soc. 2021; 30(3):e201026.	2021	Qualitative	Portuguese	Scielo
E7²⁷27 Marçon L, Silva PC, Justino J, Oliveira CFd, Carvalho SR, Dias TM. Formas de gobernar la vida en la calle durante la pandemia: discursos, tecnologías y prácticas. Salud Colect. 2021; 17:3338.	2021	Qualitative	Spanish	Scielo
E8²⁸28 Oliveira RG, Cunha AP, Gadelha AGDS, Carpio CG, Oliveira RB, Corrêa RM. Racial inequalities and death on the horizon: covid-19 and structural racism. Cad Saude Publica. 2020; 36(9):e00150120-e.	2020	Qualitative	English	Scielo
E9²⁹29 Oliveira Andrade R. The Brazilian slums hiring their own doctors to fight covid-19. BMJ. 2020; 369:m1597. Doi: https://doi.org/10.1136/bmj.m1597. https://doi.org/10.1136/bmj.m1597...	2020	Qualitative	English	Embase
E10³⁰30 Ribeiro AA, Rossi LA. Covid-19 pandemic and the motivations for demanding health service in indigenous villages. Rev Bras Enferm. 2020; 73 Suppl 2:e20200312. Doi: https://doi.org/10.1590/0034-7167-2020-0312. https://doi.org/10.1590/0034-7167-2020-0...	2020	Qualitative	English	Pubmed
E11³¹31 Carvalho SG, Santos ABS, Santos IM. A pandemia no cárcere: intervenções no superisolamento. Cienc Saude Colet. 2020; 25(9):3493-3502.	2020	Quantitative and Qualitative	Portuguese	Scielo

Identification	Population studied	Objective	Main results and conclusions
E1²¹21 Santos R, Wiese ML. SUS e proteção social: desafios postos às famílias frente à pandemia da Covid-19. Humanidad Inov. 2021; 8(35):196-209.	Families in situation of social vulnerability	Highlight how the Covid-19 pandemic impacts the lives of families in their relationship with social protection, with a focus on health policy.	Faced with the Covid-19 pandemic, what is found is the fragile social protection. A country marked by deep social inequalities reveals how families have difficulties and impossibilities to comply with social isolation and how they are exposed to community contamination from the pandemic.
E2²²22 Mesquita AP, Silva GF, Leoncio AKS. A violência contra as mulheres em tempos de pandemia: reatualizando a caça às bruxas. Humanidad Inov. 2021; 8(35):181-195.	Women in vulnerable situations	Dialogue on violence against women, a patriarchal pandemic prior to the COVID-19 pandemic, and discuss the conditions of women at this time of disease proliferation.	The present time has the marks of our historical and social formation, formation based on slavery, in a capitalist and heteronormative elite that perpetuated social, ethnic-racial and gender inequalities. What was explicit in several facts during the pandemic.
E3²³23 Saldanha JHS, Pereira APM, Santos AOCD, Miranda BS, Carvalho HKSD, Nascimento LC, et al. Pessoas com deficiência na pandemia da Covid-19: garantia de direitos fundamentais e equidade no cuidado. Cad Saude Publica. 2021; 37(9):e00291720.	Population with disabilities.	Identify and systematize the literature on the situation of people with disabilities in the first months of the COVID-19 pandemic.	The result of the review pointed to three thematic categories: vulnerabilities of people with disabilities facing the pandemic; rights of people with disabilities in this context; and measures to protect and access information on COVID-19 aimed at people with disabilities.
E4²⁴24 Nunes NRA, Rodrigues A, Cinacchi GB. Health and social care inequalities: the impact of Covid-19 on people experiencing homelessness in Brazil. Int J Environ Res Public Health. 2021; 18(11):5545.	Homeless population	Reflect on the challenges that affect homeless people in Rio de Janeiro, Brazil, due to the COVID-19 pandemic.	The results showed the worsening of the situation of extreme vulnerability and poverty already experienced by the homeless population before the pandemic. Lack of places to wash hands; insufficient assistance services.
E5²⁵25 Nunes NRA. The power that comes from within: female leaders of Rio de Janeiro’s favelas in times of pandemic. Glob Health Promot. 2021; 28(2):38-45.	Women’s leadership of favelas	Present how female leaders in the favelas of Rio de Janeiro/Brazil have been protagonists in meeting the demands arising from COVID-19	Female leaders in favelas often assume the roles of local authorities to ensure food security, hygiene measures, communication between residents, assistance to the vulnerable, etc. They make politics with resistance and solidarity for effective transformations.
E6²⁶26 Kauss B, Polidoro M, Costa A, Canavese D. “Semente para Luta”: ativismos, direito à saúde e enfrentamentos de pessoas LGBTI na pandemia da covid-19. Saude Soc. 2021; 30(3):e201026.	LGBTQIA+* (*) Update of this term in the review aiming at the respective development of the definition.	Investigate how the health of lesbian, gay, bisexual, transvestite, transsexual and intersex (LGBTI) people has been affected in the context of the COVID-19 pandemic, through the perception of activists from organized civil society, in the State of Rio Grande do Sul (RS), Brazil.	There were effects on community mobilization; access to health services; mental health; and situations of violence and social protection. It is concluded that the interventions of this population support the guarantee of the right to health and preservation of public policies to this population.
E7²⁷27 Marçon L, Silva PC, Justino J, Oliveira CFd, Carvalho SR, Dias TM. Formas de gobernar la vida en la calle durante la pandemia: discursos, tecnologías y prácticas. Salud Colect. 2021; 17:3338.	Homeless population	Unveil power relations, from the perspective of governmental mentality and biopolitics, to highlight the emergence of the notion of homeless population, in this pandemic scenario.	Notions of precariousness that circumscribe life on the streets is a shared condition, in search of clues about forms of resistance and the right to appear. Bodies on the streets defy the sanitary, unsanitary, irregular, disoriented and normalized order as a subspecies - are updated during Covid-19.
E8²⁸28 Oliveira RG, Cunha AP, Gadelha AGDS, Carpio CG, Oliveira RB, Corrêa RM. Racial inequalities and death on the horizon: covid-19 and structural racism. Cad Saude Publica. 2020; 36(9):e00150120-e.	Racialized populations	Reflect on the behavior of the pandemic in relation to the black population in Brazil, in dialogue with decolonial contributions and critical readings on racism.	It points to the importance of local resistance movements, operated from the place that these subjects occupy, the urban spaces precarious by action/omission of the state - the favelas.
E9²⁹29 Oliveira Andrade R. The Brazilian slums hiring their own doctors to fight covid-19. BMJ. 2020; 369:m1597. Doi: https://doi.org/10.1136/bmj.m1597. https://doi.org/10.1136/bmj.m1597...	Population of the favela of Paraisópolis-São Paulo	Report the experience of the Paraisópolis community facing COVID-19	Community experience has shown positive results in preventing and combating COVID-19. The G10 Favelas aims to implement the Paraisópolis model in other Brazilian favelas.
E10³⁰30 Ribeiro AA, Rossi LA. Covid-19 pandemic and the motivations for demanding health service in indigenous villages. Rev Bras Enferm. 2020; 73 Suppl 2:e20200312. Doi: https://doi.org/10.1590/0034-7167-2020-0312. https://doi.org/10.1590/0034-7167-2020-0...	Indigenous population - Terena de Buriti	Discuss fundamental aspects in the establishment of preventive measures in the fight against COVID-19 among indigenous people in view of the motivations for seeking health services in the villages of the Buriti Indigenous Land, Mato Grosso do Sul, Brazil.	Indigenous people seek health facilities to attend health care programs and to talk about the motivations that lead them to take care of their health. These aspects underpin the discussion of the indigenization process facing the pandemic.
E11³¹31 Carvalho SG, Santos ABS, Santos IM. A pandemia no cárcere: intervenções no superisolamento. Cienc Saude Colet. 2020; 25(9):3493-3502.	Population deprived of liberty	Analyze the effects of the pandemic on prisons and how governments and civil society have organized themselves in order to reduce the consequences on these places.	Inequality in the Brazilian Penitentiary System reproduces that of society in general, in which there is more access to tests for the new coronavirus when occupying a position of social or financial privilege.

[1] cualhete.deborah@unifesp.br