Primary Health Care Strengthening Program (PHC)

epCertify with HIPERDIA Care Line – JPS

Lever
Organization of the work process and care pathways in the Health System

Type of grant
Product development

Alagoas, Bahia, Maranhão, Paraíba and Pernambuco

Benefited population
218,755 people, 89 health teams and 537 Community Health Workers (CHWs) in the states where the project is being implemented.

Initiative supported since 2024
Implementation:
Partners:
Partnership management:

With a focus on monitoring hypertension and diabetes in Primary Health Care (PHC), the project utilizes the epCertify registration certification tool to improve the quality of care for non-communicable diseases (NCDs). The initiative is active in ten municipalities across Bahia, Maranhão, Paraíba, Pernambuco, and Rio Grande do Norte.

The solution integrates data from the Citizen’s Electronic Health Record (PEC) with information collected by Community Health Agents (ACS), enabling real-time monitoring of blood pressure, blood glucose, exams, consultations, medications, and risk stratification. This strategy supports managers and teams at Basic Health Units (UBSs) in decision-making and the longitudinal follow-up of individuals with hypertension and diabetes.

In 2025, the project advanced the integration of the HIPERDIA portal with the PEC across all participating municipalities and the registration validation of the population over 18 years old. By the end of the year, 145,971 people, out of a total of 211,246 registered, were already being tracked by the tool. The period also included remote and in-person training sessions for managers, doctors, nurses, and community health agents.

Outcome

100% of the population over 18 registered, improving the monitoring of hypertension and diabetes care pathways, providing the technological solution as a legacy to municipalities, and generating scientific evidence.

10

municipalities in Bahia, Maranhão, Paraíba, Pernambuco, and Rio Grande do Norte prioritized for monitoring hypertension and diabetes in Primary Health Care

100%

of participating municipalities with integration between the HIPERDIA portal and the Citizen’s Electronic Health Record (PEC) in 2025

211,246

people over 18 years old registered in the tool, expanding the database for monitoring non-communicable diseases

145,971

people monitored by epCertify by the end of 2025, tracking blood pressure, blood glucose, exams, consultations, medications, and risk stratification

Testimonials