Newborn Screening in the Brazilian Public Health System (SUS): between the right to early diagnosis and inequality in access

Abstract

Introduction: Neonatal screening, known as the "heel prick test," is one of the main public policies for prevention and early diagnosis in Brazil. Performed between the 3rd and 7th day of life, it identifies metabolic, genetic, and endocrine diseases that, without early detection, can cause serious sequelae or death. Implemented in 2001, the National Neonatal Screening Program (PNTN) is part of the SUS (Brazilian Unified Health System) and currently screens for six pathologies. However, scientific advances have expanded the number of detectable diseases in other countries, and Brazil, through Law No. 14.154/2021, has begun the gradual expansion of the test to up to 50 diseases. Despite legal progress, structural, economic, and regional challenges persist that compromise equity in access to early diagnosis and treatment. Objectives: This study analyzed the importance of expanding neonatal screening in the SUS in the face of social inequalities and compared national results with findings from recent literature. Materials and Methods: This applied research, using a mixed-methods approach (qualitative and quantitative), utilized data from DATASUS and scientific databases, considering variables such as the number of births, coverage, income, and health insurance plans. Results: The results indicated that only 60% of samples are collected within the ideal period, below the target of 95%, with greater shortfalls in the North and Northeast regions. The average cost of R$ 250.00 for the expanded test in the private sector reinforces the elitism of access to early diagnosis. Conclusion: It is concluded that, although essential for reducing infant morbidity and mortality, neonatal screening still faces structural and operational inequalities. Strengthening the program requires investments in infrastructure, training, and monitoring, ensuring that the expansion of the test represents an effective advance in equity and neonatal health in Brazil.