Introduction: The “Projeto de Formação e Melhoria da Qualidade da Rede de Atenção à
Saúde” (QualiSUS-Rede) covers health regions, defined based on peculiar conditions. Among
these regions is the Interfederative Health Network, TOPAMA, a state border region in the
Legal Amazonia, located in the extreme north of the state of Tocantins, bordering the states of
Pará and Maranhão. This region presents an unfavorable scenario in terms of meeting the goals
of the Health Surveillance Actions Qualification Program (PQA-VS), which comprises the
Ministry of Health's initiatives to improve the Unified Health System (SUS) and improve the
continuous and progressive process of health surveillance actions. Objective: To identify the
determinants listed by the health surveillance teams, which affect the achievement of activities
to reach the goals of the PQA-VS, in 30 municipalities in the TOPAMA region. Methods: This
dissertation is an excerpt from the “QualiTOPAMA Central Project – Qualification of Health
Surveillance Actions, Strengthening and Organization of the Interfederative Health Network
(TOPAMA Network)”. It was built around the production of two scientific articles on the
subject. Results: Both produced articles demonstrated the need to strengthen Permanent
Education in all the studied cities, in addition to the need for greater integration between health
surveillance and primary care. In article 1, the municipalities with the worst performances were
identified for the fulfillment of the 14 goals of the PQA-VS and in this same study it was
possible to observe that no municipality reached all the agreed indicators. In article 2, the profile
of the civil servants of the 30 municipalities participating in the research was described, as well
as the identification of the main difficulties identified by health professionals in achieving the
program's goals, in addition to correlating weaknesses with the difficulty in meeting the
indicator. Conclusion: The PQA-VS is a very broad program that contributes to the
improvement of the SUS. The goals and indicators provide municipal management with an
assessment and identification of its weaknesses and strengths. It is a program that aims the
planning and implementation of public health measures for the protection and promotion of the
population's health, in addition to the prevention and control of risks, injuries and diseases.
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