Social protection for homeless individuals with tuberculosis from the perspective of Brazil's street clinic teams

Abstract Background The homeless population in Brazil faces significant challenges in accessing healthcare services, especially concerning tuberculosis. High rates of loss to follow-up and unsatisfactory outcomes in disease control indicators underscore the urgent need to improve healthcare for this vulnerable group through adapted social protection strategies. Therefore, the aim of this study is to understand how these strategies are perceived and utilized by professionals, considering the specific challenges faced by this vulnerable population. Method Online qualitative research was conducted with twenty-four healthcare professionals from eleven Brazilian states. The study utilized the theoretical and analytical framework of social determinants of health and employed content analysis supported by lexical diagnostics to examine participants' perceptions of social protection strategies in tuberculosis treatment among homeless individuals. Results Participants highlighted the critical importance of social protection strategies in improving treatment adherence and achieving tuberculosis cure, despite the obstacles faced. Fragmentation of healthcare services and social disparities in the daily lives of the homeless population emerged as significant barriers to accessing and effectively utilizing available social protection measures. Conclusion Informants emphasized the urgent need for more comprehensive public policies that not only aim to eliminate tuberculosis but also promote social reintegration of homeless individuals, ensuring their full access to fundamental rights. It was concluded that a holistic approach with greater equity, considering clinical, contextual, and structural aspects, is essential for effectively managing the health of this vulnerable population.