The National Policy for Reducing Morbidity and Mortality from Accidents and Violences (PNRMAV), of the Ministry of Health¹1 Brasil. Ministério da Saúde (MS). Portaria GM/MS nº 737, de 16 de maio de 2001. Política Nacional de Redução da Morbimortalidade por Acidentes e violências. Diário Oficial da União; 2001. was created in 2001, a few years after the World Health Organization explicitly highlighted violence as a serious Public Health problem in 1996. This policy broke new ground by incorporating the issue of violence into the country’s Public Health framework and adopting a preventive approach to its multiple forms of expression.

In its short existence of just over 20 years, the PNRMAV has only been evaluated in a study carried out in five cities, one in each of the country’s major regions²2 Minayo MCS, Deslandes SF. Análise diagnóstica da política nacional de saúde para redução de acidentes e violências. Rio de Janeiro: Editora FIOCRUZ; 2007.. In a leap forward in time, at the end of the year 2019, the Ministry of Health decided to support the assessment of the implementation of this policy, with the aim of identifying its penetration in the national territory and verifying its degree of implementation, with a view to updating it and making the necessary adjustments. The team from the Jorge Careli Department of Studies on Violence and Health at the Sergio Arouca National School of Public Health (CLAVES/ENSP/FIOCRUZ), was invited to carry out this task.

This thematic issue presents some of the results of a study that sought to identify how the National Policy for Reducing Morbidity and Mortality from Accidents and Violences in Brazil is progressing. The research work, conducted from the second semester of 2020 through August 2023, adopted the seven guidelines of the policy as its core tenets and duly triangulated quantitative and qualitative methods. It then prepared and applied closed questionnaires and held in-depth interviews with managers and professionals in primary, pre-hospital and hospital care and recovery/rehabilitation, and drew up evaluation indicators of the implementation of the policy. The data were analyzed according to the total number of participating municipalities involved in the capitals and regions of the country, by population size (municipalities with up to 99,999 inhabitants, and those with 100,000 or more inhabitants), and addressed municipal, state and federal management units.

In this issue, three articles address the care provided by the Unified Health System (SUS) service network to victims of accidents and violence at each level of complexity of health care. One article focuses on the monitoring and notification of violence in Brazil, another focuses on the training of SUS professionals on the topic of accidents and violence, and yet another analyzes the creation and current status of the violence prevention and health promotion centers, which is the main strategy created to implement the actions of the policy. A final article reflects on the progress made, the upcoming challenges and those that persist after more than two decades since the policy was approved by Ordinance No. 737 of May 16, 2001, of the Ministry of Health.

Reading these articles makes it possible to appreciate that the policy has made steady progress in several respects, but still faces major obstacles, the most important of which being its failure to be prioritized as a government policy. The lack of political, financial and technical support set the tone for the interviewees’ statements. The policy still needs to be institutionalized in the municipalities that it has reached, and also disseminated in those in which its existence is as yet unknown.

We trust that this informative and unprecedented repository of knowledge will serve as a guide to the SUS managers and professionals and help to promote public policies aimed at reducing accidents and violence, as well as their impacts, which so greatly affect the population, especially the most vulnerable groups.

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