Análise dos componentes e domínios da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) presentes nas políticas públicas de saúde do Brasil

Abstract

Introduction: The International Classification of Functioning, Disability and Health (ICF), recommended by the World Health Organization (WHO), has been applied as a pedagogical, statistical, clinical, research, and policy-making tool. Despite its versatility, studies indicate a low level of use of the ICF in public policies. Objective: To identify federal health-related normative acts in Brazil that include ICF components and domains, and to classify them according to the Second-Level Classification of the ICF. Method: A scoping review guided by the PRISMA-ScR Extension for Scoping Reviews. Data collection was conducted by two teams: the Selection, Analysis, and Data Extraction Team, and the Consensus Committee, both composed of occupational therapists with experience in health care. The teams alternated between blinded and unblinded work in each stage. Data were collected from the Ministry of Health’s Health Legislation System (Saúde Legis) using the following filters: Source: Official Gazette (DOU); Status: In force; Term: health; Period: May 22, 2001, to September 28, 2024. Results and Discussion: A total of 44,003 normative acts were identified, of which only five explicitly mention the ICF — four published in 2012 and one in 2023 — all classified according to the ICF Level 2. These normative acts addressed the following components: Environmental Factors (48.4%), mainly related to health services and professionals; Body Functions (23.6%), suggesting an emphasis on describing the individual’s functional and physiological status, aligned with the biomedical model; Activities and Participation (18.5%), referring to daily life activities, political and community life, and interpersonal interactions; and Body Structures (9.6%), with findings involving upper and lower extremities and musculoskeletal structures, indicating functional impact resulting from structural alterations. It is noteworthy that, between May 2001 and September 2024, few federal normative acts incorporated the ICF. Final Considerations: The findings highlight the applicability of the ICF in guiding health policies in Brazil, but also reveal its limited use at the federal level. There is a pressing need to integrate health policies that reinforce rights, social participation, and inclusion, as well as to expand analyses of normative acts in future studies at state and municipal levels, in order to broaden the understanding of ICF implementation within the SUS.