The Rise of Brazil's Primary Care Digitalization: 12 Billion Records Across 27 Federative Units as a Foundation for Real-World Evidence and Scientific Democratization

Background: Brazil operates one of the world's largest national primary health care information systems. Since 2013, the Health Information System for Primary Care (SISAB), the digital platform of the e-SUS primary care strategy, has collected standardized records of all clinical and community health activities performed by Family Health Strategy teams across all Brazilian municipalities. Yet comprehensive longitudinal analyses of this national data infrastructure remain scarce in the international literature. Methods: Descriptive ecological study with time-series analysis using publicly available secondary data extracted from SISAB on May 18, 2026. Annual records were collected for four pro