ClarIA, an artificial intelligence-powered alert system, has been integrated into the municipality’s electronic health record system to help detect signs of violence. The project is a partnership between the Recife municipal government, the public health organization Vital Strategies, and the Federal University of Juiz de Fora (UFJF).
The Recife municipal government has taken an innovative step in addressing gender-based violence with the launch of ClarIA, an artificial intelligence tool developed to enable the early identification of women who may be at risk of violence and femicide among patients receiving care at primary health care facilities. The initiative reinforces prevention as a central pillar of policies to protect women and strengthens the public health system’s ability to recognize warning signs before violence escalates.
ClarIA was developed through a partnership between the Recife municipal government, through its Municipal Health Department, Vital Strategies, a global public health organization, and the Federal University of Juiz de Fora (UFJF). As part of this pioneering project, the tool analyzed health care records from 16,000 women who experienced violence and received care at the municipality’s Family Health Units over a ten-year period.
The analysis, combined with cross-referencing data from Sinan (Brazil’s Notifiable Diseases Information System), made it possible to identify not only direct signs of violence but also patterns of illness and behavior frequently associated with women experiencing violence. One finding stood out to researchers: in the 90 days preceding a serious assault or even a femicide, many of these women seek health services more frequently, often reporting mental health-related concerns.
“Today, 75% of notifications of violence against women recorded in SINAN are made by emergency departments, while only 1% originate in primary health care. We are working to change this reality because early identification, understanding the context, providing appropriate and supportive care, and referring women through the appropriate care and protection network can make all the difference in their lives, helping to break the cycle of violence and even prevent fatal outcomes,” said Recife’s Municipal Health Secretary, Luciana Albuquerque.
ClarIA works by analyzing clinical and historical data recorded in health information systems. When it identifies signs consistent with potential situations of violence, it generates an alert in the Citizen Electronic Health Record (PEC e-SUS). Primary health care professionals – working in Family Health Units (USFs) and Traditional Primary Health Care Units (UBTs) – also have access to technical resources to help them provide more appropriate and effective care.
One of these resources is the Practical Guide to Care for Women Experiencing Violence in Recife, a reference document for professionals working across the municipal health network. The 45-page guide provides detailed information on clinical, psychosomatic, and social signs that may indicate violence — including when a woman does not explicitly disclose it.
The guide also outlines referral pathways within Recife’s Health Care Network, detailing primary and specialized health services, as well as referral services available to women experiencing violence.
“Recife is integrating a technological resource into a carefully designed process of professional training and strengthening the support network. This is essential to ensure the ethical use of the tool while respecting patients’ privacy and rights. The goal is to ensure that professionals are equipped to make the appropriate referrals to help protect these women,” said Pedro de Paula, Senior Vice President, Global Innovation, Vital Strategies.
Before the strategy is expanded to other primary health care facilities, ClarIA was tested through a pilot project in Health District I, involving three Family Health Units — Santo Amaro III, Santa Terezinha, and Pilar — as well as one E-Multi multidisciplinary team. A total of 62 professionals were trained to identify and provide appropriate care to women who may be experiencing violence.
According to the Recife’s city government, the initiative will be expanded to an additional 40 health facilities, bringing the total number of professionals trained to care for women experiencing violence to 664, including physicians, nurses, dentists, and community health workers, as well as three E-Multi multidisciplinary teams.