Evaluation of social assistance services for people experiencing homelessness in Brazil: strengths and barriers from an implementation evaluation

This study aimed to evaluate the implementation of Specialized Care for Vulnerable Populations (SEAS) and the Specialized Reference Centers for People Experiencing Homelessness (Centros POP) in Belo Horizonte, Brazil, identifying potential strengths and barriers. This evaluative study adopted the Type 1b implementation analysis framework proposed by Champagne et al. Previously validated questionnaires were administered to management and care professionals to assess the structure and process dimensions of the services. These instruments enabled the description of staff characteristics and the assessment of the degree of implementation (DI) of the services, taking into account the structure and process dimensions. The study included 88 respondents and achieved a high response rate—70% for SEAS and 80% for Centros POP. The implementation analysis indicated that both services were partially implemented. The DI for SEAS was 74.2%, higher than that of the Centros POP (62.2%). Overall, the process dimension received more positive evaluations than the structure dimension. The findings provide guidance for local management on achievements and gaps. Key barriers identified include the insufficient number and inadequate structure of vehicles for SEAS; lack of safety in and around the Centros POP; and the need to consolidate both intersectoral and intrasectoral workflows. The lessons learned offer valuable insights to support the design and evaluation of social assistance services for this population in other countries where homelessness has a significant social impact. Finally, a future research agenda is proposed, emphasizing the need to advance knowledge and invest in mechanisms that can improve the lives of people experiencing homelessness and, ideally, support their transition out of homelessness.