A regionalização como instrumento de governança pública em saúde no estado do Paraná: análise dos vazios assistenciais como subsídio à ação do estado

Everyone has a right to health and the State’s duty is to provide it. SUS (unified health system) main principles are universalization, integrality and equality which are based on the decentralization, regionalization and hierarchization directives and shows the importance of a territorial perspective for planning healthcare actions. Decentralization was the strategy chosen to implant SUS, since municipalities were in charge of providing and organizing the municipal healthcare services. Nevertheless regionalization, that’s to say service, institution and practice integration, was not performed satisfactorily, thus jeopardizing the health system decision making process and causing disputes between municipalities over financial resources instead of developing an interdependent and cooperative net. This way, it is important to analyze if health regionalization has a good potential for being used as public governance tool. The present study aims at giving answers to the following research problem: What are the contributions of regionalism to the State of Paraná public governance applied to health? Besides that, it also aims at assessing the State of Parana health regionalization to identify healthcare gaps and help the State actions through public governance principles applied to healthcare. Therefore, the study used a quantitative-qualitative, exploratory and descriptive research, plus secondary data concerning bibliographic and documental research. The present study analyzed the current hospital bed distribution by compared to the ideal distribution allowing the identification of healthcare gaps in the regional healthcare centers, besides considering medical specialties in the State of Paraná. The study conclusion is that health regionalization is an important tool for reducing healthcare gaps concerning hospital beds permitting the use of seven to ten public governance principles applied to healthcare, as established in the present study, and shows health regionalization is an important pubic governance tool.

Proposta de uma matriz de decisão em energia hidrelétrica com o uso do método multicritério, para formulação de políticas públicas no estado do Paraná

Brazil is internationally acknowledged for its renewable sources, most notably, hydroelectric power plant projects which correspond to 65% of electricity production supply to the National Interconnected System. The main question behind this research is: what are the weights and the relative importance of the variables which have influence on the decision making process for the expansion of hydroelectric generation projects in Parana? The main objective is to propose a multi-criteria decision procedure, in association with water sources options that take into consideration the weight and relative importance of the alternatives having influence on the decision by enterprises in the generation of electricity in the state of Paraná. As far as the approach to the problem is concerned, this research can be classified as having mixed methodologies, applying Content Analysis, Delphi technique and the Analytic Hierarchy Process. Following Delphi methodology, a group of 21 was selected for data collection, all of those linked to Paranaense hydroelectricity market. And the main result was the construction of a decision tree in which it was possible to identify the importance and relative weight of the elements associated with the four dimensions of energy. In environmental dimension, the highest relative weight was placed on the loading capacity of Parana system; the economic dimension, the amortization of investment; in social dimension, the generation of direct work places and in institutional dimension, the availability of suitable sources of financing. Policy makers and business managers make their decisions based on specific criteria related to the organization segment, market information, economic and political behavior among other indicators that guide them in dealing with the typical tradeoffs of projects in hydropower area. The results obtained in the decision tree show that the economic bias is still the main factor in making investment decisions. However, environmental impacts on the State loading capacity, income generation, providing opportunities for direct as well as indirect jobs. And at an institutional level, the absence of funding sources show that the perception of experts is focused on other issues beyond the logic behind development per se. The order of priority of variables in this study indicates that in the current environment of uncertainty in the Brazilian economy as many variables must be analyzed and compared in order to optimize the scarce resources available to expand local development in relation to Paranaense water matrix.

Um olhar sobre a lei Maria da Penha no Paraná: avanços e desafios

This study aims to analyze the process of implementation of Maria da Penha Law in Paraná from the perception of persons directly involved in combating violence against women in that state. To achieve this goal, the implementation in Curitiba was taken as the main reference, due to its status as capital, being the headquarter of the political powers and the place where are some feminist social movements. We have chosen qualitative approach of interpretative nature as research methodology, because it is a method that allows the analysis of the responses and as a data collection technique. We also have chosen the individual semi-structured interview as interview mode, because it gives greater freedom to the interviewee to discuss the matter, but it is delimited to the study objectives. The research included nine persons, including members of the Judiciary and Public Ministry, public servants and activists. The importance of the study stems from the relevance of the numbers of violence against women in Brazil, and more specifically by the significant occurrence of this kind of acts in the state of Paraná, which currently occupies the 3rd place in the ranking for the most violent states. The paper also discusses gender relations by understanding that violence against women is the result of an asymmetrical power relationship between men and women; human rights because violence is a blatant disregard of women's human rights; on public policies and technologies to confront this form of violence. Among the policies, the Maria da Penha Law is highlighted as one of the most striking examples of public policy for combating violence against women. The research found out which was the participation of Paraná in the discussion and implementation of Maria da Penha Law, identifying relevant facts and people and also what was the repercussion obtained by this law. As for the implementation in Paraná, it was possible to determine progresses, difficulties and challenges of the process. The greatest advances obtained so far are the facilities of: Court of Domestic and Family Violence against Women in Curitiba, Maria da Penha Patrol and Women's Special City Office of Curitiba. As for the difficulties, they are related, among others things, to the physical structure, training of agents, political will, and even cultural issues, which are directly linked to gender issues. Thus it was found that the law is implemented in the state, but there are still several challenges to be achieved, which consist, mainly, of the structure increment for combating violence; awareness and change of mentality of public officials; training of service agents and a greater social participation in combating violence. We concluded that the need for change in gender relations, which is an educational and social evolutionary process and therefore time consuming, is also a challenge.

Programa ciclovida como política de mobilidade urbana sustentável: estudo empírico na Universidade Federal do Paraná

The urban mobility has in the bicycle its symbol of the most environmentally sustainable modal of transportation of the planet, title conferred by the United Nations Organization (ONU). Nevertheless, the cities suffer with the traffic jam caused by the automobile fleet growth, what implies in a larger displacement time, injuries to the environment, to financials and to the quality of life. In order to build in a sustainable way the urban mobility, public policies are necessary to encourage the preferential usage, by the society, of the mass transit or the non-motorized type of transportation. Objecting cooperate with the public power and the civil society, this study intents to, through an analysis about the UFPR Extension Program - CICLOVIDA, propose a sustainable urban mobility public policy development, with emphasis in the bicycle´s usage. eferentially, it is discussed concepts such as Society, State and Government as well as public policies, which go in cycles to the State´s and Government´s responsibilities; and are presented the Sustainable Urban Mobility Public Policies (PPMUS) in Brazil. Also, it is debated about the transport by bicycle as an option to the sustainable mobility. Methodologically, the study is of an empiric-social nature, with the application of both qualitative and observational methods, what characterizes as an exploratory level of research, with the researcher´s involvement in the participant form, due to her acting on the Program. Regarding the research lineation, it was used the bibliographic and documental form as well as case study, by means of the nonparametric sampling by accessibility or convenience. Related to the data collection technique, it was used structured interviews with self-applied questionnaires and natural participant observation. Aligned with the research´s objective and matter, the outcome confirmed that the Extension Program CICLOVIDA of the Federal University of Paraná (UFPR) may effectively contribute in the development of a PPMUS proposal with emphasis in the bicycle usage. Thus, it was built a political proposal with a free form writing, objecting subsidize policies both institutional as public MUS through the bicycle usage and therefore, support the mobility, also contributing to the sustainability and to the public development planning.