Trajetória do hospital dia Dr. Elger nunes: um recorte histórico da psiquiatria e saúde mental no Rio Grande do Norte

In Brazil, the mental health network proposed by the Psychiatric Reform inserts the intermediate and replacement services in the pursuit of alignment or resocialization of patients with mental and behavioral disorder in the community. Was adopted, among other services, the Center for Psychosocial Care, Home Therapy, Sheltered Home, Day Hospital and psychiatric beds in general hospital. In this context, the State of Rio Grande do Norte implanted the Day Hospital Dr. Elger Nunes (HDEN) in Natal / RN in 1996, linked to State Department of Public Health. At HDEN happened a multi and interdisciplinary therapeutic work, besides being the scene of disciplinary practices, and extension projects for graduate courses in Higher Education Institutions in the city. However, with the process of decentralization of local services, the hospital was terminated by an administrative state act in 2006, leaving damage to the activities provided to users, disciplinary practices and extension activities. From this breakdown, the objective was to narrate the trajectory of HDEN through a multidisciplinary team of professionals and teachers who used it as a field of disciplinary practices. It is characterized as a documental and qualitative, backed in the technique of thematic oral history, following the phases: authorization of the interviewee, interview recording, transcription, textualization and transcreation of the material obtained. We used documents, ordinances, general reports of activities, among others, plus interviews to fifteen employees who used this service, being thirteen part of the multidisciplinary team of professionals and two graduation professors of health care area, nursing and medicine. The stories collected were organized according to the technique chosen, respecting its steps. In preparing the body subjected to ALCESTE computer program, priority was given to the vital tone for the formation of categories and classes elected by the program, structured in three thematic areas. In the first axis, called Trajectory of HDEN, were recalled the beginning of its activities, the steps of that time, their activities, and its actors - users, families, professionals, and teaching practices. The second axis has dealt with the process of extinction of HDEN, rescuing the feelings of employees, the main reasons given at the time and immediate postextinction scenario. And the third axis revealed in an articulated form the situation of mental health in Natal / RN, listing to the challenges and prospects for the psychosocial care, starting from the trajectory of HDEN with emphasis on activities. Moreover, the trajectory of HDEN provides recognition of the historical basis outlined in the constitution of the network of substitute services present in the current scenario of psychosocial care in the city of Natal and in RN.

A participação popular na elaboração de políticas públicas de desenvolvimento local: um estudo no Município de Serrinha/RN (1997-2004)

The question of participation has been debated in Brazil since the 1980 decade in search a better way to take care of poulation s demand. More specificaly after the democratic open (1985) begins to be thought ways to make population participates of decisions related to alocation of public resources. The characteristic of participates actualy doesn t exist, population to be carried through is, at top, consulted, and the fact population participates stays restrict to some technics interests at the projects, mainly of public politics of local development. Observe that this implementation happens through a process and that has its limits (pass) that could be surpassed through strategies made to that. This dissertation shows results of a research about participative practices in city of Serrinha between 1997 and 2004, showing through a study of the case of Serrinha what was the process used to carry through these pratices in a moment and local considered model of this application. The analyses were developed through a model of research elaborated by the author based on large literature respects the ideal process to implant a participative public politics. The present research had a qualitative boarding, being explorative and descritive nature. The researcher (author of this dissertation) carried through all the research phases, including the transcriptions of interviews that were recorded with a digital voice recorder. Before the analysis of these data was verified that despite the public manager (former-mayor) had had a real interest in implant a process of local development in city, he was not able to forsee the correct process to do it. Two high faults were made. The first was the intention to have as tool a development plan, what locked up to make this plan was the booster of supossed participative pratice and no the ideal model that would be a plan generate by popular initiative. The second one was absence of a critical education project for the population that should be the fisrt step to carry through a politc like that

Governos locais e políticas de promoção econômica: uma análise da promoção econômica nos municípios brasileiros com população acima de 50 mil habitantes

This work aims to analyze the policy of economic promotion in the Brazilian cities of medium and great size (with population above of 50.000 hab.). The objective of the research is to launch light in the debate on the regional and municipal development, presenting the recent hypotheses supplied by literature. Of complementary form, had for specific objective presents the results of the Research of Basic Information of Cities - PIM, of Brazilian Institute of Geography and Statistics (IBGE), in two surveys carried through together to the Brazilian local governments (1999 and 2009). It analyzes the instruments of economic promotion used by local governments and the influence of the development variables, as the Local Human Index of Development (HID-L) and the Local Gross Domestic Product (GDP-L). The research sample that factors as HID-L and GDP-L has significant influence in economic promotion of cities and must be taken in account in the definition of the local strategies of development

A intervenção do poder judiciário no acesso a medicamentos no Rio Grande do Norte: uma análise sob a ótica das políticas nacionais de medicamento e de assistência farmacêutica

The present study aimed to evaluate the inclusion of the principles of the National Medicines Policy - PNM and the Pharmaceutical assistance - PNAF in the prosecution of lawsuits involving medicines. To fulfill this necessity , data collection was performed on the website by the Tribunal Rio Grande do Norte - TJ RN ( Rio Grande do Norte Court) , in 2012 . It was obtained 115 judgments, which were analyzed in order to generate Monitoring Indicators from lawsuits and conduct content analysis proposed by Bardin (2006). The results showed that : a) 100 % of the decisions were favorable to the author , b) 76 % of decisions were requests by the trade name of the drug , c) only one drug (eculizumabe) had not granted by ANVISA , d) 36 % of drugs were present in the list of standard medicines in SUS , 16 % of primary care block and 20 % of specialized component , e) 76 % of the decisions presented the request of at least 01 non-standard medicine. With regard to decentralization of PNM and PNAF we observed a commitment to this principle at judicial decisions, to see that municipalities and states are often forced to buy medicines of responsibility from another federal entity or other tertiary units as CACONs and UNACONS. The content analysis revealed that the argument from the judges used when you utter their decisions was that the right to health is recognized by Brazilian law as a fundamental right and should be guaranteed by the State for all its citizens. So, health is more than budgetary constraints of federal entities, which are severally liable for lawsuits , regardless the medication requested belongs or not to a particular block of a pharmaceutical assistance funding. Given these data, it is observed that there are gaps in the judgment when it comes to the insertion of the words and principles of PNM and PNAF, creating then the need for greater dialogue between the executive and judicial, so that they may consider relevant the effectiveness and application of such principles to minimize the negative consequences of the phenomenon of health judicialisation. Keywords: Judicialisation, Medicines, Public Policy, Pharmaceutical Care

Reflexões sobre a política de descentralização em saúde: uma análise a partir do Hospital Monsenhor Walfredo Gurgel em Natal (RN)

The process of decentralization of health policy in Brazil has evolved throughout the second half of the twentieth century, advancing by leaps and bounds in the last two decades. The various public institutions have assumed the function of responding to a growing demand for medical care and hospital. Monsenhor Hospital Walfredo Gurgel - H.M.W.G. fits into this context as an institution par excellence-oriented service the demand for medium and high complexity. This paper presents some questions about the process of decentralization and devolution occurred in Brazil. To do so is a brief historical background and politics, showing the concepts of reform and counter-reform and how the processes mentioned in the Country Correlates develop local social development of the decentralization process and discusses the modifications in policies social intervention in recent decades and the state health policies. Presents the implementation of a Health System in Brazil and the state showing how the decentralization of health policy occurs in Rio Grande do Norte. Finally, it explores the role of H.M.W.G. in health policy in RN. For this, portrays the institution and is located within the decentralized structure of health policy in the state and capital. An analysis of the demand for hospital care and the budget situation is realized at the close of work, correlating the role of HMWG with the decentralization of health policy in Brazil and Rio Grande do Norte. The methodology used for the preparation of this work was based on documentary research, systematic nonparticipant observation, field diary and analysis of data, documents and content. This set shows a quantitative and qualitative methodology that strips the institution, enabling the understanding of their role, boundaries, threats and opportunities

Serviço Social Audit Saúde no SUS/RN: projeto ético político profissional e de reforma sanitária

Health policies in Brazil, the decentralization of SUS management responsibilities for the three spheres of government has driven the creation and regulation of the audits of health services in the National Audit Office, this is a trend of neoliberal policies imposed by international bodies like the World Bank and IMF to peripheral countries characterized by productive restructuring and reforming the state focuses on the presence of two competing projects in the area of health: Health Sector Reform Project which is based on the democratic rule of law with the assumption of health as social right and duty of the State in defending the extension of the conquest of rights and democratization of access to health care guaranteed through the public financing strategies and the effective decentralization of decisions pervaded by social control and privatized Health Project which is based on the state minimum, with a reduction in social spending or in partnerships and privatization, stronger nonprofit sector, subject to capitalist interests, is made effective through strategies targeting health policy and refilantropização actions. In this context, the present study is an analysis on the work of social audits of public health in infants from a qualitative and quantitative approach, embodied by the critical method of dialectical Marxist social theory that enabled us to unveil the characterization, the demands, challenges and outline the profile of Social Work in teams inserted audits of SUS in RN, but also provided evidence to demonstrate the prospects and possibilities of this area of activity of social workers. It was also found that through the audit work that the state fulfill its role as bureaucratic and regulator of health services with efficiency, effectiveness and economy. Yet, paradoxically, the audits of SUS may provide a vehicle for enforcing rights and ensuring the fundamental principles contained in the project of health reform, because it can be configured in a space of political struggle as representing a new field of knowledge production that needs to be appropriate for a theoretical critic able to redirect the social interests in favor of the user. From this perspective, it is concluded that the work of social audits of public health in infants despite the social relevance that prints, as they constitute an activity study of reality and its transformation proposition requires a transformative political action guided the discussion Marxist theory holds that the ethical project professional politician of Social Work

Redesenho das configurações estruturais na gestão universitária: ações derivadas da inovação e flexibilidade na legislação pós-LDB 1996

This paper is set in a scenario in which higher education institutions suffer from external pressure to increase efficiency. The legislation after the Law of Directives and Bases for Education (LDBE), from 1996, is characterized by the fragmentation in its implementation, raising a concern with flexibility and innovation in several normative devices as well as aspects that must be incorporated to its organizational structure. The policies examined in this thesis are: Distance Education (DE); Law of Innovation and the Program of Support to Restructuring and Expansion of Federal Universities (PSREFU). This thesis aims to observe to what extent the characteristics of innovation and flexibility, which mark the new post- LDBE educational legislation, influence the organizational redesign of the Federal University of Ceará (UFC). For being about implementation policies, using contingency approach in order to collect the internal dynamics permeating the redesign of higher education institutions, the thesis focuses on the impacts caused by flexibility and innovation. This is a qualitative research, with case study methods, archive research and semi-structured interviews with members of the university administration. The results don t allow us to confirm the adoption of a more flexible and innovative configuration in the university but it is possible to identify the presence of those elements in the implementation changes, characterizing the hybrid structure. The changes mainly expose the extension of the management of projects to the administrative and academic components related to the institution. In terms of projection, the study found changes in the elements which characterize the current setting and the tendency of the university for adopting a diverse organizational structure. However, if the decentralization of management persists, the academic units may adopt their own structural solutions, but with no evidence of changes in the professional organization in most units. In this perspective, this thesis states that there are difficulties when incorporating innovation and flexibility to their organizational structure, which lead to improvised solutions, superposing skills through the redundancy of structures created with the same purpose or copying exogenous solutions

A redefinição do espaço urbano de Natal/RN a partir da influência dos serviços: uma análise das avenidas Bernardo Vieira e Engenheiro Roberto Freire

This paper analyzes the influence of trade and services in the reconfiguration of urban space in Natal, with the Avenues Bernardo Vieira end Roberto Freire Engineer as privileged analysis. Initially, we discussed the concepts of production and reproduction of urban space, urban centralities, decentralized, services and public policies, especially transport and tourism. Then, we show the construction of urban space from Natal, highlighting the historical formation of the districts of Ribeira, Cidade Alta and Alecrim, pioneers in the service sector, noting that currently there is an ongoing process of decentralization in the city of such activities, to other areas of the urban fabric of Natal. Later, we studied the Avenues Bernardo Vieira to Roberto Freire Engineer, noting, in both the distribution of commercial activities and services, and issues related to transportation, traffic, tourism and socio-economic problems, identified them. Finally, testify that Natal, from the 1980s, underwent a process of decentralization of services, both to the south, and north of the city on the ball. In this process of decentralization we ascertain the role of public policies on transport and tourism, complementing the action of private enterprise, through the real estate market, on Avenue Roberto Freire Engineer.

Políticas públicas de educação ambiental: a gestão do programa municipal de educação ambiental de Mossoró/RN

Study about environment education public policies, emphasizing the directress since the 1970 . It analyses the environment education administration of Mossoró city, indentifying its articulation with the international directresses and the Environment Education National Policy (PNEA), established according the law number 9.795/99. The text takes as empiric reference the Environment Education National Policy (PNEA) of Mossoró city, realized since 2006. In order to make the research, we employed as methodologic proceedings a bibliographical and documental revision from wich we developed a contextualization of the propolsals toward a environment Education policy and administration, the institution of the environment Education in Brazil, in the neoliberal context on the State reform ambit. We also employed a semi-structured interview, having as individuals two Environment Education Municipal Program Administration of Mossoró city / RN state administrators and nine Municipal Education System educators. The analysis was done from the historic and dialetic perspective, trying to understand the facts in its totallity. The results revealed that the environment Education has become to be emphasize as an environment crises superation strategy since the 1970 s. In this context, the environment Education administration directress, in the United Nations (UN) initiative ambit, emphasizes the participation and the partnership as a way to share responsabilities between the State and society. In the neoliberalism affirmation context, in the 1990 s, these directresses were fortified, once, since the State reform, their functions were redimensioned and the State turns into a stronger planner an controller, inducing the society to act as a public polcies executor. Therewith, a deconcentration action process is consolidated, rather than an administrative and pedagocgic decentralization, historically revendicated on Education by the progressist sectors. Even though the administrators interviewed have revealed the wish that the schools become autonomous on the PMEA execution, through the NEAs, we notice that the methods employed do not contribute to that, because of the decisions concentration on the associated managership ambit and the few human and financial resources. In spite of the difficulties, the research showed that the Mossoró municipality innovated on the environment Education field, by the institution of the NEAs, even though they demonstrate fragilities regarding their performance, revealed on the educators and adiminstration talk on the interviews. We verify that the main difficulties come from the politc culture installed on the municipality, ruled by a technocracy and power concentration wich brings difficulties to the implementation of a democratic and participative administration, even though it would not be totally impossible, even on the circumstances described

Compartimentação política do território: uma análise do processo no Curimataú oriental Paraibano

During the 1980‟s, the Brazilian State has undergone a process of redemocratization, causing a profund change in the political and institutional organization of the country. That reorientation of the Brazilian federative structure had as normative framework the enactment of the federal Constitution of 1988, occuring after its enactment a considerable political opening under the cloak of new democratic arrangements of tax and fiscal decentralization, which generated a new federative order, especially with regard to municipalities. Such institutions contributed to the creation of several new municipalities, involving, directly, changes in the structure of national territory, driven by the political context. This case was notoriouns in the 1990s, increased in the country's municipal mesh and spread all over the states of the federation. The Paraíba State was integrated in this context, creating in this period, 52 new municipalities. In the perspective, it will seek to understand the purpose that sustained this process of fragmentation of Paraíba state territory. For this purpose was made use of several bibliographies, secondary data, documentary sources and research in locus of the municipalities of Casserengue and Riachão, located in the Paraíba‟s Curimataú Oriental microregion, which were selected as a focus for specific analysis of the event. It is understood, however, that the production of municipalities, includes several intentions through political appropriation of the territory, although, being permeated by the Institutional

Caracterização da comunidade bentônica do recife raso de Pirangi/RN, Brasil, e avaliação do seu processo de estruturação sob impacto de pisoteio

Despite being areas of socioeconomic and ecological importance, the reef environments in northeastern Brazil have been suffering with cluttered tourism impacts, such as trampling, activity that leads to decrease in abundance of organisms, especially benthic, and loss of biodiversity. The objectives of this study were 1) to characterize the benthic community in the shallow sandstone reef of Pirangi/RN, identifying patterns of zonation, and 2) evaluate its process of structuring under different degrees of impact of trampling, providing information to the proper use of the area. Data on abundance of organisms, the percentage coverage of the substrate and physic-chemical parameters were collected. The formation of two zones on the reef was observed: one that considers submerged areas and ones with shorter time of exposure, lower roughness and higher heterogeneity in the coverage of the substrate, with a predominance of sand, foliose algae, rodolit, being related to organisms such as gastropods, crabs and sea-urchin; the second zone comprises areas with longer time of exposure, greater roughness and predominance of bedrock uncovered, being associated with organisms such as barnacles, gastropods, bivalves and crabs. It is concluded that the studied reef presents its own zonation pattern, influenced by both the time of immersion and the substrate characteristics, such as roughness and type of coverage. To answer the second objective of this study, four experimental blocks were mounted on each of the three areas of different intensities of trampling, containing the following treatments: control (isolated from trampling), shaved isolated, trampling and shaved trampling, with data collection by 11 months. The data in abundance, diversity indices and living coverage of the substrate were compared between areas and treatments. The results showed that at the trampling areas, at the end of the experiment, differences were observed between the intensities of the impact, where higher values of abundance and richness of mobile fauna and richness of live coverage (ANOVA, p <0.05) were found in the area of higher trampling intensity. For fauna withdrawal of trampled scraped treatments, it was observed in the area of greatest impact that the abundance of small benthic invertebrates is more than three times smaller than that at the area of intermediate trampling (ANOVA, p <0.05). Initial isolated areas and final ones differed only as to the percentage of live coverage, with an increase of 35% at the end of this experiment. As for the areas that were completely scraped and isolated at the end of the experiment was observed an increase in the percentage of live coverage of 11.11% compared to the initial amount in the area of intermediate impact and 37.5% in the area with greater impact, indicating recovery of the area. It is suggested that the current use of the reef of Pirangi be reviewed, with a decentralization of trampling, or a decrease in visits, so that it does not occur at high intensities

Estrutura e desempenho organizacional: uma análise na Universidade Federal do Rio Grande do Norte

This research analyses the components of the organizational structure of the UFRN (Rio Grande do Norte Federal University) and to what extent they affect organizational performance. The study, classified as exploratory and descriptive, was conducted in two phases. The first phase consists of a pilot test to refine the research instrument and to identify the latent components of the organizational structure, and the second to characterize these components and thereby establish relationships with organizational performance. In the first phase, the research was conducted in 20 UFRN organizational units with the participation of 84 employees between technical-administrative and teachers, after considering missing values and outliers, while the second phase occurred in two stages: one conducted with 279 valid cases, consisting of technical-administrative and teachers of 37 UFRN units, and another with 112 managers of the institution in the 49 units identified in this research. The instrument adopted in the first phase was composed of 36 indicators of organizational structure, with six extracted and adapted from the instrument developed by Medeiros (2003) and 30 prepared based on the literature review, from Mintzberg (2012), Hall (1984), Vasconcellos and Hemsley (1997) and Seiffert and Costa (2007) and 7 performance indicators adapted from Fleury and Mills (2006), Vieira and Vieira (2003) and Kaplan and Norton (1997) from the self-assessment instrument in use by the university. In this stage the data were analyzed using the techniques of factor analysis and reliability analysis by means of Cronbach’s alpha, aiming to extract the factors representing the components of the organizational structure. In step 1 of the second phase, the instrument, refined and reduced in the previous phase, with 24 variables of organizational structure and 6 for performance was used, while in step 2, a semi-structured interview guide with questions, organized into nine organizational structure elements, was adopted aiming to gather information to understand the relationship of structure to performance of the UFRN. The techniques used in the second phase, as a whole, were factor analysis and reliability analysis to characterize the components extracted in the previous phase and to validate the performance variables and correlation analysis, regression and content analysis to establish and understand the relationship between structure and performance. The results showed, in the two stages, six latent components of organizational structure in the context under study: training and internalization, communication, hierarchy, decentralization, formalization and departmentalization - with high levels of Cronbach's alpha indexes - which can thereby be characterized as components of UFRN structure. Six performance indicators were validated in this study, showing them as efficient and highly reliable. Finally, it was found that the formalization, communication, decentralization, training and internalization components positively affect UFRN performance, while departmentalization has an adverse affect and hierarchy did not show a significant relationship. The results achieved in this work are important in future studies to support the development of a model structure that represents the specifics of the university

Papel do município e relações federativas: atuação de municípios cearenses nas políticas de formação continuada de alfabetizadores

The investigation analyze s the role of the municipalities in the ongoing development of literacy teachers, having as a field of study the municipalities of Jaguaruana and Palhano, both in the State of Ceará. The political - educational space adopted as a sample of the study is the p eriod between the years 2003 and 2006, when the emphasis on cooperative action among the federated entities is observed in the Government’s guidelines and Brazilian educational policies, showing the municipal presence in the implementation and execution of these policies. T he historical - dialectical materialistic perspective, understood as an analysis of the social reality as historical elaboration and product of the human praxis, is expressed as the required theoretical - methodological path. The investigatio n is operationalized through interconnected stages: one that involves bibliographical and documental analysis, in which the theoretical input of the research is added, as well as the Federal, State and M unicipal documents accessed ; and another, regarding t he field work, studying the specific character of the object and its mutual rela tionships in the municipalities . The research brings the notion of intergovernmental relationships and cooperative mechanisms as central theoretical tools and, dialoguing with them, ideas such as decentralization, municipalization and municipal autonomy are inserted into a theoretical/practical body, through which the historical and logical aspects of the object are detailed. The study describes and interprets the policies of on going development of literacy teachers with focus on the national guidelines formulated since the 1990’s and on the govern mental incorporation in the national and subnational spaces. In this sense, the analysis is based on the comprehension of the interrel ationship between the municipal policies and the p olicies created by the S tate or Federal G overnments in order to offer ongoing development of literacy teachers. Considering the investigated sample, it shows how the municipal role and the relationships bet ween the State and municipalities of Ceará have emerged, as well as their characteristics regarding the education management policies, taking into account the practices of municipalization and cooperation between the State and municipalities in their histo rical composition. It shows the practices which aim at the ongoing development of literacy teachers observed in the researched municipalities, pointing out the realities and specific marks left by municipal presence in the area, demonstrating the assigned role and the role played. Based on the points of view of the managers interviewed in the municipalities of Jaguaruana e Palhano, it is possible to note the meaning and effectiveness of the policies carried out. With such elements, it discusses the municipa l asymmetries in their homogeneities and heterogeneities rega rding the execution of their federative role. The analysis shows that th e role of the municipalities vary according to the historical, political and social interventions in each municipality. In the fields of formulation and execution of educational policies, the actions of the municipal governments, situated and with expressive interferences, reveal asymmetries in the sense that some municipalities have bigger autonomy and participate more effect ively in the production and distribution of policies than others. In terms of the researched realities, the study shows that taking care of the policies of ongoing development of literacy teachers is not a task that should be assigned exclusively to the mu nicipalities, nonetheless it is a role that they play with varying degrees of success. This role is in fact a joint competence of the federated entities, in the scope the Brazilian cooperative federalism.

Políticas públicas, desenvolvimento local e participação social nas instâncias de governança associadas ao turismo no Rio Grande do Norte

In contemporary dynamics, a change is observed in the institutional structure of the state, culminating in several policies for the tourist sector which promote a new management format. The from this view, the Tourism Regionalization Macro Program (TRP), considered a significant program to Ministry of Tourism, arose as an answer to this new reality, having as strategy a joint working of structuring and promotion turned at decentralization of actions, valuing the residents participation in the search of the permanent dialogue between peers and revaluation of places and territories, based in the regionalization process. Based on this bias, this study aims to examine the role of the Tourism State Council of Rio Grande do Norte, with regard to the tourism planning, trying to understand it and solve it as governance Instance, through the Tourism Regionalization Program interventions, given the participation context of its actors and agents. For purposes of this study is delimited as time frame the year 2007 at 2014, understanding that it was this time, there was greater council members accession, as well as different types of sectors representation of civil society, as a result of a tourism public policy based on principles of innovation and participation. In relation to the research problem, this study is conceptualized as a qualitative and the chosen method is the materialist dialectic. Still on the methodological options, utilize the Content Analysis. The results show that the institutionalization of governance instance as the Conetur does not contributes, ideally, in the planning and management process of participatory and integrated tourist activity, facing a fair direction of your space production. The research indicates that there are debates, discussions and guidelines (still in a timely and targeted form), but not reverberates practical effects, by act in a conjuncture that Is strategically designed for political and economic power game, setting the hegemonic actors performance, which uses this arena to instill personal desires and wishes, that are decided in absentia to the council.

iSalud: uma arquitetura para publicação e distribuição de sistemas de informação para o SUS

The Brazil Telehealth Networks Program was established by the Ministry of Health in 2007. Its main objective is to support professionals in Primary Health Care (PHC) by offering educational qualification, resulting in more favorable conditions to fixate the professional in remote areas. The formulation and management of telehealth services are performed by scientific and technical centers that are operated by public institutions of higher education and responsible for providing tools and services in the context of the regions where they are. However, one of the problems generated by this decentralization is the development of various tools with different types of language, architecture and without any regulation and integration of information with the Ministry of Health. Aiming to solve the above problem, we propose the specification, implementation and validation of an architectural model in the development and distribution of the Unified Health System software tools. This proposed architecture enables tools developed in telehealth center to be shared among the other centers, thereby preventing the unnecessary use of resources.