34 resultados para Políticas públicas de Saúde


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If, on one hand, only with the 1988 Federal Constitution the right to health began to receive the treatment of authentic fundamental social right; on the other, it is certain since then, the level of concretization reached as to such right depicts a mismatch between the constitutional will and the will of the rulers. That is because, despite the inherent gradualness of the process of concretization of the fundamental social rights, the Brazilian reality, marked by a picture of true chaos on public health routinely reported on the evening news, denatures the priority status constitutionally drew for the right to health, demonstrating, thus, that there is a clear deficit in this process, which must be corrected. This concern regarding the problem of the concretization of the social rights, in turn, is underlined when one speaks of the right to health, since such right, due to its intimate connection with the right to life and human dignity, ends up assuming a position of primacy among the social rights, presenting itself as an imperative right, since its perfect fruition becomes an essential condition for the potential enjoyment of the remaining social rights. From such premises, this paper aims to provide a proposal for the correction of this problem based upon the defense of an active role of the Judiciary in the concretization of the right to health as long as grounded to objective and solid parameters that come to correct, with legal certainty, the named deficit and to avoid the side effects and distortions that are currently beheld when the Judiciary intends to intervene in the matter. For that effect, emerges as flagship of this measure a proposition of an existential minimum specific to the right to health that, taking into account both the constitutionally priority points relating to this relevant right, as well as the very logic of the structuring of the Sistema Único de Saúde - SUS inserted within the core of the public health policies developed in the country, comes to contribute to a judicialization of the subject more in alignment with the ideals outlined in the 1988 Constitution. Furthermore, in the same intent to seek a concretization of the right to health in harmony with the constitutional priority inherent to this material right, the research alerts to the need to undertake a restructuring in the form of organization of the Boards of Health in order to enforce the constitutional guideline of SUS community participation, as well as the importance of establishing a new culture budget in the country, with the Constitution as a compass, pass accurately portray a special prioritization directed constitutional social rights, especially the right to health

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During the ninth century, owing to the process of industrialization, new social conflicts were showed, forcing the Government not to remain inert. The necessity of answer to these new demands requires from the State some actions that assure the new economic, cultural and social rights, able to exceed the formal equality, according to the principles of redistributive equality and well-being. Among the social rights, the right to health is showed up, which is placed at the Universal Declaration of Human Rights and the International Treaty for the Economic, Social and Cultural Rights, as a necessary term to promote the dignity and the free development of the human personality. Under the Constitutional Law, it is clear that the implementation of the right to health, placed at the 6th article of the Brazilian Constitution, demands a government activity, which usually requires a provision of material goods, depending on budgetary resources. The Legislative and Executive Branches have a very important role in compliance with the constitutional regulations about the satisfactory offer of health care services, besides the correct use of the resources at this area. The adoption of public policies is the way of Government action to the planning and realization of this right. Though, some public policies are usually made apart from the social compromises, to the detriment of the basic social rights. The government has a discretionary competence to manage the health services. That is the reason it is necessary the control of the political choices, through the popular control, the extrajudicial control by the Account Courts, or the judicial review. Owed to the constitutionalization of social rights, the constitutional justice has a very relevant role, concerning to the constitutional jurisdiction, in a way the Judiciary Branch assume your position as a player that transforms the society. On the control of the public health policies, there is a cast of official instruments, judicial or not, to the guarantee of the collective right to the public health services, and to allow the citizens to reach the real implementation of the right to health

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This study analyzes the event of the Feast of Our Lady of Grace, located in the municipality of Florania / RN as a tourism product, inserted in a process of transformation of a sacred place, in principle determined by religious motives, in a destination "tourist-religious". We seek to understand to what extent state intervention, with policies aimed at boosting the tourism sector as well as the interactions among key actors in the space, are able to modify and streamline the city of Florania, particularly Feast of Our Lady of Grace. The methodology also includes the review of the literature using the deductive method the application of questionnaires to the pilgrims, tourists and pilgrims totaling 150 questionnaires. Along with the economic agents of the municipality, 36 questionnaires were administered according to the model adopted by REDESIST. Complement this research interviews with key Officials of the Municipal Government and the Church. Despite the recognition by the actors of the importance of tourism to the economy of the city of Florania, encouraging the development of the sector is still lagging, some worked and policies / programs listed actually pass by the "Paths of Faith" of Florania. Concerning the Feast of Our Lady of Grace, the bottlenecks reported by researchers and economic agents are very partially affected by the policies / programs and when this occurs, the effort seems to be only reactive, resulting from the pressures experienced by the municipal government (mayor)

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Family farming has been considered as the new axis of rural development in the country, the focus of several public policies, especially the National Program for Strengthening Family Agriculture - PRONAF and Food Purchase Program - PAA. PRONAF was created with the aim of providing credit to farmers, while the PAA to support family farmers through the purchase of its production. In this context, the objective of this study is to analyze the correspondence of these two public policies for family farming, in the Territories of Citizenship of the state of Rio Grande do Norte, between the years 2008 to 2010. In the methodology, the analysis was performed by comparing the distributions of the two programs in the territories of citizenship status. There were also statistical tests of differences in proportions, and Spearman correlations, and estimated a logit regression model, in order to measure the probability of a farmer participating in the PAA is associated with one of the modes of PRONAF. The data used were obtained from the National and Supply - CONAB at the Institute of Technical Assistance and Rural Extension - EMATER, and the Ministry of Agrarian Development - MDA. Among the key findings was noted that policies were associated with a direct, but low in the districts of the Territories of Citizenship. And that, in the years 2008 and 2009, only in the territories of Mato Grande, Alto Oeste and Seridó, the actions of PAA and PRONAF had direct and significant correlations. It was found that in most of the territories, policies are performed randomly, ie that both have no correlation to each other. The estimates of the logit model showed that the chance of a family farmer, the PAA participant, receive credits PRONAF A, is higher in the territory of Mato Grande, and would have a chance to fall in PRONAF B in all areas surveyed. Moreover, farmers in the territories of the Assu-Mossoró, Sertão of Apodi, Seridó and Alto Oeste, participating in the PAA would be more likely to receive credits PRONAF C, reflecting thus the family farm more consolidated these territories

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Public politics of Service to the Child: The Challenge of the Action Articulated in the Project Belém Criança (2001-2004) if it constitutes in a study on the politics directed toward the children of 0 the 6 years. It has as objective to analyze the configuration of the politics of integral attention to the child, evidencing the form as the same ones they had been redimensioned by the neoliberal ideas and by the lines of direction of the international organisms. The work has like empiric reference the project Belém Criança, developed by county of Belém from a partnership with the Deep of United Nations for Infancy (UNICEF), in the period of 2001 and 2004. The project intends to develop an articulated action among the several county departments which offer assistance to the children looking for to rationalize the resources and to optimize the services. Amongst the methodological procedures that materialized the research distinguished: The bibliographical review and documental allowed to analyze the contextualization of the public politics and, between them, the social politics of attendance to the child; the historical revolution this attendance; the paper of the UNICEF how articulator of the politics in municipal scope; and the paper of county how executer these politics. Still it was utilized, the half-structuralized interview, Having like subjects: the representative of the UNICEF in Belém, the municipal co-managers and actors of community in which the project was implemented. The result of the analyzes review that, historically, the politics destined to the child they had been being dimensioned having like support the fight of social movements vindictive for publics politic which guarantee the fundamentals rights these citizen. Although legal dimension of current politics of attendance to the child, to assume a vision of completeness and the guarantee of the rights, it still has a great exaggeration between the speech and the practical one. Actually, the same one are elaborate inside the neoliberal optics, with ruled actions by the beginning in combat to the poverty, implanted with low costs and with practice which to lead to the excessive fragmentation, generating inadequate actions and punctual programs which don t guarantee the social quality of the attendance. This perspective was evidenced to the most of the actors which the Project Belém Criança don t constitute itself a real public politic toward the child of 0 the 6 years, although present innovating aspects, how the mobilization and participation. It was demonstrated yet, in the participant s depositions of the research, that the bureau had numberless of difficulty to develop the action preview in the project, it has seen the great complexity of articulation between the several organism responsible by politics of attendance

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The research aimed to understand the general perception of men about their health care in a health unit família. This is an exploratory and descriptive qualitative approach, developed at the Center for Health Dr Vulpiano Cavalcante in the City of Parnamirim / RN. Participated in the investigation 12 men enrolled in the Estratégia de Saúde da Família ESF (Family Health Strategy), in the age-group 20 to 59 years lived in the catchment area of one of the ESF teams unit above. Data were collected from July to August 2009, through structured interviews, which, after transcription have undergone a process of identifying meaning units, coded and categorized according to the precepts of content analysis according to Bardin. Following in the footsteps of this method, originated the following themes: "Revealing what motivates men to seek assistance in the Estratégia de Saúde da Família," "Expressing knowledge of the Estratégia de Saúde da Família ", "an opinion about the care health and relationship with the ESF. The analysis was processed according to the principles of symbolic interactionism as Blumer. To support the discussions were used literary themes about man in the context of public health policies and the man in the family and the influences of gender. These, when they had their properties and dimensions analyzed, raised the central category Man on the Estratégia de Saúde da Família . The results show that respondents have limited knowledge about the ESF, your actions turn to use the service when no obligation arising from discomforts and accuracy of care. Moreover, delivering the opinion of the care with your health, even need, but recognizing that do not perform self-care. Given this reality, we can conclude that the perception of the man about his health in the ESF permeates gender issues that influence their behavior toward disease prevention and health promotion. This situation requires that the professionals and managers of health initiatives for the inclusion of man in the actions of the ESF assistance starting from the understanding of their conceptions of health care.

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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

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The reality of water resources management in semiarid regions, such as the Seridó region, has been shaped by a complex chain involving social-cultural, political, economic and environmental aspects, covering different spheres of activity - from local to federal. Because water is a scarce element, the most rational way pointed out by our recent history has been to move towards an increasing emphasis on the need for a truly rational, integrated, sustainable and participatory water resources management, supported by legislation and by a network of institutions that could materialize it. In this sense, despite all the advances in the formulation of public policies in water resources, which ones have indeed lead to significant changes that have occurred or are underway in semiarid regions such as Seridó? What factors may be preventing the realization of the desires rationality embedded in the framers of water policies intents? How to properly manage water resources if the current actors who promote their management and the political, human, cultural and institutional processes that intervene in this management, show strong traces of unsustainability? The research methodology adopted in this paper led to a breakdown of the traditional approach to water resource management, to integrate it into other areas of knowledge, especially to political science and public administration, catalyzed by the concept of "sustainable development". From a broad, interdisciplinary literature review, an exhaustive characterization of the river basin Seridó, a set of interviews with key people in the public administration acting in the region, a series of diagnoses and a set of propositions were made in order to correct the direction of current public policies for the region. From the point of view of public policies, it is in the deployment phase, not in its formulation, which lies a major problem of the lack of significant progress in water management. The lack of coordination between government programs are well characterized, as well as the lack of efficiency and effectiveness of their actions. The causes of this secular model are also discussed, including political factors and social relations of production, which led to a stalemate difficult, but of possible solution. It can be perceived there is a scenario of progressive deterioration of natural resources of the fragile ecosystem and a network of environmental and social consequences difficult to reverse, the result of a persistent and inertial sociopolitical culture, whose main factors reinforce itself. The work leads towards a characterization of the water resources management also from the perspective of environmental, institutional, political and human sustainability , the latter being identified, particularly as investment in the development of people as autonomous beings - not based in ideological directives of any kind - in the emancipation of the traditional figure of the poor man of the hinterland" to the "catalyst for change" responsible for their own decisions or omissions, based upon an education for free-thinking that brings each one as co-responsible epicenter of (self-) sustainable changes in their midst

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The nature of this thesis is interventionist and aims to create an alternative on how to control and evaluate the public policies implementation developed at the Institute for Technical Assistance and Rural Extension of Rio Grande do Norte State. The cenarium takes place in a public institution , classified as a municipality that belongs to the Rio Grande do Norte government and adopts the design science research methodology , where it generates a set of artifacts that guide the development of a computerized information system . To ensure the decisions, the literature was reviewed aiming to bring and highlight concepts that will be used as base to build the intervention. The use of an effective methodology called Iconix systems analysis , provides a software development process in a short time . As a result of many artifacts created by the methodology there is a software computer able of running on the Internet environment with G2C behavior, it is suggested as a management tool for monitoring artifacts generated by the various methods. Moreover, it reveals barriers faced in the public companies environment such as lack of infrastructure , the strength of the workforce and the executives behavior

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This study aimed to examine the perception of dentist-surgeon about the Permanent Education in Health (PEH). It is characterized as a qualitative research with focus in the field of public health policies. It refers specifically to the development of Permanent Education policy in Health in the state of Rio Grande do Norte. They were participants of this research 42 dentist surgeons and 83.3% females and 16.7% males, participants in Specialization courses approved and agreed by the Permanent Education Center in Health (PEC-RN) in the period 2005 to 2007. These professionals are part of the Family Health Strategy (FHS), and 11.9% work in management at the central level and 88.1% are directly related to oral health care in the Basic Health Units of the Family, 30 cities in the state. Data collection was through a questionnaire, with questions that guided the research development and achieve the objectives proposed. The socio-demographic data were analyzed using the descriptive statistics and subjective content was subjected to content analysis by Bardin. The emerging categories from the textual material generated by respondents were: program content, methodological approach and concepts of Permanent Education in Health. The subjects surveyed reported that the program content is more comprehensive and directs to the reflection of everyday practices, with regard to the methodological approach, concern that occurs through discussion and reflection with dynamic, participative, varied and constructive activities, questioning and putting as the main focus. As for understanding of the concepts of the PEH, there was a consensus that define as education stable strategies which contributing to transform and improve the health workers to have the upgrade, improvement of practices, being based on everyday experience and taking into account the accumulation and renewal of these experiences. Therefore, results presented showed that there is a clear understanding of the subjects on the proposals and guidelines of the PEH. It was concluded that lack continuous access to the policies proposed by Ministry of Health involving health workers, managers, communities, through social control and the teaching-service integration and that they are worked within the health system and can classify all these segments of society favor the existence of a more participatory, effective, fair and better quality health service

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The assessment of oral health status in elderly patients is essential for the development of specific health policies. The prevalence of oral diseases is high in this population. The self-perception of oral health conditions influences the demand for oral care and quality of life for seniors. The aim of this study was to assess self-perception of oral health status in 100 elderly of both sexes, aged 60 years or older and functionally independent the Basic Health Unit of Felipe Camarão II, Natal, Brazil. For comparison of self-perception data was collected in Bom Pastor, Natal / RN. In this research data were collected a questionnaire grouped into two parts. The first part with the socio-demographic data, subjective and objective condition of oral health and access to the service, the second part GOHAI Index. This index consists of 12 items that make it possible to obtain information involving aspects of chewing, speech, phonation, and self-assessed oral health. The results were subjected to statistical tests of Mann-Whitney and Kruskal-Wallis test (α = 0.05), to identify possible predictors of self-evaluation. As a result, 69% were female, ages ranged from 60 to 86 years, with a median of 65 years. In relation to marital status 48% were married. For the years of study, the sample had an average of 3 years. For the last visit to the dentist, only 27% of seniors had visited the Dentist for less than a year. Regarding the questions about the presence of gingival and dental problems were answered by 46% and 21% respectively. The data on the perception of your teeth and gums, 44%. The index showed GOHAI value for self-perception of 30 points to Felipe Camarão and 28 points for the Bom Pastor, both considered a low perception. We identified predictors of self-rated number of people in the room, participate in any associational activity, there is problems with your teeth and your gums. Concluded a negative self-perception of oral health condition by Gone in both areas, influenced by socioeconomic and cultural issues, although they realize the importance given to oral health, but by the misfortunes of other prominent favored little valuing of oral health

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Due to the fact of oral health sector reestructuration within Brazilian public health politics, this work had the object of evaluating, under users point of view, the accessibility to oral health services in Santa Cruz (RN), focusing on the organizational aspect. To achieve this, questionnaires were given to users in their homes, considering the censitary sector. Nine sectors of the urban zone were evaluated, selected by chance, and one from the rural zone, selected by convenience. The sample was composed by 194 users, calculated considering the estimated prevalence of event represented by the indicator I ve never been to the dentist + I ve been to the dentist more than three years ago from the Projeto SB Brasil Report . To complement the results, interviews were made with others actors involved in the process of oral health care: professionals (dentists) and manager (Health Municipal Secretary). From the data obtained it was possible to identify that 12,9% of the population had never visited the dentist, and that the search for the service was not influenced by the users individual and socioeconomics characteristics, excepting the gender. It was verified that 36,1% of the users went to the dentist in less than one year, with the youngests (p<0,05) being among those who went to the dentist more frequently. 63,3% of the interviewed related that they found some kind of difficulty when they search for dentistry services, with the difficulties for schedule, the queues and the long wait among the most cited. It was identified that 43,2% of the users wait three weeks or more for the appointment. It is still pointed out that 71,4% of the interviewed find difficulties to get urgency appointment, the long wait to be attended by the dentist was the most found. 92,9% and 94,1% of the interviewed had never been headed to especialized appointments and complementary exams, respectively. Due to the data founded, it was possible to verify that the accessibility to oral health services in Santa Cruz (RN) is damaged by factors related to the organization of public polices developed, mainly in relation to the working process

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The objective of this study was to characterize the socioeconomic profile of the family farmers who live and work in Brazilian rural space and highlight the importance of family agribusiness through the significant relation between some variables as the value of the total production, GDP share in total area of the establishments, agricultural production and farmer income, that show the important participation of these farmers in agricultural productivity and consequently on the economy of country. Therefore, this sector deserves a greater attention and more investment in the development of public policies that lead to a quality education in rural areas, availability of technical courses for farmers, technical assistance more efficient and effective, as well as funding more readily available

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A partir dos diagnósticos das vulnerabilidades da condição juvenil contemporânea, as Políticas Públicas de Juventude tem ganhado maior força e um lugar mais definido nas pautas das demandas e conquistas sociais. Faz-se necessário, então, direcionar atenção para estas Políticas Públicas, a fim de promover uma reflexão sobre como ocorre a execução destas junto ao seu público alvo. Esta dissertação centraliza sua análise no Projovem Adolescente (PJA), uma das modalidades Programa Nacional de Inclusão de Jovens PROJOVEM que se destina ao atendimento de jovens com específica faixa etária entre 15 a 17 anos, com caráter assistencial e socioeducativo. Desta forma, o objetivo geral deste estudo foi discutir as ações do Projovem Adolescente no que diz respeito ao processo socioeducativo, a partir da perspectiva dos adolescentes participantes da cidade de Natal/RN. E, especificamente, objetivou-se: investigar de que maneira os adolescentes avaliam as atividades das quais participam, considerando se suas expectativas coincidem com as propostas do serviço; averiguar a participação dos adolescentes na elaboração, execução e avaliação das ações socioeducativas do serviço; bem como compreender as motivações que contribuem para a inserção e permanência ou evasão dos adolescentes no PJA. Para tanto foram realizados três grupos focais com adolescentes participantes do Projovem Adolescente, em diferentes núcleos do serviço, no município de Natal/RN. Cada grupo focal contou com dois encontros, em que primeiramente foram debatidos aspectos da participação nas ações socioeducativas e, num segundo encontro foram realizadas oficinas de produção de fanzines. A análise qualitativa dos dados foi realizada a partir da perspectiva teórica do materialismo histórico-dialético, utilizando-se como método de análise o Método Comparativo Constante, baseado na Teoria Fundamentada, que busca compreender o significado do fenômeno sob a perspectiva dos participantes. Os resultados foram apresentados divididos em eixos de análise os quais versaram sobre: as concepções dos jovens sobre adolescência e juventude; e a participação nas ações socioeducativas do PJA, destacando-se as características positivas e negativas apontadas pelos participantes, a relação dos jovens com o trabalho e as possibilidades e contribuições do PJA em seus contextos de vida. Em vista da análise empreendida, é possível constatar que a concepção dos participantes sobre a própria vivência da adolescência e juventude se encontra marcada pela absorção de determinadas imagens socialmente atribuídas aos jovens, como a que considera a juventude enquanto etapa de preparação para o mundo adulto. A participação nas ações socioeducativas, por sua vez, foi, de uma maneira geral, avaliada positivamente pelos participantes, não obstante esta avaliação, os jovens apresentaram uma visão muito crítica sobre a execução do serviço no município de Natal, relatando conhecer bem as dificuldades de ordem da gestão, bem como as contradições e limitações nas ações do serviço. Compreende-se a perspectiva da inclusão social no contexto neoliberal em que são implementadas as políticas sociais, contudo acredita-se que dar voz aos jovens participantes contribuiu para proporcionar uma reflexão sobre o modo como as políticas sociais, através do Projovem Adolescente tem atingido seu público, considerando as questões e perspectivas apresentadas pelos jovens como ferramentas a serviço das juventudes na construção de políticas democráticas e efetivas

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The lack of studies aimed at the mental health of the rural population, the social, economic, familial and emotional impact that mental disorders produce and the vulnerability that women have in this context, lead us to believe in the need to investigate the mental health demands of female rural workers, in order to subsidize the development of more effective and culturally sensitive public health programs and policies that take into account the specificities of this population. The present study aims to investigate the prevalence of common mental disorders (CMD) and the possible factors associated with the emergence of such disorders among women living in a rural settlement in Rio Grande do Norte. This survey has a quantitative and qualitative character with an ethnographic approach. As methodological strategies, we made use of an adapted version of the socio-demographic and environmental questionnaire prepared by The Department of Geology/UFRN s Strategic Analysis Laboratory to evaluate the quality of life of the families from the rural settlement and the mental health screening test Self-Reporting Questionnaire (SRQ-20) to identify the prevalence of CMD in adult women from the community. Complementing the role of methodological tools, we use the participant observation and semi-structured interviews with women who presented positive hypothesis of CMD attempting to comprehend the crossings that build the subjective experience of being a woman in this context. The results point to the high prevalence of CMD (43.6%) and suggest the link between poverty, lack of social support, unequal gender relations and the occurrence of CMD. We also verified that the settled women do not access the health network to address issues relating to mental health and that the only recourse of care offered by primary health care is the prescription of anxiolytic medication. In this context, the religiosity and the work are the most important strategies for mental health support among women