A humanização no parto e no nascimento: os saberes e as práticas no contexto de uma maternidade pública brasileira

The practice of medicine related to the gestational processes tend to be organized according to the context and the place of work, being thus dependent of the conditions both social and economical, and of the physical structure and the functionality of the services. The high mortality rate in this process has diminished, since 1986, the study made by the World Health Organization (WHO) as to the technical aspects and the social inequalities that influence this situation in different geographical contexts. This culminated recommendations that proposed the reorientation of the dynamical practice of medicine, with a focus on the safety of maternities. Brazil adopted, in the year 2000, the suggestions of the OMS, emphasizing the humanization as the main reason for these actions. However, this discussion tends to not consider the problems caused by the social inequalities and the epidemiological and social conditionings that define the actions of the Unified Health System (Sistema Único de Saúde SUS). In this area, this research seeks to analyze the practices, cares taken, and the universal symbol that promotes and rewards the assistance to the birth of children by the SUS. Besides the analysis of the public documents that deal with this subject, an ethnographic study was developed in a maternity in Natal/RN, considered a model of humanization after receiving the Galba de Araújo prize in 2002. In this stage, the methodological strategies were observed, and the focus of the individual interviews with workers and users of this service. In the analysis of the data, it became evident that the different professional workers and women who gave birth, tend to show concern of the standards the delimit production and reproduction of the practice of medicine, as they favor the absence of a critical posture of the actions destined to the population. Besides this, if became evident that the institutional difficulties associated to the economical, cultural, and political problems also difficult the involvement and the reflection of the workers in favor of assisting changes of the process. There is also a utilization of a perspective prescriptive of humanization in the everyday life of the social workers, without reflection of its meaning. Some workers present, in their statements, a preoccupation with the social and economical aspects that affect the practice of medicine, and with the limitations of the humanization discourse that disarticulates the necessities of those involved in the process of formation, and soon tend to return to the discussion of humanization while a kind practice characterized by the minimization of the interventionist actions. Now the users of the system show themselves before the dynamic of the services, submitting themselves to what is offered while assistance, without questioning and/or reflecting about their usual shortages. Therefore, to think of changes in the know and do of the practice of medicine destined to the birth of children implies reflection on the quotidian production of these practices and of the social contexts that influence the process of assistance in the practice of medicine. Herein it would be possible to predict the appropriation, by different workers concerning their exasperations and necessities, making them active in the pursuit of their rights as citizens

A relação entre os determinantes sociais em saúde e os investimentos setoriais e a mortalidade infantil em municípios brasileiros com mais de 80 mil habitantes

Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment

A produção das desigualdades: análise da relação entre trabalho infantil e indicadores sociais

The International Labor Organization (OIT) estimates that there are around 118 million children subjected to child labor around the world. In Brazil, there are 3.5 million workers aged between 5 and 17. This exploitation practice constitutes a serious social problem, including of Public Health, since these workers are exposed to a wide range of risks, such as those related to health, physical integrity and even to life, which may cause them to become sick adults and/or interrupt their lives prematurely. Therefore, this research aims to investigate the relationship between the frequency of child labor in the age group of 10 to 13 years and some socio-economic indicators. It is a quantitative research in an ecological study whose levels of analysis are the Brazilian municipalities grouped in 161 regions, defined from socioeconomic criteria. The dependent variable of this study was the prevalence of child labor in the age group of 10 to 13 years. The independent variables were selected after a correlation between the 2010 Census of child labor in the age group of 10 to 13 years and secondary data had been conducted, adopting two main independent variables: funds from the Family Allowance Program (PBF) per 1,000 inhabitants and Funds from the Child Labor Eradication Program (PETI) per a thousand inhabitants. Initially, it was conducted a descriptive analysis of the variables of the study, then, a bivariate analysis, and the correlation matrix was built. At last, the Multiple Linear Regression stratified analysis was performed. The results of this survey indicate that public policies , like the Bolsa Familia Program Features per 1000 inhabitants and Resources Program for the Eradication of Child Labour to be allocated to municipalities with HDI < 0.697 represent a decrease in the rate of child labor ; These programs have the resources to be invested in municipalities with HDI > = 0.697 have no effect on the rate of child labor. Other adjustment variables showed significance, among these the municipal Human Development Index (IDH), years of schooling at 18 years of age, illiteracy at 15 years of age or more, employees without employment contract at 18 years of age and the Gini Index. It is understood that the child labor issue is complex. The problem is associated, although not restricted to, poverty, the social exclusion and inequality that exist in Brazil, but other factors of cultural and economic nature, as well as of organization of production, also account for its aggravation. Fighting child labor involves a wide intersectoral articulation, shared and integrated with several public policies, among them health, sports, culture, agriculture, labor and human rights, with a view to guaranteeing the integrality of the rights of children and adolescents in situation of labor and of their respective families

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

Programa Liberdade assistida em Natal/RN: adolescentes em conflito com a lei e a violação de direitos

This work shows the results of the research: Attended Liberty Program Adolescents in Conflict with the Law and the Disapproval of Rights, effected in the community of Natal, Rio Grande do Norte, in period of august 2007 to September 2008. It aims to analyze the social-educative attendance directed to adolescents in conflict with the law through the state, since the Social-educative Measure Attended Liberty, known, as an idoneous way of confrontation to the practice of infraction acts imputed to the adolescent, that needs to give emphasis, in disadvantage of the Social-educative Measurement of Internment, to be proposed (ECA, art 118 and 199) to follow the adolescent in this quotidian, close to his family and community, proposing him through social-educative work, the access to education and occupancy, as well other public services, that help him to surpass the context of privation and disapproval of rights in which lives joined to his family. In our study, it was observed in sequence of approaching, subsidized for theoretical-methodological procedures justified in quantity and quality research, that were privileged to the documental research, the observation and the interview almost structured, besides a theoretical basis about the subject, that the relation of category and inequality in which the capitalist society sustains itself, does the practice of infraction acts imputed to the adolescent, acquires a classist character, in which the property of the money defines the access of the justice. And more, many of the poor adolescents that get into conflict with the law, dweller of the periphery districts of Natal/RN, becomes evident as for segment that has been attended in the Jurisdiction of the Infancy and Youth and in the LAN of Social-educative Attendance, becoming individual the infraction act and its confrontation. We hope in this work, to contribute for the care of the reality of the adolescent in conflict with the law in the Attended Liberty Program, without pretension to exhaust it, as well as later studies about the theme

Programa Agente jovem em Arez/RN: juventude e violação de direitos

This paper proposes discusses the theme of the youth and of the violation of rights in the context of the Young Agent Program developed in the local authority of Arez/RN, sugar cane region of the Brazilian northeast. We take like empirical reference, the young people in the age group from 15 to 17 years old that were participating of the activities of the Program, in the period of April to July of 2008. Objectives of this study were constituted, economical-partner apprehended the conditions and cultural of the young participants of the Young Agent Program, in the context of violations of rights; as well as the analysis of the limits and means, of the bases theoretician-politician, methodological and of the activities developed in the Program. In the persecution of the objectives we use like methodological instrumental the observation, activities in group with the focal group technique and the application of semi-structured interviews. As result, we notice that the violation of rights of the young persons inserted in the Young Agent Program of Arez sets itself up as reflex of the multiple determinations of the social question, inherent in the capitalist society, specified in the context of the poverty and of the social unequality that they acquire visibility in the hunger, in the unemployment / menial job, in the precarious dwelling, in the low schooling, for lack of leisure, in the violence between others. The approximations systematized in this healthy work relevant for the Unveiling of the reality of the Brazilian youth, specifically of Arez young people, in such a way that they come to subsidize future inquiries, are eaten by me also it promotes the discussion around the way like the Social Politics Programs they are implemented and driven in the capitalist society, in its neoliberal format, where the focusing and the selectivity is put on top to the detriment of the universal access of the democratic rights. So, the great challenge that is put for the XXI century is to cause to the voices from these which they do and this which build this country, in the continuous and tireless search of the rights realization in the struggle against the barbarism installed in the capitalist societycapitalista

As organizações não-governamentais (ONGs) de atenção à criança e ao adolescente em Natal/RN: contribuição na garantia de direitos?

In contemporaneousness watches in Brazil the emergence of a "new" relationship between State and society based on partnership, which will allow the growing playacting organizations "non-profit" and "public interest" in the management of social public policies. In that sense, as part of a logic of global restructuring of the Capital, under the aegis of the neoliberal project, starting from the years of 1990, an administration model is had in favor of the market that looks for to minimize the actions of the State, reinforcing the outsourcing of the social public politics, and consequently, debilitating rights legally conquered. In that way, with this study it was pursued as general objective to apprehend the actions developed by Non-governmental Organizations NGOs in the child's area and of the adolescent in Natal / RN, verifying in that measured, these contribute to the warranty of rights or they reproduce practices of welfare work, and as specific objectives: to identify the group of the actions developed by NGOs in the child's area and of the adolescent in Natal / RN; to analyze the practice of NGOs of the point of view of the human resources, of the administration, of the financing, of the user's participation in the decision processes, as well as the quality of the services and the continuity of the actions of these organizations; and to apprehend the relationship between the researched organizations and users in the process of implantation of the actions, in order to identify the perspective that guide the practice of NGOs is going in the direction of contributing in the warranty of rights or in the reinforcement to the welfare work. In summary the results showed two trends in the actions of the NGOs, in the direction of the provision of services, which still unfurls in two perspectives of handouts. The other trend will give priority to the defense of rights of children and adolescents, with actions of political impact strengthen the promotion of public policies state, thus contributing to guarantee rights

Famílias privadas de liberdade: a saga da violência vivenciada por adolescentes que trilham os áridos caminhos da criminalidade

This paper has as its main focus the relation between the infringement act and the adolescents families social economical problematic, who obey the social educational deprivation of freedom at CEDUC in the district of Pitimbu RN, establishing in the theme Children and Adolescents, with the objective of showing how these families breed in the social economical and cultural political aspect. It also seizes who those adolescents are and their family members in their social aspect and as those families face their daily activities. The focus on the social matter, family, adolescent, infringement act, exclusion, inclusion formed the analysis categories which made myths and reality possible, taking into consideration the infringement act in our society. The data collection showed that those families conditions of life are of poverty. Families originated from low social classes, 62.5 % coming from the countryside and living with a daily income ranging from R$ 0,31 to R$ 8,31. Their level of education is low; there is lack of human and citizenship rights and no professional qualification whatsoever. It questions the degrading social exclusion suffered by millions of Brazilian people due to social, political and infringement economical problems. Has this favored the infringement practice? How to confirm the families lack of competence having the social vulnerability? Are the Public Political Institutions really performing the way they should? Are they really carrying out their role as they should? We have noticed that from then on, the necessity of understanding the exclusion/inclusion suffered not only in an imprecise and empty way, but understood as processes of integrative exclusion or ways of delinquency, where the excluding is not only the only one who has lack of material care but the one who is seen or recognized as a person, is not being treated as one. The effort of this paper provided an approach to our object, and the seizing of a close relation between the infringement act and the exclusion process or inclusion suffered, which are submitted to families of those adolescents who deprive of freedom

O serviço social na previdência social: a afirmação do seu espaço na materialização dos direitos

The work of the professional of social worker in social security policy, it is seen wrapped in an adverse situation to consolidate the ethical-political project work, marked by the materialization of the neoliberal policy essentially promotes the reduction of social rights historically achieved by the class struggle worker. In this sense, with the aim of analyzing the statement of work of the Social Worker in Social Security, their struggles and challenges to the realization of rights, against the current situation is that it renders the theoretical basis of the discussions to be fought. Thus, we performed procedures such as methodological research literature and documents in detail of our analytical categories in order to base the discussion on social security policy. The survey area covered was the Executive Management of Social Security Mossoró and Natal, representing a total of 07 (seven) surveyed social workers who work in the Department of Social Work. Thus, the research allowed us a comparison with the work of Social Workers and this allowed us to reach some conclusions: first, the fact that Social Security does not guarantee in its entirety, the conditions necessary for the work of Social Worker, taking into account the lack of human and material resources for its realization, and the virtual absence of professional secrecy, and second, that the social workers surveyed say the ethical-political project of Social Work, in exercise professional from engaging in projects and social movements related to the protection of social rights and working class, thirdly, that the statement of professional design, contributes to the formation of a new professional activities, based on an analysis of whole and an action more interventionist, critical and purposeful, able to relate to the interests of users who seek their services, the consolidation and socialization of social rights. Thus, the direction of the work of professional of social worker to support the theoretical and methodological maturity in recent years acquired the expertise and ethical-political daily, consolidated its space in claiming social security institution, the rights so hard fought in an environment grounded in the disintegration social struggles

Processo de trabalho em saúde: uma análise das condições de trabalho dos assistentes sociais no âmbito hospitalar

This paper presents the survey results: PROCEDURE FOR WORK IN HEALTH: an analysis of working conditions of social workers in hospitals. Analyzes the inclusion of social workers in work processes in healthcare, specifically in the public hospital, from the objective conditions of work, according to which materializes professional action. The aim is to understand them from the point of view of its relationship with users and other health professionals through the privatization of health, which prevents the Unified Health System (SUS), limiting the operation of the services and the guarantee of rights. The approach to the reality studied was through theoretical and methodological procedures based on the qualitative and quantitative research, focusing on documentary research, observation, semi-structured interview and the theoretical foundation. It is observed that the inclusion of social workers in this context arises from the demands derived from expressions of social issues, "raw material" of professional work, and the gaps resulting from contradictions in the process of rationalization / reorganization of the SUS, meaning that the needs the population are confronted with the content and form of organization of services. At the hospital, the professional actions are developed through the shift, space contradictory clash between the collective and individual, in which individual activities are prioritized and ad hoc unplanned and reduced to the solution of "problems" of users, through actions assistance in an emergency and bureaucratic. These findings emphasize the inadequacy of space and lack of minimum conditions of service to users, which undertakes the professional with regard to ethical and political principles of the profession, since it is the responsibility and duty of the social guarantee the secrecy and privacy of users what is revealed during the process of professional intervention. The professional social workers is permeated by the diversity of skills and competence; lack of planning activities, by incorporating the institutional discourse at the expense of professional goals, by knowing the Code of Professional Ethics, for small number of professionals, the increasing number informality; by poor working conditions and wages; by discouraging research and participation in social policy councils, as well as professional training

Extensão universitária: concepções e ações na UFRN sob a temática direitos humanos e justiça no período 2008 a 2010

This paper concerns a study on the University Extension, by reference to the research extension activities under the theme human rights and justice, developed in the period 2008 to 2010 in UFRN. To do so, it tried to learn the concepts of extension in Brazil from the 1970s until the 2000s in contemporary times. This study considered the neoliberal social context of the University, dominated by educational policies focusing on the hegemony of liberal ideas about society, reflecting the great advances of capital on the organization of workers in the last decades and intensified in the 1990s. This research was guided by two great motivations: the opportunity to apprehend a way to enforce the commitment of public institutions of higher education to the disadvantaged sections of society and what role the university extension space plays as a socially committed public university. The general aim of this study is to identify inside the university extension education what does it mean for practitioners and extension activities and what results it produces to society and to the academic training of future professional citizens in the current neoliberal context. The research has been developed from an analytical and critical approach based on quantitative and qualitative data, using observation techniques and semi-structured interviews. We sought to investigate and understand the social reality, the main object of this work, with an interest in identifying the need for a new teaching/learning process and for a new university practice, in order to effectively improve an advanced academic formation. For this, some interviews have been conducted with teachers, students and the external community involved in extension actions in the period defined by the work, i.e., from 2008 to 2010. In this stage, it was observed that the academic work of university extension is essential to civic education. It was recognized too as a privileged space where university fulfills its social commitment towards society, as long as it joins scientific and popular knowledge having in view a new science and a new social order

O trabalho dos assistentes sociais no âmbito hospitalar: as particularidades da sua inserção no Hospital Universitário Onofre Lopes (HUOL), em Natal/RN/

This study aimed to analyze the work of social workers at the Hospital Universitário Onofre Lopes (HUOL), with the analytical approach the contracting process with the HUOL with the National Health System (SUS), which is set from 2004. Thus, this study sought in times of state reform, restructuring and tension between enlargement / reduction of social and labor rights, understanding the limits and possibilities of social work in HUOL, analyzing how these determinations bounce in the practice of social workers included in the collective process of health work. From a theoretical and methodological historical and dialectical materialism, we conducted literature search, in which developed book report and readings of texts, articles, books that focus on the central categories of the study, namely: Work, Social Work, Health, Health Reform , Project ethical and professional politician. Operationalized also a documentary research, on the Brazilian Public Health Policy, (SUS) and of the Education, as well as research field in which we conducted interviews with 11 social workers, employees packed the HUOL. We conclude that social workers did not participate in the discussion process of contracting the HUOL with the Municipal Health Secretariat of Natal, RN, manager of health and full resetting of user access, via reference setting - counter-referral services provided by the hospital brought the main demands on Social Work guidance regarding the functionality of SUS, and the social intervention in the struggle to guarantee such access. However, the data show that the expansion of demands that require the intervention of the social worker at HUOL is not associated with quantitative growth of these professionals need. Such conditions inflect the possibilities of materialization of the professional ethical-political project, even though that these professionals worry and seek the intellectual improvement, quality of service and to guarantee the social rights of users in the professional practice everyday

Violência e luta por direitos no capitalismo contemporâneo: crítica à configuração do atendimento às mulheres no Rio Grande do Norte

This research analyzes the Rio Grande do Norte care services to women who face violence in the context of contemporary capitalism. To do so, we situate the patriarchy in the set of current social relations and its relationship with the corporate determinations in everyday life. The new functions of the Patriarchy in the capital sociability permeates the lives of individuals and particularizes the relationships of violence which affects women, requiring, in the immediate level, policy-making to face them. The research found an arsenal of contradictory possibilities and limitations in dealing with violence. In this process, forms of struggle and resistance predominate, which appear as possibilities and limits were identified relate to the socio-historical context of regression of the rights, historical moment in which increase the objective difficulties in everyday life to ensure the legal achievements. It is worth to emphasize the achievements and contradictions that characterize the struggle process for rights, linking services to women to the social policies and to the limits they face in opposition to the aims of the State to meet the mandatory requirements of capital, reducing its role as the main guarantor of policies and rights. In this sense, the trajectory of the achievements that have referred to the proclamation of a specific law to deal with combat violence against women, the Maria da Penha Law - 11.340/06, which provides an integrated set of measures that, if implemented, would allow the women protection from relations of violence they experience. We identified in Rio Grande do Norte precarious services that are essential to achieve the Maria da Penha Law. This situation requires a feminist organization to claim the rights that enable women to see themselves as people with rights in the process of collective struggle. This is the historical need for continuity of struggles that accumulate policies for the existence of a new model of social relations of gender. One of the possibilities that are presented in the current context is the impact on the public budget in order to ensure compliance with the budget for public policies for women - woman budget. In this perspective, feminist segments in national and state level have been organized to understand the functioning and monitoring of social policies. This is a condition and prerequisite for ensuring policies to ensure basic rights and the violence combat , which still requires an integrated set of services. The survey results allow us to consider that the struggle for rights is necessary at this historical moment, however it is not sufficient in human emancipation, which requires new forms of social relations that determine substantive equality between men and women. Thus, the feminist movement faces the challenge to organize and strengthen itself in daily life, in order to execute a project that changes the meaning of women's rights, articulated to a corporate project which wants other command in the set of social relations . This study emphasizes the need for a more and more organic connection between feminism and social struggles, to ensure the inclusion of women in anti-capitalist struggle

O sistema de garantia dos direitos da criança e do adolescente: análise da trajetória e do processo de resolubilidade dos casos de violência doméstica sexual em Recife PE (2007-2011)

This work discourses about the child and adolescent s Guaranty System of Rights (GSR), on the intervention in cases of juvenile domestic sexual violence, in Recife. The course (trajectory) is analyzed, where circulate cases of sexual violence, until its resolution, in (GSR). Actually, the violence represents a serious problem of public health. Was thought about the difficulties and the limits that make GSR become a full field of contradictions and challenges for the effectiveness of the children and adolescents rights. Therefore, it was verified the treatments that are developed by GSR, how this system is structured and articulated and how occurs the resolution of the sexual violence cases against children and adolescents. Proceedings of the quantitative and qualitative research were used, was done observation, directed interview and analysis of documents. Thus, the field research was the visits in these institutions: Restauração Hospital, Police Management of the Child and Adolescent (PMCA) three Guardianship Councils, Dom Helder Camara Center of Studies and Social Action (CENDHEC) and the Tribunal of Childhood and Adolescence. The research subjects were seven professionals of GSR. The theoretical discussion is guided in reflections about the children and youth rights, in the violence theme and in the construction and institutionalization process of GSR. In this experiment, was noticed there are many difficulties for working together the GSR, because many obstacles are found when we call the responsible institutions, besides some violence cases happen again. This system is not totally institutionalized and articulated, faces structural problems, material, poorly qualified professionals, underinvestment, low transfer of public resources, among other difficulties, causing many losses in the implementation of public policies that enforce secured rights by legislation

Movimentos sociais e organização popular em Natal-RN: enquanto morar for privilégio...

To the extent that the expansion of cities is increasingly pushing and segregating the working class to outlying areas, devoid of services and infrastructure, the urban space is also important as a space in the class struggle, and in this direction, the this study aims to analyze the political organization of urban social movements and popular organizations existing in Natal-RN, nowadays, in their process of struggle for social rights, with emphasis on the right to the city. With this dimension, we appropriate the contributions of historical and dialectical materialism because we believe that this benchmark enables the understanding of the processes of collective organization and a critical perspective of totality, going beyond its immediate appearance. For production data conducted literature, documentary and field, through semi-structured interviews recorded with (the) mapped leaders of organizations in our survey, as well as advisory bodies to the movements studied. The results of the study allowed us to characterize the action of the political movements in urban Christmas struggle for recognition and guarantee of the right to the city and seize the advances and obstacles in the process of intervention of social movements and popular organizations existing in Natal, highlighting dilemmas and contradictions underlie the processes of organization and mobilization in the contemporary period. Thus, we conclude that the Natal territory, as in contemporary Brazil, the urban and political action movements that show the public scene and intertwine necessarily relate to historical trend that has been performing since the 1990s, when the country entered a period marked by a new bourgeois offensive