Política de assistência social no Brasil: uma análise a partir das tipologias de políticas públicas

The study of public policy typologies is still a knowledge field which lacks more embracing and applicable studies to different sectors. On that perspective, this work, Social Assistance Policy in Brazil: an analysis from the typologies on public policy, pursues to add the relevant literature to social assistance what focus on the public policy ratings. Moreover, it concerns about a study on the the national policy of social assistance implemented by the Brazilian government from the theoretical referrence of the public policy typologies. For that reason, the referential framework of the public policies as well as the analisys of its fundamentals/principles that are indispensable for achieving a bigger goal, that is to tipify the social assistance policy based on the different public policy typologies and characterize it through the main elements which are intrinsec to the social political and economic reality of Brazil. Thus, the issue suggested for the work is: what is the profile and the political trajectory of the social assistance implemented by the Brazilian Government? How it presents, above all, the features of a distributive, focused and lawful policy, the work has been done througho the following hypothesis: the social assistance policy in Brazil has been of universal, assistance, and focusing aspects. For each of those features granted to the social assistance policy, there is a gathering of changes according to the social, political and economic moment of the country and that stands out due to the different institutions within every cyclical period. The work showed that besides the social policy has gone through meaningful changes during the last decades, even though the adoption of the Organic Law of Social Assistance and its rules, some of the mentioned characteristics still remain, as long as the State s primacy goes on being the economic policies over the dubbed social policies. Notwithstanding, the social assistance will build up itself from the materialization of the growing of the social rights related to the State, but also assuming an important role on the amplified reproducing process regarding the capitalist social relations

Expressão da ética na assistência de enfermagem aos jovens intoxicados

Analisar sobre o processo de cuidar da equipe de enfermagem na visão dos usuários intoxicados por tentativa de suicídio. Metodologia: estudo descritivo exploratório, de abordagem qualitativa, realizada em um centro de assistência ao intoxicado da Paraíba/Brasil, com nove usuários. Como critérios de inclusão, participaram as pessoas que tentaram o suicídio por intoxicação, nos meses de abril e maio de 2010, período de coleta de dados do estudo, e que tivessem condições de responder as questões formuladas. A coleta de dados foi realizada por meio de entrevista semiestruturada com uso de formulário, cujos dados foram tratados pela Análise Temática. A pesquisa foi aprovada conforme avaliação do Comitê de Ética em Pesquisa da UEPB e mediante CAAE nº 0003.0.349.133-10. Resultados: os participantes concentraram-se na faixa etária de 14 a 26 anos, predominando o gênero feminino e o consumo de agrotóxicos na tentativa de suicídio. A análise dos discursos permitiu identificar que todos os integrantes demonstraram-se satisfeitos com a assistência de enfermagem, entretanto, apontaram ausência de comunicação com os profissionais cuidadores e atraso para a realização dos procedimentos. Conclusão: a ética na assistência de enfermagem supõe o estabelecimento da valorização do humano durante as atribuições profissionais, proporcionando o bem-estar daqueles que não enxergam a dádiva maior, que é nesse plano, a vida

Dimensões da satisfação do paciente geriátrico com a assistência fisioterapêutica

Introdução: Os idosos constituem os maiores consumidores dos serviços de saúde, especialmente os de reabilitação, tornando imprescindível a avaliação da qualidade da assistência fisioterapêutica prestada. A satisfação do paciente tem sido considerada uma das melhores e mais eficazes formas de avaliar o cuidado e direcionar o provedor do serviço para suprir as necessidades e expectativas do paciente-cliente. O objetivo deste estudo foi investigar os principais aspectos (preditores) que contribuem para a satisfação do paciente geriátrico com o tratamento fisioterapêutico ambulatorial. Métodos: Trata-se de um estudo com enfoque epidemiológico, transversal e descritivo de cunho exploratório. Foi utilizado o instrumento de avaliação da satisfação do paciente com a fisioterapia, desenvolvido e validado para a população brasileira por Mendonça em 2007, com uma escala de satisfação do paciente composta por 23 itens. Os dados foram coletados na sala de espera de 29 clínicas de Fisioterapia da rede privada da capital do RN/Brasil e a amostra selecionada de forma não-probabilística constou de 221 pacientes com idade superior a 60 anos, que realizaram entre 5 e 60 sessões de fisioterapia onde os dados foram coletados, deveriam ser usuários de plano de saúde e ter condições cognitivas preservadas. Resultados: A análise fatorial indicou a existência de quatro fatores com autovalor maior que 1: interação pacienteterapeuta (7 itens) α = 0,901; acesso e atendimento de recepcionista e pessoal de apoio (8 itens) α = 0,888; ambiente físico e satisfação global (5 itens) α = 0,835; e conveniência (3 itens) α = 0,711. Os itens com maiores escores de satisfação completa foram os contemplados nos aspectos de interação paciente-terapeuta, especialmente o respeito e a gentileza do fisioterapeuta. As associações realizadas através do teste do Qui-quadrado e regressão logística binária entre a satisfação do paciente e as variáveis sócio-demográficas, percepção do estado de saúde e capacidade funcional demonstraram que a satisfação do paciente idoso associa significativamente com o sexo e estado civil. Os achados revelam que as mulheres mostram-se mais satisfeitas com a fisioterapia. Conclusão: Os aspectos interpessoais demonstraram ser preditores relevantes para assistência fisioterapêutica satisfatória, especialmente na população idosa que requer atenção além do suporte puramente técnico

Discursos e práticas na formação de profissionais fisioterapeutas: a realidade dos cursos de fisioterapia na região nordeste do Brasil

This study had a multidisciplinary focus, investigating the areas of health and education, and proposes to discuss the formation of health professionals, requiring their understanding of the factors involved in the production of knowledge, given that this formation has an impact on the quality of human and social life. The aim of this work was to investigate the relationship existing between the process of physical therapist formation and the practical activities developed during the undergraduate course in the Northeast of Brazil. This is an exploratory descriptive study with qualitative significance. The sample consisted of 73 subjects (33 professors and 40 students) from 6 physical therapy courses at different institutions in the Northeast of Brazil. Data collection was conducted through focus group interviews. In addition, we used a school assessment instrument from the health area. The data, analyzed using dialectical hermeneutics, showed that the Northeast of Brazil has the second largest number of physical therapy courses in the country, with 93 (11 public and 82 private) out of a total of 510. These numbers represent a growth of 1062.5% since 1991. The pedagogical projects are guided by National Curricular Directives as well as by the country s health system. The prevalent pedagogy is that of transmission, and the contents/disciplines are generally not integrated with practice, a situation that hinders the integrality and interdisciplinarity of health care. It can be concluded that there is a need for implementing integrated curricula and for better qualified professors to effectively put this process into practice

Iniqüidade em saúde: uma extensão das desigualdades sociais no sistema público de saúde do Brasil (2003-2006)

This issue analises the unevenness in the brazilian system of public health care as an extension of socials inequities. It is a theoretical study based in a historical method, using empirical camp from academic, corporation and institution researchs, along the period 2002-2006. Equality and effectiveness in health systems are analitical basic cathegories grap in the root of the doctrine, principles and organization of the Unique Health System, in which sectorial actions are inserted. Discuss the estructural prodution and determined those inequalities through some social determiners of health system: income, land, food securitiy, nutritional situation, basic sanitation, epidemiological inequities and public management policy. Carry out a thematic review over health social production, it formlation and the goals of social policies, as well as the insertion of the equality principle in the assistance system, in the frame of the running public health regulations. It uses reflections that enlighted the correlation between the process of political-institutional actions and equity on health assistance. Analized the pertinency of sectorial reorganizational strategies on basic attendance, confronting the hipothesis that those strategies reinforce social inequities in health system, because it organize diferential assistance levels over not equal baselines. The results show up that social inequalities, even remaining, have had a small decrease; that the selectiviness of actual public policies and the duplication of the health system, increases the differences within and between the social classes and configures the assistance as inequal. The basic care system has great shortages that also appeares in middle and complex assistance levels. As conclusion, it remarks that the health assintance system, even with it integrality has limits; structural problems on material conditions of living and health system could not be reversed only with institutional legal arragements; by the contrary, in border conditions, these strategies produce policies that reinforce inequities, neglecting the equity principle of the system in which frame, they work. One patina of this tim

Desenvolvimento e assistência social : uma avaliação da efetividade da política de assistência social nos municípios de Assú e Mossoró (2004 -2008)

This thesis, whose title is DEVELOPMENT AND SOCIAL ASSISTANCE: AN EFFECTIVENESS EVALUATION IN SOCIAL ASSISTENCE POLICY IN THE CITIES OF ASSÚ AND MOSSORÓ/RN (2004/2008), has as main aim to evaluate effectiveness in Social Assistance Policy in the cities of Assu and Mossoró/RN, from 2004 to 2008, identifying its impacts and effects in life of its users. The methodological process for the research was composed by: a) Literature review on this theme, development of public policies; social public policies, public policy evaluation and Social Assistance Policy in Brazil; b) Documental research from Municipal Management of Social Development and Municipal Counsels of Social Assistance in the cities of Assu and Mossoró/RN about the object of this study and empirical field; c) Field Research constituted by the realization of Focal Groups with Social Assistance users and semistructured interviews with municipal managers from Assú and Mossoró. It was also taken into account participant observations in events and activities related to Social Assistance previously mentioned, considering field management and also the response to users demands. Articulating the themes of Development and Public Social Policy in Social Assistance was the theoretical purpose for this thesis. To achieve this purpose, it was performed two theoretical displacements related, at the same time, to the notion of development and to the concept of Social Assistance, which means to comprehend development as social change and improvement in users life quality, expressed in the expansion of their capacities and liberties (SEN, 1993, 2000), and the Social Assistance as an element for development. Such displacements provide a view of Public policy and Social Policies and evaluate National Policy of Social Assistance achieved in those cities. As product, this thesis presents a methodological purpose for effectiveness evaluation in Public Policy, taking into account expansion of capacities and liberties, concluding that Social Assistance Policy in Assú and Mossoró/RN, even in lesser extent had its impact and caused effective results in the life of their users and provided an expansion of their capacities and liberties, improving life quality and empowered agent condition for those subjects. The results show that this Policy has been proved to be effective, and consequently, it was considered, in this thesis, to be also an element and an allied for development

O município brasileiro e o direito fundamental do acesso à justiça: a prestação da assistência jurídica municipal ao necessitado

This scholarly work aims to investigate the feasibility and constitutionality of access to justice through the provision of full and free legal assistance by the Brazilian municipalities. Investigates the historical aspects of federalism in a global context, emphasizing the contributions left by American federalism. In the Brazilian context, emphasizing the importance of municipalities as federal entities and their outstanding characteristics, while addressing regional issues of federalism. Leanings to the more detailed analysis of the Brazilian municipalities, contextualizing its legal status, its independence and its constitutional powers. It is emphasized in the same way, the relevant transformations of Brazilian municipalities over the last twenty years of this Constitution of the Federative Republic of Brazil in 1988, especially the various constitutional amendments that affected the local autonomy and budgetary aspects, fiscal and skills, bringing significant changes to the municipalities. It is an approach to the concept of justice and deepening the studies on the fundamental right of access to justice in its various connotations. In this vein, it is a study on the legal advice provided in Brazil, especially the powers of the Public Defender of the States and Union, as well as the provision of such public service by Brazilian municipalities and its relevance to citizens in need. At this point, it deepens the relevance of the theme of this dissertation earning the implications of municipal performance in the provision of legal assistance provided to the needy, and the activity of the Municipal Attorney or legal counsel in conducting such a task and its implications for legal and procedural especially on the constitutionality or otherwise of the conduct of such public service, confronting the constitutional articles that are correlated with the subject. Within this context, evaluates the municipal legal assistance under the test of constitutionality, in particular the assistance given by the Executive, through the Municipal Attorney or specialized secretariats and that provided by the Legislature, although it only has the typical functions of legislating and control the municipal accounts, comes in a few municipalities in Brazil deploying sectors with the performance of legal services to the needy. At this point the thesis, one wonders if some important aspects of this activity such as political influence and patronage, very common in day-to-day municipal prosecutors and legal advisers, public employees or occupying commissioned positions within the municipal administrative structure in several municipalities throughout Brazil. Finally, there will be a conclusion as to the constitutionality of the service being done by presenting proposals and recommendations that may improve the municipal legal aid, allowing a constitutional backing to this important service is being provided in capital cities and municipalities throughout the length of Brazil

Representações Sociais do ser idoso e suas implicações na assistência e nas práticas educativas voltadas à população idosa residente em Natal/RN

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Validação de protocolo de assistência para pessoas com úlcera venosa na atenção primária

People with venous ulcers constitute as an important public health problem, its treatment is onerous and require assistance provided by trained professionals, systematized through protocols, however what lies in the assistance is that the management of this group of people differs from that preconized in the scientific literature, interfering with wound healing and quality of life of affected. In this sense, the construction of a assistance protocol specific to people with venous ulcers (VU) can help professionals of the Family Health Strategy both in patient assessment as and in establishment of quality assistance. Thus, this study aimed to analyse the validity of a multiprofessional assistance protocol for people with venous ulcers in primary care by health professionals using Delphi technique. This is a quantitative study, the methodological type conducted in two steps: first step related to integrative literature review to subsidize the development of the protocol, then these aspects were organized and proposed to the judges of the study through the Delphi technique. The study was initiated after approval by the Research Ethics Committee. The first step was performed between August and September 2012, in the virtual library of health, in the page of the Coordination of Improvement of Higher Education Personnel, of Municipal Health Secretariat and international guidelines of associations and in the subsequent step carried out between September 2012 to January 2013, was performed search by Lattes platform of the National Council of Technological and Scientific Development, in order to identify health professionals in Brazil who act as judges of the instrument and then, via online, the form was submitted to them.The sample for the second step was 51 judges in the first round and 35 for the second round Delphi. The analysis was done by adopting Kappa index ≥ 0.81 and Content Validity Index (CVI)> 0.80. In the first submission for the judges, items that did not reach Kappa and CVI established were: request / realization / test results, demographic data, medical history, risk factors, verification of pain / vital signs / pulse / infection signs / lesion location/ edema and pain treatment. After removal of items which have not obtained Kappa or CVI index established, it was found achieving optimal levels of these index for the categories. In the next step was the ressubmissão of protocol to judges through the Delphi technique in it was found that, of the 15 categories of the protocol, 12 presented higher scores in Delphi 2 phase and the other three categories remained the same Kappa and IVC of the previous phase. As for the average of evaluation requirements of the protocol was found that the scores assigned by the judges were higher in the second phase in nine of the 10 items, remaining the same in only one of the items indicating validity of the instrument before the consensus of the judges. Thus, we accepted the alternative hypothesis in this study, as they were obtained in the second Delphi phase the validity index greater than or equal to the Delphi 1 phase. The formulation of this assistance protocol valid and reproducible will enable a reorganization and redesign of assistance, with standardization of actions and continuity of care for persons with venous ulcers in primary health care

Assistência odontológica diferenciada para crianças de 0 a 3 anos: avaliação de impacto no Serviço Público Municipal em Natal-RN

In Brazil, 0-5 years old children just have an oral health care system since 1990 s. Innumerable experiences of implantation of the attendance to the babies in the cities had appeared throughout the years, but it hasn´t been evaluated the comparative effect between children displayed and not displayed to the program. In this regard, the main of this research was describe the Early Childhood Oral Health Care in public health service in Natal, Rio Grande do Norte, Brazil and evaluate the impact of this specific oral health care for babies by comparison of indicators between exposed and non-exposed children. It was created an experimental group, formed by children covered by program which was paired, based on sex, age and socioeconomic status, with a control group, formed by uncovered children. After filling ethical application, the parents of children were questioned about some risk factors to dental caries and, in sequence, it was accomplish an oral examination in the child. It was verified the Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), dmf-s and verification of caries activity. The sample was 40 children in each group. The results showed, for VPI, a difference of 7 percentile points for the experimental group, however this difference had no statistical significance, obtained by Student s t test (p=0.314). In relation to GBI, the control group showed a low mean (0.8%) comparing with experimental group (2.77%) and this difference was statistically significant (p=0.003). The results for dmf-s and evaluation of caries activity showed no statistical difference between groups. Among the probable reasons for absence of impact of intervention, could be included: (a) the practice model was the same in two groups, or the difference was very weak and (b) the oral health care has intrinsic limitations for to impact on oral health in low income populations

A ação do psicólogo na assistência social: interiorização da profissão e combate a pobreza

A pobreza, como uma das manifestações da questão social , é elemento constitutivo do padrão de desenvolvimento capitalista, extremamente desigual, em que convivem acumulação e miséria. Nas últimas décadas, sob a égide do ideário neoliberal, verifica-se um incremento em políticas de combate à pobreza no Brasil, de caráter focalizado e compensatório, tanto por meio de ações diretas de transferência de renda, quanto pelo fortalecimento de serviços e programas voltados às populações pobres, com a estruturação do Sistema Único de Assistência Social, hierarquizado em Proteção Social Básica e Especial. A participação do psicólogo nas equipes profissionais do CRAS constitui um importante elemento para a discussão da inserção desse profissional no campo das políticas sociais no Brasil, considerando os limites estruturais postos pelo caráter compensatório dessas políticas, e a construção de estratégias que possam resultar em uma mudança efetiva nas condições de vida das camadas mais pobres da sociedade. Aliado a isso, por meio do ingresso na política de assistência social, um número significativo de profissionais psicólogos passa a atuar em cidades pequenas e médias, fora dos tradicionais centros urbanos, constituindo um movimento de interiorização da profissão . O objetivo do presente trabalho é analisar a ação profissional do psicólogo na assistência social no contexto nas políticas de combate à pobreza em municípios do interior do Rio Grande do Norte. Realizou-se entrevistas semiestruturadas com psicólogos atuantes nos CRAS de 17 municípios de pequeno e médio porte do estado. As informações foram sistematizadas com auxílio do software QDA Miner v. 3.2. A perspectiva defendida neste trabalho refere-se à funcionalidade das práticas psicológicas no contexto das políticas de combate à pobreza brasileiras na atualidade, ao reforçar os ideais neoliberais de naturalização da questão social e responsabilização dos indivíduos pela sua condição social, além de, em grande parte, desconsiderar as particularidades e singularidades que marcam os territórios de ação. Todavia, é possível depreender alguns modos de ação profissional que estão na contramão dos mais frequentemente encontrados nesse campo. Esses modos se revelam no cotidiano do CRAS como formas diferentes de compreensão do saber fazer profissional, resultados de um posicionamento político e de uma formação profissional que buscam romper com o tradicionalismo e conservadorismo da Psicologia e do campo da assistência social

A assistência técnica e extensão rural no assentamento modelo: proposição e realidade

This discourse analyzes the technical assistance concerning the rural settlement, which is seen as a demand of the social movement that claims for agrarian reformation, and is a goal of II PNRA, launched in may 2004, as a essential national public politics on process of building and consolidation of settlement and familiar agriculture, proposing the return of technical assistance service and rural extension in Brazil, which were started in the and of 1940 s. We analyze, in particular, the technical assistance program, social and environmental agrarian reformation, on model settlement, a program created, especially, to the rural settlements, coordinated by INCRA. Based on the documental analyze and local study, it is noticed that the experience of technical assistance implemented on model settlement shows the non continuation and fragility on technical assistance actions to rural workers. This context goes against the lately technical assistance governmental apparatus, which ensures to make settlements stronger, to support and to get important the familiar agriculture system. This way, technical assistance execution, trough the tertiary service, follows the neoliberal strategy and, the State, besides decreases the estimate to public politics, takes its actions control from the State to the shared control through partnership and transferring of responsibility, expressing its historic lack of attention to the worker class demands. In spite of workers resistance, expectative and hope, the lack of these services, as well as the other politics deficiencies, which are necessary to the settlements, are endangering its activities and threatening its survival in the settlement

A gestão do Sistema Único de Assistência Social em Currais Novos (RN)

The present paper analyses the social assistance management in small cities, starting from the reality of Currais Novos City. Its main objective is to analyse the management of this politic in the context of the Nacional Sistem of Social Assistance (SUAS) through the management instruments materialized in the city: Social Assistance Plan, Budget, Management Report, Information Management, Monitorizing and Evaluation. It reveals a discrepancy between the instruments purpose and their concretude, and it identifies the main challenges in order to make them real, revealing the contradictions of such politic, through which the advances relate with the retrocesses. It remarks, in this context, the debate about Public Management and some aspects of the trajetory of the Social Assistance management in the brazilian context and the configurations of (SUAS) and of the politics in Currais Novos city. Such path allows us to identify the feebleness in the city ways to adopt the (SUAS) criteria, which is much more effective in burocratic aspects than in the change of the Social Assistance conception and in the effective incorporation of the (SUAS) principles and guidelines. Thus, problems are identified in what concerns to the important aspects for its effectivation, with the human resources, financing and social control mechanisms. It makes possible to reafirm the importance of the analysed management instruments for the effectivation of one participative and democratic management, as well as the urgency of its materialization as one of the important ellements for this politic to happen as a right and to make a stop to the unconformities between the (SUAS) determinations and its materialization

Novos arranjos institucionais: gestão local e conselhos municipais de Assistência Social

As discussões que envolvem as dimensões do Poder Local no Brasil ganham visibilidade pós Constituição de 1988, e em meio a este cenário estão presentes os Conselhos Municipais de Políticas Públicas que, apesar de terem filosofias e estruturas semelhantes, guardam particularidades, dependendo da política pública a que se referem. Na especificidade da Assistência Social, os conselhos municipais gestores emergem da condição da Assistência Social como política pública, inscrita na constituição de 1988, e aprovação da Lei Orgânica da Assistência Social – LOAS. Circunscrito neste debate, o presente artigo propõe-se a refletir sobre os Conselhos Municipais de Assistência Social (CMAS) na sua relação com a gestão local, tendo como campo empírico de análise a experiência do município de Mossoró, localizado no Estado do Rio Grande do Norte

Construção e evidências de validação de instrumentos de pesquisa para avaliação da assistência nos centros de atenção psicossocial

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES