Uma avaliação do serviço de atenção domiciliar/programa melhor em casa: o caso do hospital Monsenhor Walfredo Gurgel

This dissertation try to understand how management actions implemented by Monsenhor Walfredo Gurgel Hospital in the city of Natal promote effectively the benefits of Home Care Services / Programa Melhor em Casa . The research is exploratory and descriptive, qualitative approach. Data were collected through document analysis and the interviews with the managers of the Program in Health Department and Hospital beyond the questionnaires with the home care teams and technical management unit of Hospital Jobs. The information were treatment trough categories that analyzed to implemented actions and program objectives. The results show that: the practices carried out by the host teams produce the humanization of care by seeking to ensure access to health services and solving human form; networks of health care are not yet finalized hindering the referral of patients to other units, the networks allow support from other institutions to minimize the problems encountered, the management unit vacancies allows the reduction of costs, mainly by regulating beds and record of health initiatives in home care assists in the monitoring and evaluation process of the Services Home Care / Programa Melhor em Casa primarily the epidemiological profile and patients individual treatment plan. Concludes that most of the actions implemented by the Hospital contribute to the effectiveness of the goals of Programa Melhor em Casa

Perfis e práticas dos profissionais de saúde mental em dois hospitais psiquiátricos de grande porte

In the Brazilian network of psychosocial care, health professionals are important actors in the process of transformation of mental health public policies among various services. In the reality of psychiatric hospitals, one should understand the need to expand the debate about the current context of practices developed. This study aimed at analyzing the process of psychiatric reform and the mental health policy in the State of Rio Grande do Norte (RN) from the profiles and practices of higher-level professionals in two psychiatric hospitals. This is a cross-sectional and descriptive research, with quantitative and qualitative data, conducted in two psychiatric hospitals of RN. The universe of the target population was 95 professionals, taking into account the margin of error of 8%, non-response rate and the inclusion criteria: holding effective link with the institution by means of approval in public examination for, at least, six months, being state or municipal servant; having a minimum weekly workload of 20 hours in service; participating in care and/or activities with patients and families in a direct way. The final sample consisted of 60 professionals. The tool for data collection was a questionnaire with closed and semi-open questions about socioeconomic profile, and mental health policies, practices and training. Quantitative data were tabulated in the statistical software SPSS, and simple and bivariate statistics, chi-square type, was used for analysis by adopting the significance level with the value p<0,05. In order to analyze data, the content analysis of Bardin was used. The qualitative findings obtained with the semi-open questions in Analyse Lexicale par Context d'un Ensemble de Segments de Texte (ALCESTE) were grouped into four thematic axes: Professional action in mental health; Mental health training; Scenarios of psychiatric reform and psychiatric hospitals; Mental health policies and practices: challenges for professionals in hospitals. The profile of professionals has revealed the majority of women (89,7%), nurses (36,7%), aged 50-59 years (42,9%), weekly workload of 40 hours (52,4% ), time of completion of graduation from six to 15 years (57%), and 21,4% reported to have specialization in mental health. Regarding the practices developed in individual care, it was found an association between those who do not build or partially conducts the therapeutic project and those who conduct care related to observation and annotation. In family care, it was obtained care consultation during crisis; and, in group care, recreational activities. In the analysis of thematic axes, it was noted that, despite changes identified in the profiles and practices of higher-level professionals in care services for mental health, with the implementation of new public policies for this field, the findings indicate the confluence of asymmetries and divergences in the actions of the teams in psychiatric hospitals, difficulties in managing services, frequent readmissions, reduced quantitative of available services and equipment, high demand of users, disarticulation of the network of psychosocial care, and the very shortage of skilled human resources to compose these services. Accordingly, the evidenced scenarios partially outline the current political and ideological mismatch of the national process of psychiatric reform that denies the role of care actions conducted within hospitals, although it has not gone far enough with the creation of new services that justify the total extinction of this institution

Mulheres em situação de violência e atenção em saúde mental: um estudo no município de Natal (RN)

The present study aims to meet the attention given to women with mental health needs in specialized services for the fight against violence against women, as well as psychosocial care network in the municipality of NatalRN. It is a qualitative research characterized as research-intervention that took place in the year 2011. The study started in the Centre of Reference in which individual semi-structured interviews were carried out directed to the coaching staff and manager, in order to know the care offered in relation to the aforementioned clientele. From the Reference Centre were identified through analysis of registration records, the routes traversed by users through the network of psychosocial care and hospital network. After the identification of the same were visited two day-care Centers, two psychiatric hospitals, a basic health Unit and the local shelter. In these organizations was investigated the reception and procedures offered to users in situations of violence, the knowledge of policies for women and the coordination with the attention to women, through interviews with semi-structured individual scripts directed to professionals. The interviews were analyzed taking as starting point the theoretical framework of French Institutional Analysis, which includes the assumption of events analysers for the critical reading of dimensions introduced in the practices of care of the teams that took part in the study. The survey results revealed difficulties on the part of the same host of users with this profile, both in the face of violence as services in mental health services. This fact led to the lack of support under the guarantee of their rights, ceasing the possibilities of confronting the situations of violence, as well as in the context of mental health care

O direito coletivo prestacional à saúde e o poder judiciário: a concretização do art. 196 da Constituição de 1988 pela via jurisdicional

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

Projeto café do trabalhador como promotor de segurança alimentar e nutricional: avaliação da eficácia da unidade Natal-RN

The evaluation of public policies that promote Food Security and Nutrition (FSN) it s a multidisciplinary activity extremely relevant to the effectiveness of actions to legitimize the Human Right to Adequate Food (HRAF). This study aimed at assessing the effectiveness of the unit project Natal-RN Café do Trabalhador in promoting SAN to its users. The theoretical framework is based on the public and political and on the dimensions of the concept of FSN (quantity and quality-regularity). Through a qualitative approach, methodologically this was the work of an evaluation of efficiency of the unit Natal-RN of Café do Trabalhador project in light of the assumptions of the concept of SAN. Data collection was conducted through retrospective archival research in official documents of the project, semi-structured interviews with managers involved in its implementation (representative of the Secretary of State for Employment, Housing and Care of RN SETHAS and third party), socioeconomic questionnaire applied to the users of the unit, check the amount, regularity and quality of meals offered for 15 days (menu routine) using the descriptive form menu and form filling type checklist for verification of compliance with good practices . Methods of analysis, we used content analysis, descriptive statistics and compared to previously established parameters for the project. As categories of analysis were defined organizational arrangement, access, user, food quantity-regularity and food quality. The results show that, it was found in the category arrangement that will implement the project dismissed technical criteria for choosing the districts and the quantitative distribution of meals for each location. It was found that the valuation of the shares of the company outsources technical SETHA has not been performed. We observed in the access category, the unit has a strategic location, but lack of space in the refectory. The main obstacle to economic access for users is the lack of a register for the beneficiaries. In the category of users, it was identified that the clientele of the project it is predominantly men, with more than 51 years, low education, earning wages less 1 obtained through informal employment, which they move up through the unit transport collective, go to all days of operation due primarily to price. About the meals category quantity-regularity of food showed that the menu serves 95% of the desired needs, and that holidays and weekends are periods of disrupting the regularity of supply of meals. Regarding the category of food quality, it was found that the nutritional aspect on the menu are food sources rich in sodium, nitrates and low in fiber. In the aspect of hygiene and sanitation are the main limitations related to waste management, lack of exposure controls of food prepared and inadequacies of the physical structure. The results showed that in general and the institutional arrangement of the organs attached to the project should establish a systematic evaluation project is to establish as a promoter of and FSN overcome these obstacles

Uma abordagem crítica do conteúdo esporte nas aulas de educação física no ensino médio integrado

Researchers have analyzed how sport is being taught in the classroom as a regular subject and how it is accepted as a pedagogical action at school. This study aims to suggest some pedagogic proposal on the Physical Education subject to High School System which would be planned, formulated, and applied based on some critical approach on teaching, as well as analyzing and thinking over its impact on the students' learning, taking in consideration some conceptual, procedural and attitudinal dimensions to make possible for the students to become more critical so that they will understand how this subject works in contemporary time. .We had three specific blocs to develop our research: Historic, conceptual and cultural elements about sport; Public policies to sport; Individual, group and environmental characteristics. The method of this work was based on qualitative research through some research action. The study was made actually at IFRN (Federal Institute of Education, Science and Technology of Rio Grande do Norte state), in the city of Pau dos Ferros. Students from the second year of the computing course in high school were the participants in the research, there were 37 students from eleven different cities near Pau dos Ferros. They answered some questionares and a Research Diary. From the pedagogical intervention we could prove the students have improved their knowledge about the concept on sport itself, leaving the old idea about sport only as a physical practice such as an activity with rules or as competition, we could prove they have sport as a social-cultural event, involving policies, ideologies as well as historical interferences. Another aspect they mentioned was that sport is the citizens' right and as such there must be public policies pro sports. Understanding that sport transpires on peoples' habits as well as their behavior allowed us to identify its influence on our students' quality of life back in their home towns. Therewith, it is clear the necessity of a pedagogical focus on the content of Physical Education at school to make this subject more meaningful, so that the students will become more critical and reflexive about life and will be able be real citizens

Projeto café do trabalhador como promotor de segurança alimentar e nutricional: avaliação da eficácia da unidade Natal-RN

The evaluation of public policies that promote Food Security and Nutrition (FSN) it s a multidisciplinary activity extremely relevant to the effectiveness of actions to legitimize the Human Right to Adequate Food (HRAF). This study aimed at assessing the effectiveness of the unit project Natal-RN Café do Trabalhador in promoting SAN to its users. The theoretical framework is based on the public and political and on the dimensions of the concept of FSN (quantity and quality-regularity). Through a qualitative approach, methodologically this was the work of an evaluation of efficiency of the unit Natal-RN of Café do Trabalhador project in light of the assumptions of the concept of SAN. Data collection was conducted through retrospective archival research in official documents of the project, semi-structured interviews with managers involved in its implementation (representative of the Secretary of State for Employment, Housing and Care of RN SETHAS and third party), socioeconomic questionnaire applied to the users of the unit, check the amount, regularity and quality of meals offered for 15 days (menu routine) using the descriptive form menu and form filling type checklist for verification of compliance with good practices . Methods of analysis, we used content analysis, descriptive statistics and compared to previously established parameters for the project. As categories of analysis were defined organizational arrangement, access, user, food quantity-regularity and food quality. The results show that, it was found in the category arrangement that will implement the project dismissed technical criteria for choosing the districts and the quantitative distribution of meals for each location. It was found that the valuation of the shares of the company outsources technical SETHA has not been performed. We observed in the access category, the unit has a strategic location, but lack of space in the refectory. The main obstacle to economic access for users is the lack of a register for the beneficiaries. In the category of users, it was identified that the clientele of the project it is predominantly men, with more than 51 years, low education, earning wages less 1 obtained through informal employment, which they move up through the unit transport collective, go to all days of operation due primarily to price. About the meals category quantity-regularity of food showed that the menu serves 95% of the desired needs, and that holidays and weekends are periods of disrupting the regularity of supply of meals. Regarding the category of food quality, it was found that the nutritional aspect on the menu are food sources rich in sodium, nitrates and low in fiber. In the aspect of hygiene and sanitation are the main limitations related to waste management, lack of exposure controls of food prepared and inadequacies of the physical structure. The results showed that in general and the institutional arrangement of the organs attached to the project should establish a systematic evaluation project is to establish as a promoter of and FSN overcome these obstacles

Planejamento dos recursos hídricos da bacia hidrográfica do rio Seridó, no Rio Grande do Norte

The present research has the purpose of planning the management of the water resources of the Seridó River watershed, in the state of Rio Grande do Norte, Brazil. It has an emphasis on the amount of surface water available in this region, to provide a sustainable water supply. Based on data and information collected from public departments responsible for the management of the water resources of the Rio Grande do Norte state, well as on researches related to water resources , a watershed balance was done, and the results suggested the transposition of the waters from the Piranhas-Açu river watershed taken from the Oiticica and Armando Ribeiro Gonçalves reservoirs, integrated with the construction of 2 hidroelectrical plants and 2 elevation stations, to pump the amount of water needed to the expected demand in some public dams of the region until 2020. So, with the use of the surface water potential that exists in the region, it was demonstrated that, on the contrary of the public policies implemented in the past and in the current by the federal and state realm, it is possible to supply the currently water demands and also the future ones, in a sustainable way, without the need of importing outter water to the respective watershed. Finally, it was proposed the implementation of the Water Resources Plan in the Seridó region WRPS, aiming at providing an auto-sustainable development by significantly diminishing the effects of the dry seasons in that region, by considering the economic, social and environmental sustainability

A interface entre educação e mercado : uma análise crítica das mudanças socioculturais no contexto educacional

In the context of late modernity, the socio-cultural transformations established new social practices which corroborate discursive changes in dialectic movements, contributing to the order of the educational discourses to be more and more affected by typical market discourses and values which are covered by ideologies, hegemonic struggles and power relations. In this sense, this research study, which is based on the theoretical tenets of the Critical Discourse Analysis in its interdisciplinary branch (FAIRCLOUGH, 2006; ORMUNDO, 2010; PEDROSA, 2010; RAMALHO E RESENDE, 2011), aims at discussing how the sociocultural changes in the context of private education interact with the market proposal of neoliberal and economical policies. The research was methodologically based on the qualitative approach (CHIZZOTTI, 1991; BOGDAN e BIKLEN, 1994; MINAYO, 1994), especially on the principles of contemporary Applied Linguistics (SIGNORINI, 1998; MOITA-LOPES, 2006; MENEZES, SILVA, GOMES, 2009). Data were gathered from advertisements used in campaigns by private educational institutions and agencies in Natal/RN; the advertisements were collected in primary and secondary levels and in language courses from October to December, 2010. The data analysis indicate that education, in the context of globalization and late modernity, has become a market agency and that the new face of the educational discourse of private institutions is interwoven with a social representation of education as a site of struggle and hegemonic dispute. Therefore, the research leads us to infer that, as the educational public policies based on hegemonic economy and on ideological assumptions of international agents (Global Bank, FMI, etc.) have become widespread, education has become an arena of dispute and a powerful economic product to the market of cultural and commercial industry, thus emphasizing a society in which everything is economically based

Cinema itinerante no Rio Grande do Norte: aspectos da recepção

In itinerant film projects made in Brazil, the unique experience of watching movies on the big screen is held in open spaces, through the establishment of a contemporary ritual, under which the presence of spectators is primordial. Considering this dynamic of the performance of itinerant cinema, the main objective of this research is to analyze the process of reception of the spectators of the sessions of Cine Sesi Cultural, conducted by the Social Service Industry - Sesi, in Rio Grande do Norte state. The body of research was composed by the audience of the movie sessions of the edition developed in 2010. Analyses were made from the look on the specific audience of open sessions of this cinema project throughout a case study. Theoretical authors of Latin American as Jesus Martin-Barbero, Guillermo Orozco, Eliseo Veron and Nestor Garcia Canclini, which have important theoretical basis for the analysis of research on the cinematographic reception of the spectators, were taken as a basis. In this discussion are associated with contributions from Brazilian authors as Roseli Paulino, Fernando Mascarello, Mauro Wilton Souza, Nilda Jacks and Carolina Escostesguy. Besides the reception study, the research focuses on aspects that relate to and explain the circumstances in which itinerant cinema emerges as an alternative exhibition, for example, the context of the exhibition of films in the country, lack of public policies in the audiovisual sector, and mainly the closing of movie theaters in the inner cities of the country and the consequent migration of these rooms to the malls. Seeking to reduce the existing gap in the studies of the reception of spectators to the cinema in the country, this research presents a deeper analysis of the reception of the public of the itinerant cinema as a contribution to an important database for the diagnosis of projects such as the Cine Sesi Cultural

Silenciosas e silenciadas: descortinando as violências contra a mulher no cotidiano da prostituição em Natal-RN

The prostitution is known as the world's oldest "profession", according to some historians, "the contemporary civilization itself." However, to refer it that way, we can systematically emptying it of expressions of violence that permeate. Furthermore, this statement tries to legitimize prostitution as a practical historically related to the natural condition of women. The main objective of the research is to examine how the activity prostitucional potentiates in different forms of violence in everyday development of prostitution in the city of Natal. Accordingly, the spot of the categories of gender relations and patriarchal violence against women, refute the thesis advocated by much of feminist studies on of prostitution as an expression of autonomy of women and overcoming the patriarchal order of gender. Procedures as set methodological quali-quantitative approach, guided by the method historicalmaterialist dialectic that allows us to apprehend the object of study beyond their immediate, unmasking its contradictions. We conducted nine interviews with prostitutes belonging to the classes of People who develop the activities in the streets and prostitutes Natals` cabarets. We hand with the systematic observation activities promoted by the Association of Prostitutes in Rio Grande do Norte ASPRORN, as the visits to cabarets, as well as participation in seminars held by this entity, at which establish contacts with informants-c which have facilitated access to interviewed. We note that the economic dimension is the factor determinant for their inclusion in prostitution, all to recognize as who found an alternative for survival, since most do not has no professional training and education. Another issue important to be emphasized concerns the areas where unhealthy develop programs which by itself is characterized as a denial of rights, expressed in the socioeconomic inequality that are subject. As the expressions of violence in their daily lives, the main forms identified were the physical and social, however, there is a trend in naturalizes them, the secondary-over other issues identified as most pressing, such as not service payment by the customers. The determinants of violence identified by respondents were assigned to the woman, or is its boldness. We also, the omission of the State in the issue of prostitution, mainly embodied in absence of public policies directed to sexual rights and reproductive and generation of employment and income. Regarding the regulation of prostitution, the majority of the interviewees is contrary, arguing that exacerbate the stigma in this practice

O agrominerador familiar “Por detrás da Serra” de Parelhas, Seridó do Rio Grande do Norte

Unfavorable climatic conditions to family farming associated to the legal difficulty of retirement for workers who work exclusively in mining are indications provided by previous papers on this topic and guiding of such joint activities in a group that we have decided to call “agromineradores”, who are located “Behind de mountain” of Princess at Parelhas, Seridó do RN. However, in addition to these aspects, the research provides comprehensive analysis and thorough examination of other factors that link these families to such labor association. The theories of Habitus, field and trajectory from Pierre Bourdieu as well as the concept of institutions from Geoffrey Hodgson are central in this paper to explain the inclusion of these part-time farmers in an institutional environment shaped by social structures that influence in the choices of individual and collective behavior and leading to the relevance of the power structures within and outside the family, along with the role of public policies directed to family farmers and miners. The data analyzed showed that there is a crystallized structure that manifests themselves for years in this field, proving the link that exists between these agents and institutions that surround them in the composition of behaviors and routinizing of practices.

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

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

Use of public oral health services by the adult population: a multilevel analysis

Background It is important to assess context to explain inequalities in oral health, particularly with regard to the type of service used; thus, this study aimed to identify the social determinants of public dental service use by adults and to assess whether, beyond the level individual, existing inequalities are also expressed in the context in which individuals are embedded. Methods A multilevel analysis with three levels of aggregation of variables was performed. The individual variables were derived from the database of the SB Minas Gerais project—a survey of oral health status of the population of Minas Gerais, a state of the Brazilian Southeast region. The variable at the neighborhood level came from the Census of 2010. The variables at the municipal level were obtained from available public databases relating to oral health services. At the municipal level, the Human Development Index (HDI) variable was chosen to represent quality of life in the municipalities. Results In the final model, the following individual variables were associated with greater use of public dental services: lower income (PR = 1.98, 95% CI = 1.53; 2.58), higher number of residents at home (PR = 1.37, 95% CI = 1.11; 1.68) and higher number of teeth requiring treatment (PR = 1.49, 95% CI = 1.20; 1.84). With regard to context variables, a poorer infrastructure (PR = 0.62, 95% CI = 0.40; 0.96) leads to a lower use of public services. Conclusion The use of public services is associated with family income, how this income is divided in households, the need for treatment presented by the individual and the organization of the existing oral health service infrastructure in the municipality.

O trabalho dos assistentes sociais nos hospitais universitários Onofre Lopes (HUOL) e Hospital Ana Bezerra (HUAB) da UFRN: os desafios da formação permanente

This paper discusses the process of training social workers in the environment of University Hospitals- UH s. These hospitals provide space for professional education aiming to achieve a critical and purposeful professional performance. As environments for training, producing knowledge and providing essential services to the public, these hospitals require all members of the healthcare team to have a continued education. Understanding that training has to be a priority and conceived as constant pursuit for update through the interaction of Teaching, Researching and EPO ( Education and Public Outreach). These dimensions provide approximations and domain of theoretical and methodological, giving special importance to understanding the social reality, a sine qua non condition to the work of the Social Service professional. The main goal of the research was to comprehend how the continuous professional education of the social worker occurs and it s relation with the articulations involving Teaching, Researching and EPO, as significant elements for the job of the social workers in the Hospital Universitário Ana Bezerra and Hospital Universitário Onofre Lopes/UFRN. The research was conducted through a literature review, documentary and field inquiries with semistructured interviews including the group of 09 (nine) social workers from the aforementioned hospitals, taking as a reference the quantitative and qualitative approach to analyze mediations that stand between the subject and the social context. The results indicate that social workers in these university hospitals have their insertion beyond the care provided to patients in performance in the areas of education through preceptorship to undergraduate students and social work residents in and extension projects with low insertion in area of research. We note that there is a recognition of the importance of a continuous education, indicating that the qualification of social worker is essential in transforming their daily professional practice to better monitor, critically explain the peculiarities of public health in its everyday showing of how unequally access is provided to the users of the public health system