99 resultados para Participação popular em saúde

em Universidade Federal do Rio Grande do Norte(UFRN)


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Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care

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This work basically achieve three goals. Critically investigate the liberal democratic regime and its historical reformulation, rejecting the popular power and popular self-organization, limiting the entry of normal citizen in decision-making, believing in the market as a mediating body in regulating of the different life spheres of social. Starting from the critical liberal democracy, it discussed the concept of popular participation in the democracy, searching new democratically horizons, where the masses could have the opportunity to make decisions about their own destiny. On the basis of theoretical discussion on participation, we discuss a concrete instrument of participation, the Participatory Budgeting, comparing two participatory experiences in North and South

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A democracia tem representado ao longo da História o mais perfeito mecanismo político de convivência social, encontrando na soberania popular seu fundamento e legitimidade. De berço grego, instituiu-se sob princípios que radicavam o poder político no povo, exercido diretamente na ágora ateniense. O iluminismo dos séculos XVII e XVIII reacendeu o ideal democrático, encontrando no positivismo sua base teórica. O poder passou a ser exercido por via de representantes eleitos periodicamente. O locus da atividade política era o parlamento, ambiente fechado e refratário à participação popular, cingida, à época, ao voto do cidadão nos períodos eleitorais. O distanciamento entre governantes e governados gerou déficit de legitimidade no modelo liberal clássico, levando o constitucionalismo do século XX a abandonar o rigor formal positivista, para adotar uma nova hermenêutica, de base axiológica e centrada na participação direta do povo nas instâncias do poder. A Constituição Federal de 1988 compendiou a democracia participativa em seu texto, declarando no parágrafo único, de seu artigo 1º, que todo o poder emana do povo. Consagrou como base da soberania popular o sufrágio universal, o voto direto, secreto e de igual valor, além do plebiscito, do referendo e da iniciativa popular de leis. Garantiu ainda a ação popular como ferramenta de cidadania. A participação popular foi restringida com o advento da Lei nº 9.907/98, que impôs bloqueios processuais para seu exercício, gerando déficit de legitimidade no sistema representativo brasileiro. O propósito desse trabalho é demonstrar a necessidade de se estabelecer um novo espaço público na ordem constitucional do Brasil, de textura aberta e dialógica e de perspectiva emancipatória, que customize a participação do povo nas instâncias do poder, a partir da desburocratização dos instrumentos de soberania popular já existentes e da adoção de outros institutos democráticos semidireto, notadamente a iniciativa popular de emenda à Constituição, a revogação de mandato eletivo e o veto popular

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

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The State and Public Administration have gone through several reforms in search of a quick operation and the provision of services with quality. With the democratization of the country and the issue of the Constitution in 1988, further reform of the State and Public Administration, joined the government agenda in 1995 and included among its objectives, the principles of participation and social control. In view of this, it raises the Public Ombudsman in order to be a channel for the participation of users in the management of public affairs, social control, transparency of administrative actions, improving the quality of service and meeting the needs of the community. The aim of this study is to assess whether the Ombudsman of the State Department of Public Health to contribute to the period 2006-2008, for the improvement of specialized consulting services. The research is characterized as descriptive, qualitative approach. The collection technique used was the interview, conducted with 37 service users and two servants of the Ombudsman. The analysis was developed based on the perception of users and servers in the opinion of the Ombudsman. The most relevant results of the research showed that 41% of users search the Ombudsman because they believed that solve the problem presented. However, even with this level of public acceptance, the Ombudsman reached average index of resolvability of 53% in the period. In his role has not developed mechanisms for quality control of services, which is mentioned by 67% of users. It turned out the same fact in relation to popular participation, which is confirmed by 84% of users. For 24% of users, the problems raised were resolved, and of these, 56% believe that the Ombudsman has contributed to the positive outcome. As a result of the search results, it appears that the Ombudsman's SESPA / PA, is not fulfilling its role to ensuring the democratization of articipation in management, social control and has limited contribution to solving the problems of users and to improve the quality of services

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Alma-Ata declaration bring the Primary Attention to the Health (PAH) as first level of health attention for individuals, family and community, which considers infant group as priority. Several initiatives that gave bases to integral attention to the children health formalized in the principles of Unique Health System. Family Health Strategy (FHS) comes to strengthen this attention, instituting new ways of work organization and professional practices that gave impact in their quality indicators. One of them is children mortality, showing decline in their values. Though, studies indicates persistence of avoidable infant deaths. In Natal RN, this reality is also perceptible leading to inquietudes, mainly at the space of services production, it means, which motivated the accomplishment of the present study intending to analyse the way that the organizational and structural processes as long as the professional practices in FHS interfered in the quality of children s health attention who died by avoidable death in the year of 2007 in municipal district of Natal-RN. It treats, therefore, to an exploratory and descriptive survey of cases study type, thar had as primary sources the oficial documents of MH, the family prontuary, pregnant card, child card and testimony obt ined from instrument of research elaborated based in investigation form of infant death by MH, applied to 10 mothers of children who had avoidable death. In analysis it was appealed silmultaneous triangulation of methods and sources, allowing a bigger aproximation from obtained informations. To elucidate the cases, the aspects studied were analyzed to the light of explicative model of Social Determinants of Health. Among individual and family aspects were highlighted the related to age, schooling, family habits and customs and mother s economic condition, besides of pregnancy age, newborn weight and associated diseases, which don t differ from literature about the theme. Reffering to the factors organizational and structural processes and professionals practice, highlihgted, the treatment given by the professionals, the territorialization and adscription of areas, the difficulty of having access to the services or sleepers and the reference and counterreference. But also, the ausence or few greet, the lack of communication, few assiduity and ponctuality by professionals in service, among others. In a general way mothers considers the attendance received in the hospital good and very good , opnions that in the Basic Attention weren t so favorable, in spite of many of predictible actions in this level have been performed in the studied cases. It is observed, therefore, that the social determinants of health has a strong influence in ocurrence of infant deaths, what implicates in a large actuation by Infant Mortality Committee from municipal district. This way, it becomes fundamental the reflection and evaluation about the effectiveness and execution by the processes of vigilance to health in FHUs; the rethink about the social determinants of health in a wide and articulate way to the services quality, to permanent education, to management in service, to the given attention and to the way how it is installed the popular participation and social control. To the professionals it is presented the great challenge to review their daily practice, their values, behaviors and commitment, which ones must be guided by logical of sharing, work in team, humanescence and alterity, not only by the accomplishment of a professional duty

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The Family Health Strategy (ESF) is emerging as a possible restructuring of services and new practices of intervention in health care; it requires skilled professionals to work with that framework. Within this purpose, we established the Education Programme for Work and Health (PET-Saúde), in order to integrate teaching and service activities, focusing on primary care. On this basis, the aim of this work is to apprehend the social representation of nurse, doctor and dentist (Project PET-Natal Health RN preceptors) on the ESF, while practice field of them. It is a descriptive and exploratory study, with a qualitative approach, carried out in 07 Family Health Units (USF) included in the PET-Saúde Natal (RN). The population was composed of 35 professional components of the primary care team with bachelor's degree of the USF linked to this project. The sample was composed of 05 nurses, 05 physicians and 05 dentists, for a total of 15 subjects. Data were collected through three instruments: the drawing-themed story, a semi-structured individual interviews and field diary. The data relating to the identification of the subjects were entered and tabulated by the Microsoft Excel software 2007 version. The drawing analysis and interpretation is given by the significance attributed to the resource chart from title and keywords assigned by the subjects, considering the ESF as an inductive term. The stories and interviews were transcribed and typed and then subjected to read/listen the material and a lexical analysis through Alceste. After this process, the discursive material was analyzed and discussed by theoretical and methodological feature of the Social Representations theory. The majority of health professionals were female, aged between 46 and 52 years old, married, income less than six minimum wage, time since graduation ranged from 22 to 29 years and working time in the ESF range from 02 to 11 years. From the classification system ALCESTE were selected categories identified by: Category 1 - ESF: relations and territory; Category 2 - Training and bond profile; Category 3 - Working process in the ESF; Category 4 - Articulation between teaching and service; Category 5 - Health care and disease prevention. The representational field construction, while a process, followed the logic of structural cores in existing categories. In this sense, it is clear that the ESF is an environment rich in diversity, experience and relationships with potential such as the relationship "very subject-subject" and the link established between professional-community, but also has some weaknesses such as poor working conditions, lack of popular participation and management support, thus difficulties in the achievement of teamwork. Being essential to that end, the teaching-service aimed at the formation of a new health professional able to work in the ESF. In this research, the training of the representational field encountered a diversity of structural cores, or thoughts on training, about the ESF because of the greater emphasis on the here and now of the interaction between health professionals, the ESF, the community, PET Health-UFRN and students, emphasizing that such proposals are still considered as concepts in the context of recent health and that, therefore, are not fully realized in the social imaginary

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O diabetes é uma doença crônico-degenerativa de grande prevalência na população mundial configurando-se enquanto sério problema de saúde pública. Por ser crônico exige dos sujeitos autocuidado e autogoverno longitudinal. A autonomia, por sua vez, é um direito fundamental e também um dos princípios da bioética mais discutidos na atualidade. Seu conceito é complexo e leva em conta a vida experimentada ao longo dos anos. Quando a discussão sobre autonomia se trata de diabetes, a dependência do outro e os conflitos no controle da doença, diante de novas regras e estilos de vida, nem sempre condizentes com os valores dos pacientes, torna-a fragilizada. Embora a autonomia seja claramente parte integrante do tratamento e alicerce para uma vida digna e de qualidade, observamos que os sujeitos se tornam ainda mais dependentes dos serviços de saúde, quando se deparam com o diagnóstico e não têm confiança para tomar suas próprias decisões diante da patologia limitadora. Por isso, há a necessidade dos serviços de atenção primária à saúde traçarem estratégias para promover a saúde desses sujeitos. Os Grupos de Promoção da Saúde são estratégias recentemente utilizadas para influenciar no nível de autonomia dos sujeitos, pois possibilitam, respeitando os limites éticos, a garantia de participação decisória no grupo, através de estratégias e treinamentos de habilidades com competências claramente definidas, que favorecem o empowerment e o protagonismo dos sujeitos. Desse modo, este trabalho objetiva identificar estratégias no âmbito da promoção da saúde na ESF, que contribuam para melhor autonomia e qualidade de vida dos sujeitos com diabetes mellitus, a partir de sua percepção. E, mais especificamente, analisar o perfil clínico e socioeconômico dos portadores de diabetes da ESF; identificar as experiências, necessidades e expectativas dos sujeitos com diabetes sobre autonomia, autocuidado e qualidade de vida; e realizar um levantamento em conjunto com os sujeitos com diabetes, sobre aspectos que sirvam de evidências para construção de propostas para implantação de um Grupo Estratégico de Promoção da Saúde GEPS, com foco na autonomia. Para isto, foi realizada uma pesquisa exploratória descritiva de abordagem qualitativa e quantitativa, com 65 sujeitos com diabetes acompanhados por uma Unidade de Saúde da Família do Município de Santa Cruz/RN. A pesquisa foi realizada em três etapas interdependentes: 1) coleta de dados clínicos e socioeconômicos, para o qual foi utilizado entrevista estruturada e análise retrospectiva dos registros feitos em seu prontuário; 2) a análise das experiências, necessidades e expectativas dos sujeitos sobre autonomia, autocuidado e qualidade de vida, que se utilizou de entrevista semiestruturada com 6 sujeitos, sendo 3 com mais e 3 com menos complicações autorreferidas e verificadas no prontuário; e 3) a construção coletiva de propostas para melhor autonomia e qualidade de vida dos próprios participantes do estudo, por meio de roda de conversa. Para a análise dos dados utilizamos software de estatísticas simples para os dados das questões fechadas de cunho quantitativo e os dados qualitativos foram analisados através da análise de conteúdo. Observamos que o perfil clínico e socioeconômicos dos sujeitos com diabetes aproximam-se das estatísticas nacionais, embora existam variáveis, como cor da pele, com variação significativa. A autopercepção dos sujeitos diante de algumas complicações divergem de registros encontrados em seu prontuário o que aponta uma possível desvalorização de queixas como hipoglicemia e disfunção sexual, como também baixa adesão ao tratamento por, muitas vezes, não terem suas opiniões valorizadas. As categorias encontradas: vida, qualidade de vida, diagnostico e enfrentamento do problema, autonomia, limites e dependência assim como as práticas coletivas de promoção da saúde, apontam para a necessidade de estratégias por meio de grupos que considerem as crenças e valores dos sujeitos, favoreçam sua emancipação e torne-os protagonistas de sua própria história e de seu processo saúde doença. A autonomia é fundamental para o exercício da cidadania efetiva. É por meio dela que os sujeitos transformam sua realidade e a si mesmo. A contribuição desta pesquisa consiste em identificar estratégicas que se propõe a potencializar a autonomia dos sujeitos, através dos GEPS, norteando a atuação dos profissionais na atenção primária à saúde, que deve sustentarse em ações de prevenção e promoção da saúde e também no incentivo à participação popular e protagonismo dos sujeitos

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A Saúde do Trabalhador (ST) refere-se a um campo do saber que compreende as relações entre o trabalho e o processo saúde/doença de modo articulado a um corpo de práticas teóricas interdisciplinares. No contexto das possibilidades para se efetivar a ST na amplitude que exige este conceito, diferentes iniciativas de Educação Popular em Saúde se articulam com demandas do Controle Social em Saúde, permitindo novas abordagens para configurar a formação crítica e ativa de trabalhadores de saúde e movimentos sociais no mosaico das políticas de ST. Nessa direção, os projetos de extensão universitária orientados pela Educação Popular têm desvelado caminhos metodológicos e novas possibilidades teóricas de pensar a Atenção à Saúde do Trabalhador, de forma articulada com a necessidade de re-significar o processo de formação dos profissionais da saúde, com ênfase no cuidado integral na atenção à saúde. O estudo promovido por ocasião do Doutoramento em Ciências da Saúde propiciou a avaliação do impacto e da potência das ações destes projetos na reorientação do cuidado guiado pela educação popular no campo da saúde do trabalhador. A sistematização foi utilizada como principal estratégia metodológica para a produção dos dados analisados, além de estratégias de pesquisa qualitativa como constituintes da fase exploratória do estudo, tendo como técnica central, nesse sentido, o grupo focal. Os resultados mostraram mudanças significativas no processo do cuidar em saúde guiado pela educação popular, A reorientação de práticas e saberes, coadunadas aos princípios fundamentais do Sistema Único de Saúde, foi observada nos sujeitos que participaram da experiência. A sistematização da experiência permitiu ainda concluir que estratégias de diálogo, organização político-social e troca de experiências de vida se apresentam como cenário significativo no compartilhamento de cultura e saúde do trabalhador, oportunizando crescimento coletivo e melhor qualidade de vida.

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The State and Public Administration have gone through several reforms in search of a quick operation and the provision of services with quality. With the democratization of the country and the issue of the Constitution in 1988, further reform of the State and Public Administration, joined the government agenda in 1995 and included among its objectives, the principles of participation and social control. In view of this, it raises the Public Ombudsman in order to be a channel for the participation of users in the management of public affairs, social control, transparency of administrative actions, improving the quality of service and meeting the needs of the community. The aim of this study is to assess whether the Ombudsman of the State Department of Public Health to contribute to the period 2006-2008, for the improvement of specialized consulting services. The research is characterized as descriptive, qualitative approach. The collection technique used was the interview, conducted with 37 service users and two servants of the Ombudsman. The analysis was developed based on the perception of users and servers in the opinion of the Ombudsman. The most relevant results of the research showed that 41% of users search the Ombudsman because they believed that solve the problem presented. However, even with this level of public acceptance, the Ombudsman reached average index of resolvability of 53% in the period. In his role has not developed mechanisms for quality control of services, which is mentioned by 67% of users. It turned out the same fact in relation to popular participation, which is confirmed by 84% of users. For 24% of users, the problems raised were resolved, and of these, 56% believe that the Ombudsman has contributed to the positive outcome. As a result of the search results, it appears that the Ombudsman's SESPA / PA, is not fulfilling its role to ensuring the democratization of articipation in management, social control and has limited contribution to solving the problems of users and to improve the quality of services

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This research studies the relation between city and nature in the urbanity s plans from Natal RN, Brazil, during the 20th century. Investigates and analyses the main documents that bring environmental s ideas inside from the urbanity s plans of Natal; gives the historical and economical situation from the city in each period studied; features the urbanity s plans, using categories of analyses to comprehension of this instruments. Try to contribute in the bigger process of historical rescue of Natal, and stimulates new studies. It was used documental s research, and bibliographic material. It was identified four (04) kinds of plans: the ones that focus in health and aesthetic (1901, 1929, 1935) technology and science (1968), zoning and control (1974, 1984) and environment. The hints founded shows that environmental ideas were put inside of the plans by government demands, especially in 1994 s plan, almost always without popular contribution and without this population get understands its meanings and implications

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The present work has for object the Jury under the democratic optics, looking for to demonstrate its democratic validation. The purpose of this work was to revisit the institution, in order to bring its importance while instrument of popular participation. The work presents, first, a systematic and chronological approach of the institution of the Jury and its evolution inside of Brazilian constitutional history, objectifying, with this, to approach the narrow entailing of the Jury with the constitutional postulates. After that, the constitutional principles of the Jury had been examined, looking for to establish the popular identity of the institution and its approach with the human rights system of the Brazilian Federal Constitution. More ahead, had been examined the direct participation of the society in the Jury, going deep the questions related with the election of the jurors and the jury nullification on the American Jury. Finally, had been dedicated the study of the current conjuncture of the Brazilian Jury, its problems and the possible solutions, beyond the study of the limitation's mechanisms in the constitutional principle of the popular supremacy and the reform's projects suggested for legislators and jurists. In this way, had been looked elaborate a constitutional construction of the Jury, defending its permanence in the Brasil law system, for being a fundamental guarantee to protect the freedom, moreover for being essential to validate the Democratic State of Right, for to be the materialization of the democratic principle. For opportune, it's necessary to allege that this work had been directed to the constitutional analysis of the Jury, its legitimacy and its democratic vocation, using themselves as ideological north the American Jury System and as philosophical base the social contract theory, understanding the Jury as an instrument of protection of the society front to the state supremacy and its hierarchy structure of the power

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This research studies the relation between city and nature in the urbanity s plans from Natal RN, Brazil, during the 20th century. Investigates and analyses the main documents that bring environmental s ideas inside from the urbanity s plans of Natal; gives the historical and economical situation from the city in each period studied; features the urbanity s plans, using categories of analyses to comprehension of this instruments. Try to contribute in the bigger process of historical rescue of Natal, and stimulates new studies. It was used documental s research, and bibliographic material. It was identified four (04) kinds of plans: the ones that focus in health and aesthetic (1901, 1929, 1935) technology and science (1968), zoning and control (1974, 1984) and environment. The hints founded shows that environmental ideas were put inside of the plans by government demands, especially in 1994 s plan, almost always without popular contribution and without this population get understands its meanings and implications

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State intervention generally demands the purchase or rental of goods and services, and such acquisitions are subject to a number of indispensable legal frameworks. In the Brazilian State, Law 8.666 of 21 June 1993 and further norms regulate the necessity of a formal process, usually licitation. Given the importance of this subject to public and private spheres, one of the prerequisites of these formal contracting rules is the openness of public acts, and society s knowledge and accompaniment. The objective of this study is to investigate society s participation in public contracting, with the aim of debating theories surrounding the state/society relationship proposed by public political thought and authors in relation to legal aspects involving licitations. The principal question of this research is: despite the possibility of society s participation being predicted in the legal frameworks which orientate licitations, why is this social control not carried out? Why does it only occupy a secondary position to both individual and collective agents? In order to test some of this study s hypotheses, field research was carried out in the Coqueiral community in Aracaju, Sergipe, in relation to public acquisitions of goods and services during the period of May to September 2009. Research involved observation visits and guided interviews with the relevant community and public sector representatives. This project s hypotheses were confirmed, as this social control is not apparent, even in areas where popular participation is a strong component in asserting ones local rights, like in the Coqueiral community.

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About two decades ago Brazil has been suffered some important political changes on its government and supporter systems. In these changes the Partido dos Trabalhadores (Workers support) has been researched significant results as much legislation as executive ways. These conquests propitiate a structure for it to get an alternative motion in order to manage public goods by petista government way. Trying to examinate this we can study the Partido dos Trabalhadores government experience in Acre (1999-2002) to know about why the PT government characteristics are different from the others. To do this we assumed to conjecture a popular participation with priorities inversion and ethics in public resources administration. These are the elements of PT government way. This way we started our work making an evaluation of its bibliography. Them we do a field inquiry to analyses documents of the government projects (budget rules law, papers, approved laws, IBGE, PNUD, TSE) and semi-structured interviews with some characters of recent political Acres life. The scheme and the analysis about these givens disclose that weren t confirmed our hypothesis in part, since PT remained old local politics habitus. In other side the executive administration on PT government has got to inflect the Governance . Further on an efficient management as World Bank dispossess but PT absolve many requests of progressive sectors as well it expanded the society participation to resolutions process. By a cabinets enlargement. So it rescues a total administrative course which is printed in the called petista government way. Personally we think so it means important advancements in this Acre government way