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

Entre o mercado e a construção social: uma análise da experiência da implantação doPRONAF-infraestrutura e PRONAT nos territórios do Mato Grande-RN e sertão do Apodi-RN (1997 - 2010)

Analyzes the development experience in the Territories of Mato Grande and Sertão do Apodi in the state of Rio Grande do Norte, evaluating the actions of the National Program for Strengthening Family Agriculture, specifically the line of infrastructure (PRONAF-INFRA), and the National Program for Sustainable Development of Rural Territories (PRONAT) in these territories. Summarizes the various rural development approaches and takes the theoretical assumptions of territorial development, the concept of constructed territory and market-plan territory, further the cycle model to analyze public policies selected these experiences. Thus, we propose to test the hypothesis that most of the actions implemented would lead to the formation of market-plan territories, in other words, perceived only as a platform for the presentation of projects. The literature and documents, combined with case studies, interviews and direct observation of the meetings of committees, showed that, despite two boards are under the same laws, rules and formal regulations, have clear differences when considering the theory and concepts that were used as reference. The Apodi s territory is closer to a constructed space thus the search for a broader agenda, more autonomous and more appropriate to the reality experienced by local actors. On other hand the Territory of Mato Grande had the characteristics of a market-plan territory more present. As the result, the territory of Sertão do Apodi accesses not only as part of a greater number of policies and funding sources, ensuring a greater and more diverse investment volume than the territory of Mato Grande. Despite these differences, studies have shown that territorial boards surveyed are still far from becoming the main forum for managing the development from conception planning socially constructed. Showed, finally, that territorial development strategy is relevant, but requires a long walk and a deep and continuous learning process to be successfully implemented in rural areas of Northeast Brazil