Financiamento e gasto público em saúde: o caso do Rio Grande do Norte

Conselho Nacional de Desenvolvimento Científico e Tecnológico

São públicas as contratações do estado brasileiro? - uma experiência de contratações públicas junto à comunidade Coqueiral em Aracaju/SE.

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.

Avanços e retrocessos na articulação de um pacto territorial: a experiência do PRONAF Infra-Estrutura

Since minetics The economics and political promotion along the necessity of flexibility in states actions admited actors partipction and social controlo on process of construction in local development. The Programa Nacional de Fortalecimento à Agricultura Familiar (PRONAF) by this framework consists suprass the specific points about contry world in order to embrace territorial dimension of development, focalizing actions that estimulate co-operative pratices among local agents. This work proposal intends to identify advances and regression of PRONAF Infra-estrutura (Framework) by one territorial pact organization considering its administration about mechamisms on advantage conmflicts between distinct actor and their ables to atimulates a construction of new relationships between governors and population. Undderstanding PRONAF action like a process that come from its instrumental proportion surpass looking for substantial elements constructionm on intervention of local development considering administration mechamisms in São Paulo do Potengi (RN) city-council-starting by Conselho Municipal de Desenvolvimento Rural as well changes of institutional arrangement with território da Borborema erection. Throngh documental studies, bibliography researches and interviews we indenttfy an articulante power of Territorial pact partnerships like one of these political process and its sector character as their limits

Planejamento em saúde no Brasil: convergências e divergências entre instâncias de gestão

Trata-se de uma investigação que busca revelar convergências e divergências no processo de planificação da Política Pública de Saúde, com foco primordial na participação dos organismos de representação social na consolidação do Sistema Único (SUS), destacando a Conferência Nacional de Saúde CNS, instância que deve ter participação obrigatória na formulação de recomendações para essa política estatal. Considera que a planificação reúne elementos de concepção jurídica, técnica e política para a elaboração dos documentos intitulados Planos Nacionais de Saúde PNS. A partir de pesquisa qualitativa de base documental e argumentação com apoio de Cartografia Simbólica, põe em exame o processo de elaboração e o teor presente nos relatórios da 12ª (2003), 13ª (2007) e 14ª CNS (2011), alinhando seus eixos, diretrizes e prioridades nos correspondentes PNS nos quadriênios 2004-2007, 2008-2011 e 2012-2015. A escolha desses instrumentos, na temporalidade sugerida, tem por esteio o período em que a implantação do sistema de Planejamento do SUS PlanejaSUS, orienta normativa e tecnicamente a elaboração do PNS, tendo como uma de suas referências o que foi emanado das conferências. Propõe-se verificar as tensões existentes entre momentos distintos da definição das prioridades elencadas nas políticas públicas de saúde à luz das contribuições teóricas sobre a concepção do Estado, numa visão contemporânea associada à sua dinâmica de atuação vinculada ao modo de produção e acumulação capitalista; sobre a metodologia do Planejamento Estratégico com base na participação de atores diversos; e ainda, na análise sobre a expressão desse participacionismo na ótica dos processos democráticos representativos no SUS. Na confecção dos mapas cartográficos foi proposta a correlação entre os conteúdos dos Relatórios das 12ª a 14ª conferências de saúde com o que está expresso nas prioridades constantes nos Planos Nacionais de Saúde (2004 a 2007, 2008 a 2011 e 2012 a 2015), verificando-se aproximações e distanciamentos existentes entre o que expressa a sociedade e a política governamental. Conclui-se que, do exame crítico entre as diretrizes e prioridades contidas no acervo documental existente e sua metodologia de construção, com fundamento na argumentação do aporte teórico trabalhado, são verificadas tensões e harmonizações que revelam pontos convergentes e dissonantes das pactuações e consensos entre os atores sociais representantes dos segmentos, no qual critério da representatividade condiciona a defesa de opiniões, interesses e prioridades, de modo diverso para os que estão implicados nesse processo de planificação

O incesto : discurso e ideologia

This research had as purpose to establish the logic symbolic present in the contemporary society that facilitated the emergency of a public speech on the incest, and, consequently, to demonstrate the ideological nature that structures it. Event associated to the order of the taboo, the incest would be the transgression of the injunction that, second Lévi-Strauss, facilitated the emergency of the Culture while symbolic order, differentiated of the natural order. The injunction of the incest would reveal the elementary and universal structures of the order symbolic presents in the human societies: the demand of the Rule as rule; the reciprocity and the gift, present element in the social changes that it transforms the individuals in partners, increasing a new quality in the transferred value, according to Lévi-Strauss. Starting from this, I developed the hypothesis second which the phenomenon of the alone incest became an event of discursive order and public as right social transformations affected the normative system (social representations, values, moral) regulator of the relationships among the social subjects, being reflected like this, in the own structuring of the Law. A second work hypothesis was developed starting from that. I develop it leaving of the argument that if when inserting the discussion of the thematic of the defense of the children and adolescent rights, being then, considering it while "privileged modality of sexual abuse against children", the present central subjects in the structuring of the social entail would be leaved. Being like this, the partner-institutional speech on the incest would answer the social demands of order and social control, becoming like this, discursive formations of ideological character. This research work tried to follow the hypothesis above referred, demonstrating the singular sense that it will be attributed to the incest in the contemporary society, particularly, its relationship with the Law and the transgression in the contemporary society

Avaliação do programa saúde da família no Rio Grande do Norte

The Family Health Program implemented in Brazilian municipalities from 1994 represents today the most promising proposal to promote important changes in municipality`s health systems, to allow universal access to health care, comprehensiveness, equity and to promote social control, achievements provided by the health reform process and incorporated to the Unified Health System principles. However, many are the challenges imposed to the Family Health Program so that it can cause these advances. In this study, we aimed to answer the following research question: what are the results of the Family Health Program in relation to beneficiaries at small, medium and large municipalities? The hypothesis that guided this work was that the variation in levels of achievement/results (strict, impacts and effects) of the Family Health Program is related to the size of the municipalities. Therefore, our general aim was to evaluate the results of the Family Health Program in municipalities at Rio Grande do Norte, Brazil. And as specific objectives, to measure strict results, effects and impacts of the Program, from the criteria of efficiency and effectiveness on the beneficiated population, and to measure the Program`s impact on the organization of municipality`s health system. This is an impact assessment research, developed from multiple case studies with quanti-qualitative approach. The study included small municipalities (Acari and Taipu), midsize (Canguaretama and Santa Cruz) and large (Natal and Mossoró). The individuals chosen to the research were users/beneficiaries of the Program and health professionals. Data analysis was performed using descriptive statistics and content analysis compared from the Program`s logical /theoretical model. The results obtained in relation to the principles evaluated (universality, comprehensiveness and community participation) presented that municipalities show different results, although not directly related to the size, but related with characteristics of the Program`s implementation form in each municipality and the arrangements made for its operationalization. The positive effect that generated significant change in people`s lives has been linked to the increase of access and to the decrease of geographic barriers. However, to the municipal health system, regarding the changes desired by the Program, it was not observed a positive impact, but a negative impact related to the increase of barriers for the user to access other levels of the health system

Fazer a ponte para a escola de todos(as)

The purpose of this study is to understand what are the matrix elements in which everyday activities of social author/authors, actor/actors and actress/actresses are embedded, in order to carry out the Escola da Ponte s political and pedagogic process (PPP). Thus, the object of this study is to reflect on an experience developed in a public school supported by the Portuguese State within the scenario of institutions that are committed to building up a school of the people by investing in democratization and community participation in their management process. The methodological course of action was targeted at the presuppositions of qualitative research (WOODS, 1999; BURGESS, 1997; MILLS, 1982; OLIVEIRA, 1998; BOGDAN and BIKLEN, 1994; MACEDO, 2000; CASAL, 1996; GEERTZ, 2000), with data collected from random word association (MACHADO and CARVALHO, 2003), the discourse of the interviewed (KAUFMANN, 1996; SILVA, 2006; 2002), observation notes and documents (ELIAS, 1997). Based on a multiple reference and theoretical framework, the investigation revealed elements that are construed as the raw material and pillars supporting the bridge of a school of the people, as well as the self-organization of the school community which emerges as a dimension that binds together all the elements and brings new arrangements into the school dynamics by moving from the individual to the society (DUPUY, 1990). Along this line, the central argument is that in the short and long run the public school quality does not spring from macro educational policies, nor from ephemeral mass-production programs, projects or governmental policies, but from the intent of the professionals working there in becoming authors and characters in the process of building up and carrying out the PPP. The Project has been conceived in the light of the needs and intentionality of the community whose support comes from the participation and social control held by the students families and the community s power to force to action public administration central agencies aiming at having the State fulfill its responsibilities

Política de democratização da gestãoescolar: um labirinto de sentidos, discursos e contradições?

Este estudio tiene por objeto investigar la política de democratización de la administración educativa de la consideración de los procesos socio-históricos que participaron en el programa de modernización de los paradigmas de administración, por la forma en que la política de descuentos y que se entiende por los sujetos dentro de la escuela. Se considera que la democracia defendida por la política de democratización de la educación por el neoliberalismo / gerencialismo, siendo el resultado de un acuerdo que aspira a dirigir la sociedad hegemónica, portador del gen, las diferentes concepciones de la democracia, por lo tanto, en su en el interior se colocan en posición, los elementos conceptuales de los diferentes proyectos de la sociedad. Por lo tanto, vamos a ver cómo, en el Estado Dom Escuela Nivaldo Monte, esta política se (re) significado y transformado por los sujetos, incluyendo las diferentes formas que se delinean en la dimensión de la democracia, autonomía, participación y representación. Aborda el tema de estudio en vista del materialismo histórico y dialéctico, por lo que consideramos que es posible examinar el objeto en sus fronteras, pero no de manera fragmentada o enajenados o la mediación de la determinación del capital económico, político, cultural y simbólica de la sociabilidad la globalización, para superar los matices asignado a estructuralista metodología de diseño teórico adoptado, usado, en el entendimiento de que considera que la macro y micro estructuras están formadas por una relación de complementariedad entre los procesos micro y macro. Entre nuestras conclusiones parciales, que argumentan que la gestión democrática y la gestión de la administración son diferentes formas de administración, antagónicos, aunque este efecto fue una especie de coincidencia, le distinguen: en primer lugar, si queremos apoyar la calidad de las escuelas públicas, y en segundo lugar que la organización de gestión crea las condiciones para la gestión democrática legal y legítimo, mientras que se establecen las condiciones que tanto impracticable y difícil como imposible y muy difícil de llevar a cabo la gestión de la administración que conduce a la conclusión de que, finalmente, la gestión democrática es imposible de llevarse a cabo por medio de la gerencia pública y la gerencia pública es imposible de llevarse a cabo por medio de la democracia. Sin embargo, la participación institucionalizada de la gerencia pública puede promover la extensión del control social sobre el estado y contribuir a la transformación social, que parece que está un reto difícil, pero no improbable, y es probable que se siga investigando.

Análise de qualidade da atenção à criança na estratégia saúde da família: o óbito infantil evitável como referência

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

Conselhos municipais: prática e impasses no cenário contemporâneo

Pela experiência de inserção militante em dois conselhos municipais, apresentamos informações sistematizadas e essenciais sobre a composição desses espaços de controle social. Quais são alguns dos problemas essenciais no funcionamento concreto dos conselhos? Pela perspectiva social crítica, procuramos apreender as contradições que atravessam esses dispositivos de controle social. Oferecemos pistas orientadoras para os profissionais da Psicologia que buscam atuar na linha do compromisso social e que se engajam na participação nesses importantes mecanismos sociais de discussão e deliberação no âmbito das políticas públicas.

Do Fundef ao Fundeb: avaliando o passado para pensar o futuro: um estudo de caso no município de Pirapozinho-SP

Este artigo, que envolve a combinação de procedimentos quantitativos e qualitativos, traz resultados de pesquisa que analisou o impacto do Fundef na estruturação da rede municipal de ensino de Pirapozinho-SP, e mostra como estes resultados trazem subsídios para um funcionamento mais adequado da atual política de financiamento da educação. Constatou-se que, mesmo sem aumentar os recursos financeiros do ensino fundamental, o Fundef racionalizou e tornou mais eficiente a sua aplicação, diminuindo desvios e desperdícios, e que a instituição dos Conselhos de Acompanhamento e Controle Social possibilitou maior participação popular na fiscalização do executivo aumentando a transparência dos gastos com educação, que a constituição do Fundef abriu a possibilidade de implantação do Fundeb atualmente em vigor e que a melhoria no funcionamento deste está relacionada ao aumento da participação da sociedade nas decisões da política educacional e ao investimento na qualificação desta participação.

Abrindo espaços: os paulistas na formação da capitania do Rio Grande do Norte

The "paulistas", or be, the pioneers of the town of São Paulo of Piratininga, were hired by the Portuguese Crown as instrument of repression and social control between the centuries XVII and XVIII, were involved in conflicts of the Captainships of the North of the State of Brazil after expulsion of the West of Indian Company. That moment corresponds to the beginning of the conquest of the sertão , and of the consequent resistances offered by the Indians of the interior of the continent that barred the Portuguese colonial project. The colonial sertão was understood as all area outside of the Portuguese jurisdiction, in contrary condition to the Sugary zone. In such events, the labor of the "paulistas" was employed by the rights to his abilities in traversing the weeds. With that, we are going to detach the participation of the "paulistas" during and after the called "Guerra dos Bárbaros" in the captainship of Rio Grande, as well as the output of that space from the establishment of the groups that were mobilized for the conflict

A educação permanente em saúde na ótica dos cirurgiões dentistas

This study aimed to examine the perception of dentist-surgeon about the Permanent Education in Health (PEH). It is characterized as a qualitative research with focus in the field of public health policies. It refers specifically to the development of Permanent Education policy in Health in the state of Rio Grande do Norte. They were participants of this research 42 dentist surgeons and 83.3% females and 16.7% males, participants in Specialization courses approved and agreed by the Permanent Education Center in Health (PEC-RN) in the period 2005 to 2007. These professionals are part of the Family Health Strategy (FHS), and 11.9% work in management at the central level and 88.1% are directly related to oral health care in the Basic Health Units of the Family, 30 cities in the state. Data collection was through a questionnaire, with questions that guided the research development and achieve the objectives proposed. The socio-demographic data were analyzed using the descriptive statistics and subjective content was subjected to content analysis by Bardin. The emerging categories from the textual material generated by respondents were: program content, methodological approach and concepts of Permanent Education in Health. The subjects surveyed reported that the program content is more comprehensive and directs to the reflection of everyday practices, with regard to the methodological approach, concern that occurs through discussion and reflection with dynamic, participative, varied and constructive activities, questioning and putting as the main focus. As for understanding of the concepts of the PEH, there was a consensus that define as education stable strategies which contributing to transform and improve the health workers to have the upgrade, improvement of practices, being based on everyday experience and taking into account the accumulation and renewal of these experiences. Therefore, results presented showed that there is a clear understanding of the subjects on the proposals and guidelines of the PEH. It was concluded that lack continuous access to the policies proposed by Ministry of Health involving health workers, managers, communities, through social control and the teaching-service integration and that they are worked within the health system and can classify all these segments of society favor the existence of a more participatory, effective, fair and better quality health service

O consumo de álcool entre os adolescentes estudantes de escolar privadas católicas de Natal-RN

This study has an object the understanding of the alcohol phenomenon consumption that occurs among teenagers. It is adopted as research locus catholic private schools of Natal - RN, which receive pupils proceeding from the social groups pertaining to the classes taken from Natal private schools. The researched public corresponds to 87 teenagers, who had answered to a mixing questionnaire, with open and closed questions. The research uses as a procedure the intentional election, which for the access easinesses privileges subjects who, at the moment of the research accomplishment, reveal to be in condition to participate of it. The study presents quantitative and qualitative character. It presents the following objectives: 1-Identify in which circumstances the teenagers make alcoholic beverage use; 2 -To identify the knowledge that the teenagers have on the alcohol effects; 3 -To identify the performance role of the school institution on the prevention of alcohol use by teenagers. The analysis method used corresponds to the one called answers interpretation method. Regards to the theoretical-methodological support, the Social Control Theory and the Symbolic Interactionism Theory are adopted as referential. Its contained chapters are organized in the following way: The first chapter approaches the situation of drugs adolescent consumption in general and the social confrontation of this situation. The second chapter presents sociocultural aspects of the alcohol consumption and the description of some of the researched public characteristics. The third chapter emphasizes the school and its performance next to the teenagers and the society in general, towards the prevention and combat of the alcohol use, as well as of other drugs