A importância da fiscalização do serviço público como instrumento de gestão e política pública: uma breve análise do Sistema de Transporte Coletivo Urbano de Passageiros da Cidade de São Paulo

O trabalho tem por objetivo analisar a importância da fiscalização do serviço público como instrumento de gestão e política pública. Para tanto, propõe-se estudar o Sistema de Transporte Coletivo Urbano da Cidade de São Paulo, a partir do modelo instituído através da Lei nº 13.241/01, assim como toda a estrutura jurídica e elementos característicos presentes nessa forma de delegação. Sem a preocupação de esgotar o tema, com base na doutrina, o trabalho pretende abordar os principais conceitos que envolvem a prestação de serviços públicos, o dever legal de fiscalização e a estrutura legal da prestação dos serviços de transporte coletivo. E, a partir disso, verificar se o sistema de transporte municipal possui instrumentos jurídicos adequados á fiscalização dos serviços delegados. Além disso, busca-se avaliar se isso é suficiente para a prestação de um “serviço adequado”, ou seja, se os instrumentos de fiscalização utilizados, por si só, são efetivamente capazes de garantir as condições de regularidade, continuidade, eficiência, segurança, atualidade, generalidade, cortesia na prestação e modicidade das tarifas, conforme preceitua a lei. Em síntese, entende-se que o ordenamento jurídico dispõe de diversos mecanismos que permitem a fiscalização dos serviços públicos. Ademais, que encontra-se juridicamente adequado o modelo de fiscalização adotado pelo Município de São Paulo, para o sistema de transporte público. Todavia, apesar de ser correto, o modelo ainda necessita de melhorias, tanto no que diz respeito às obrigações estabelecidas nos contratos de concessão e permissão em vigor (e respectivos regulamentos, como é o caso do RESAM – Regulamento de Sanções e Multas), quanto na sua operação e, principalmente, na sua fiscalização. Por fim, o trabalho aponta que, tanto a regulação, quanto a fiscalização ou até mesmo a gestão, quando realizadas de forma inadequada, fomentam a prestação de um serviço público com má qualidade, ou seja, inferior à esperada pela população.

Dois ensaios em economia da saúde

We test for asymmetric information in health insurance by means of a special survey conducted in 1998 in Brazil. The distinct features of the database are twofold. First, it displays information on individual morbidity-an issue still unexplored in the empiricalliterature on insurance. Second, unlike other countries studied in the literature, the coverage leveI offered by the Brazilian free public health service is much lower than its private counterpart-making informational problems more likely. We find evidence of information asymmetries associated with some diseases (e.g., hypertension and heart disease) but not with others (e.g., cancer and chronic renal disease).

Os ciclos de conferências da defensoria pública do Estado de São Paulo: controle e participação social

O objetivo desta dissertação é estudar os Ciclos de Conferências da Defensoria Pública do Estado de São Paulo para entender qual papel eles desempenham em relação a participação popular na gestão da Defensoria Pública. O problema de pesquisa consiste em verificar se e como elas contribuem para garantir a participação social dentro da gestão da Defensoria, levando em consideração o estudo sobre a implementação ou não das diretrizes elaboradas pela população durante a realização dos I, II e III Ciclos de Conferências e a compreensão das diferentes falas que os atores tem em relação aos Ciclos de Conferências. A conclusão é a de que os Ciclos de Conferências não foram absorvidos de forma homogênea pela instituição como um importante mecanismo orientador das prioridades institucionais, capaz de vocalizar os anseios da população, arejando a instituição, e colaborando com a construção de políticas públicas alinhadas às demandas da população. É necessário que seja pactuado e esclarecido o caráter das propostas elaboradas nas Conferências (caráter deliberativo ou consultivo) sob pena do mecanismo participativo em questão perder aderência popular.

Voluntariado nas entidades sem fins lucrativos, rede colaborativa para uma saúde pública de qualidade

Trata-se de um caso para ensino descritivo sobre o voluntariado em organizações da sociedade civil sem fins lucrativos na área da saúde. Identificado como um dos vértices da rede de governança colaborativa dos prestadores de serviço em saúde pública. No contexto do caso são apresentados conceitos de liderança voluntária e tomada de decisão em uma organização da sociedade civil sem fins Lucrativos na área da saúde. Análise de atores de governança colaborativa como complemento de qualidade na prestação de serviços para saúde pública é o foco do caso de ensino apresentado. O caso traz como pontos para reflexão e debate sobre a força motriz e o elemento de sustentação da rede colaborativa da saúde pública e a importância deste arranjo de relação Sociedade-Estado. O caso é indicado para estudantes de administração pública, políticas públicas, governança colaborativa, gestão social e áreas e afins.

O Congresso Nacional, as relações civis-militares e a política de defesa no Brasil (1999-2014)

A partir de 2008, o Brasil empreendeu um conjunto de ações na área de defesa nacional sem precedentes desde a redemocratização do país. A publicação da Estratégia Nacional de Defesa foi um marco nesse processo. O documento viabilizou reformas no Ministério da Defesa e a expansão de projetos estratégicos para reaparelhar as Forças Armadas. Pela primeira vez, os investimentos chegaram a superar os gastos com custeio no orçamento destinado à defesa. Além disso, os militares ampliaram os serviços sociais na Amazônia e participaram mais ativamente de ações de segurança pública nas metrópoles brasileiras. O objetivo deste estudo é avaliar como essa nova conjuntura impactou nas atividades parlamentares relacionadas à defesa nacional e aos assuntos militares. Para isso, foi feito um levantamento de todas as proposições de deputados federais e de senadores relacionadas ao tema desde 1999, ano de criação do Ministério da Defesa. Os resultados demonstram que a defesa nacional continua tendo um papel secundário no Congresso Nacional. Apesar da instalação de frentes parlamentares, subcomissões e o uso de outros instrumentos inéditos que conferiram visibilidade ao tema nas casas legislativas, a quantidade de iniciativas diminuiu nos últimos anos. Em contrapartida, instituições de controle, fiscalização e investigação, como o Ministério Público e o TCU, têm sido mais atuantes. No mais, observamos que os deputados mais ativos vêm de estados com maior quantidade de militares em proporção ao número de habitantes. Isso sugere uma conexão eleitoral na atuação nas questões de defesa.

Autonomia administrativa financeira e orçamentária das defensorias públicas estaduais: análise e descrição dos seus modelos

Passados mais de dez anos do reconhecimento da autonomia administrativa, financeira e orçamentária às Defensorias Públicas Estaduais, o que se deu através da Emenda Constitucional n° 45/2004, ainda é possível encontrar instituições desta espécie que sofrem com interferências diárias nos mais variados aspectos de sua administração, em total desrespeito ao que determina a nossa Lei Fundamental. Entretanto, curiosamente este problema não tem se mostrado de maneira uniforme no cenário nacional, havendo estados onde as Defensorias Públicas gozam de mais autonomia e prestígio, enquanto existem outros onde estas sofrem para ter igual direito reconhecido. Neste sentido, partindo de um referencial teórico básico sobre autonomia da Defensoria Pública, a presente pesquisa teve por objetivo explorar os elementos que compõe tal conceito, buscando posteriormente verificar e descrever as assimetrias existentes entre os modelos de autonomia encontrados nas Defensorias Públicas estaduais ao redor do país. Para tanto, foram coletados dados através de observação direta, pesquisa documental e entrevistas, os quais foram posteriormente tratados e interpretados através da metodologia da análise de conteúdo. Os resultados obtidos através das consolidações efetuadas no âmbito das cincos categorias de análise propostas permitiram a conclusão de que a assimetria entre os modelos existentes é um fato, sendo perceptível principalmente nas áreas de Administração Financeira e Orçamentária, bem como na Formação da Alta Administração da Instituição. Também foram constatadas duas barreiras fundamentais para a implantação do modelo de autonomia preconizado pelo ordenamento, qual seja, a baixa autonomia na previsão de despesas no processo orçamentário e a ausência de limite próprio de pessoal para a Defensoria Pública na Lei de Responsabilidade Fiscal.

Licenciamento ambiental em postos de revenda de combustíveis à luz dos princípios constitucionais de defesas do meio ambiente: o caso do município de Natal/RN

This study approaches the question of the administrative procedure of the environmental licensing of ranks of fuel resale, taking as basis a study case of the reality of the City of Natal/RN (Brazil). For in such a way, it was done a retrospect on the evolution of the system of road transport in Brazil, having started to briefly analyze the urbanization process that if after accented in the capitals of the Brazilian States the decade of 1950, relating these subjects with the growth of the sector of fuel resale. After that, it was transferred boarding of the defense of the national environment to the light of ambient principles constitutional. In the sequence, a boarding on the ambient guardianship in the Federal Constitution of 1988 was made, treating basically specifies and on the national urban politics and the national politics of the environment, with its instruments. In the sequence, it was transferred the analysis of the abilities and attributions of the National Advice of the Environment (CONAMA) and its Resolutions, for then only enter in the most important part of this work: an analysis of the environmental licensing of ranks of fuel resale, in the reality of the City of Natal/RN. Before this specific boarding, it was proceeded specifically a survey and communication from the applicable norms to such establishments (Resolutions of the CONAMA and norms of the ABNT), for after that carrying through an geo-ambient characterization of the City of Natal/RN. Finally, a reflection was made on the possibility of magnifying of the state activity, in terms of guarantees for the responsible members for the environmental policy and of administrative efficiency, through the idea of the ambient regulation. For the accomplishment of this study, it was proceeded research in diverse sources such as books, magazines, sites of the Internet, periodicals, thesis and dissertations, among others material, beyond visits the agencies that direct or indirectly act with the ambient defense and as fuel resale, such as Secretariat of Environment and Urbanism of the City of Natal (SEMURB), Institute of Economic Development and Environment of RN (IDEMA), Brazilian Institute of the Environment and the Natural resources You renewed, Executive Management of RN (IBAMA/RN), Public prosecutor's office of the Environment of Natal (Public prosecution service of the RN), National Agency of Oil (ANP) and Union of the Retailing of Derivatives of Oil of the RN, among others. To the end, satiated regulation is observed that although on the substance of the ambient licensing in ranks of fuel resale, also with federal, state and municipal norms, the municipal Public Power is very far from the fulfilment of its institutional functions, in the question environmental policy of these establishments, a time that few are the permitted ranks of resale in the city of Natal/RN

Acesso à justiça enquanto direito fundamental: efetivação pela defensoria pública

The Federal Constitution of 1988 is recognized for its enlargement in the face of large amount of provisions that make it up, among which many are fundamental rights. The fundamental rules set up the foundation of a democratic state, however, are the necessary legal mechanisms to be effective, its exercise is not enough merely to state them, but to offer ways for them to stop being just written standard on paper, and come to be viewed and exercised day-to-day. In this sense, access to justice presents itself in our times, as a cornerstone for a just society dictates. In this light, access to justice can be seen as the most fundamental of rights, which translates as instruments able to safeguard the fundamental rights not only against the action/omission violating the state but also the very particular. Furthermore, access to justice within the legal country, is not right for everyone, despite the willingness of the Citizen Charter in its article 5, paragraph LXXIV, ensuring that the State shall provide full and free legal assistance to those in need. More than half of the population lives in poverty and can´t afford to pay legal fees or court costs as well as a bump in their own ignorance of their rights. The judiciary, in their primary function, is in charge of trying to correct the violation of the rights, intending to effect a true distributive justice, serving as a paradigm for the promotion of substantive equality of human beings, however, is difficult and tortuous access Justice for those without financial resources. In this vein, we present the Public Defender, as keeper of the masses in its institutional role, defending a disadvantage, in the words, as a mechanism for effective access to justice, ensuring therefore fundamental rights. Public Defenders arise at the time or much discussion highlights the priority of actual access to justice, custody, therefore, intimate bond with the pursuit of fundamental rights, in which, that advance the broad range of rights, without whom could defend them or guardianship them

Diagnóstico Socioambiental da disposição final dos resíduos sólidos no distrito de Guajiru São Gonçalo do Amarante/RN, ressaltando a situação socioeconômica dos catadores

One of the concerns of this century is with the handling and the final destination of urban solid waste (RSU), where depending on the form as they will be made use, they can cause diverse problems, they are of ambient or social order, being able to generate the loss of the quality of life and illnesses to the population, of direct or indirect form. The objective of the present work was to diagnosis the environmental partner situation of the Final Destination of the urban solid residues in the District of Guajiru, city of São Gonçalo do Amarante/RN, standing out the partner-economic situation of the scavengers. The research was carried through in the period of March of 2008 the October of 2009, with a methodology developed through analyzes them of documents made available for the state ambient agency, the Air base of Christmas and managing agencies of the city. For collection of the date, it was used directly application of the questionnaire with 20 existing scavengers in points of destination of residues, evaluation of the old place of final destination through the use of the spread sheet of the IQR (Index of Quality of the Residues), developed for the CETESB, identification of the matter dump and photographic register. For effect of treatment of the data, a descriptive analysis with regard to the answers of the interviewed scavengers was carried through. The acquired date, Scale had been according to tabulated and analyzed in Excel 2003, where they had been generated graphical to observe the behavior of the data. The results show that of the twenty interviewed scavengers, 35% possess age between 20 and 30 years; 75% possess incomplete basic education; 60% inhabit in houses of waal or huts (cardboard or wood); 55% do not make use of system of water supply and system of sanitary exhaustion; with regard to income monthly for scavengers, 35% had presented income between R$ 200,00 and R$300,00 and 20% possess income above of R$ 500,00 for possessing another source of income; 80% of the interviewed ones, use some type of equipment of individual protection; In the year of 2009, confirming what it was informed by the State agency of Environment, during the field visit, we evidence that the city of Is Gonçalo do Amarante, currently, destines its residues in Sanitary landfill of São Region Metropolitan of Natal in the District of Massaranduba in the city of Ceará-Mirim, after some interventions of the State Public prosecution service. However, in the district of Guajiru some diggings still exist that today are used as final destination of RCD' s (Residues of Construction and Demolition) of the cities of Natal and São Gonçalo do Amarante, as well as private dumps that are used by scavengers that deviate the final destination (Sanitary landfill) of the residues of the great generators (supermarkets, shopping Center and hotels), with presence of urubus, generating a new ambient problem for the city and the aeroportuária security. Ahead of this scene, the study it suggests viable alternatives for the elimination of the private dumps and for the social situation of the escavengers, aiming at to improve its quality of life and 10 to minimize the ambient impacts caused by the inadequate destination of the solid waste in the community of Guajiru, São Gonçalo do Amarante/RN, being able to contribute so that the public managers carry through action in the handling and the control of the final destination of the urban solid waste

Desenvolvimento de um modelo computacional para a ampliação do atendimento do Programa de Acessibilidade Especial Porta a Porta - PRAE

Worldwide, the demand for transportation services for persons with disabilities, the elderly, and persons with reduced mobility have increased in recent years. The population is aging, governments need to adapt to this reality, and this fact could mean business opportunities for companies. Within this context is inserted the Programa de Acessibilidade Especial porta a porta PRAE, a door to door public transportation service from the city of Natal-RN in Brazil. The research presented in this dissertation seeks to develop a programming model which can assist the process of decision making of managers of the shuttle. To that end, it was created an algorithm based on methods of generating approximate solutions known as heuristics. The purpose of the model is to increase the number of people served by the PRAE, given the available fleet, generating optimized schedules routes. The PRAE is a problem of vehicle routing and scheduling of dial-a-ride - DARP, the most complex type among the routing problems. The validation of the method of resolution was made by comparing the results derived by the model and the currently programming method. It is expected that the model is able to increase the current capacity of the service requests of transport

Edentulismo funcional e seus fatores de risco em adultos

The purpose of this study was to investigate the risk factors to the functional edentulism in adults aged 35 a 44 years old of Natal-RN, 278 adults took part in the study. They were all selected from a previous dental loss prevalence study thus being complemented by an active research. The study was a case-control based and data collection was made though a survey as well as with a clinical examination. The cases were identified through individuals with 20 or more teeth. Age and gender were used as variables of pairing off. The data was analyzed through chi-square, significant level of 95% to the checking of its force associations. The independent variables were grouped in three levels. The first one, more macro, is related to the region where the individual lives, which was also related to the second level, the family-based one, linked with a third level, at this low socio-economical level, where the domiciliary density was favorable, living in capital cities, regions with prime sanitary condicitions, with predominant possibility of accessing the public dental service, but in despite of this, only looking for this service when tooth ache is felt, where preferentially an aid dressing treatment is executed in detriment of preventive procedures. From all the samples, less than 25% of the individuals make use of tobacco and alcoholic beverages for quite a number of years. There was an association of functional edentulism with all the studied variables in a regional method. In the family-based with Critério Brasil (OR=4,45) and monthly wages (OR=9,62) and to an to an individual level, the associations took place with the current use of kind of attendance (OR=1,78), looks for dressing treatment (OR=2,51), does not look for preventive treatment (OR=3,31), pain as the main cause of demand (OR=1,92), previous treatment as the demanding reason for dental service (OR+0,28), interval of the last visit to the dental service (OR=1,35) and when advise was received (OR=1,66). It was noticed from the results that the functional edentulism is much more expressive in those families which live in environments with precarious social economical sanitary conditions. Such conditions seem to have a direct influence upon the family social economical conditions which are also shown in detriment to functional edentulism. In the same way, the collection of variants influence the social economical conditions of the individual, as well as the kind of dental service searched by them, the reason of the search and the interval of the last visit to the dental service were strong determiners to the functional edentulism. Beyond that, individual habits like the use of tobacco and its frequency on its previous use influenced in a significant way the existence of functional edentulism in the studied population

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

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

Dependência química em mulheres :um estudo sobre o consumo de medicamentos ansiolíticos no serviço público de saúde de Natal/RN

This work was concerned to investigate the meaning attributed to anxiolytic drugs by women, in public health service. It proposes a joint analysis through a link between three dimensions: the woman, the drug, and public health service itself, in an hegemonic medical assistance model. It is observed that the relation between these elements has a great influence over the use and construction of a particular meaning, by the user. The medication is analysed as a consumption merchandise and as an health symbol. In this way, it reflects a biologized vision, which believes the drug as a solution for all health problems. It tries to analyse the generalized medical prescription for anxiolythics and it s consequences. It focalizes also the production and utilization of public health services by patients, mainly women. The question related to the use of anxiolytics and the meaning construted by women is analysed focusing the way that relations of masculine/feminine gender are organized in our society. At this point of view, it tries to understand the dimension that these questions have in subjectivity production, and how it acts in the health/disease process. Finally, this work tries to understand, in a broad sense, the use of anxiolytics looking at the problem not only as a biological question, but also as a cultural matter. The research was done over seventeen women, all of them anxiolytic users. It was used, as research instrument, semi-structured interview associated with methodological analysis of user s speeches

Serviço Social Audit Saúde no SUS/RN: projeto ético político profissional e de reforma sanitária

Health policies in Brazil, the decentralization of SUS management responsibilities for the three spheres of government has driven the creation and regulation of the audits of health services in the National Audit Office, this is a trend of neoliberal policies imposed by international bodies like the World Bank and IMF to peripheral countries characterized by productive restructuring and reforming the state focuses on the presence of two competing projects in the area of health: Health Sector Reform Project which is based on the democratic rule of law with the assumption of health as social right and duty of the State in defending the extension of the conquest of rights and democratization of access to health care guaranteed through the public financing strategies and the effective decentralization of decisions pervaded by social control and privatized Health Project which is based on the state minimum, with a reduction in social spending or in partnerships and privatization, stronger nonprofit sector, subject to capitalist interests, is made effective through strategies targeting health policy and refilantropização actions. In this context, the present study is an analysis on the work of social audits of public health in infants from a qualitative and quantitative approach, embodied by the critical method of dialectical Marxist social theory that enabled us to unveil the characterization, the demands, challenges and outline the profile of Social Work in teams inserted audits of SUS in RN, but also provided evidence to demonstrate the prospects and possibilities of this area of activity of social workers. It was also found that through the audit work that the state fulfill its role as bureaucratic and regulator of health services with efficiency, effectiveness and economy. Yet, paradoxically, the audits of SUS may provide a vehicle for enforcing rights and ensuring the fundamental principles contained in the project of health reform, because it can be configured in a space of political struggle as representing a new field of knowledge production that needs to be appropriate for a theoretical critic able to redirect the social interests in favor of the user. From this perspective, it is concluded that the work of social audits of public health in infants despite the social relevance that prints, as they constitute an activity study of reality and its transformation proposition requires a transformative political action guided the discussion Marxist theory holds that the ethical project professional politician of Social Work

O Serviço Social e a exclusão/inclusão social dos portadores de HIV/AIDS :demandas e desafios nos hospitais públicos

This research presents the labors developed by the Social Service unto socially excluded HIV/Aids positives at public hospitals in Rio Grande do Norte (RN). It purposes to identify and to analyze the demands brought by the holder onto the Social Service professional as well as the challenges the latter face to minister to the former. It privileges, from the methodological viewpoint, the qualitative and quantitative analysis with the application of questionnaires, direct observation, semi-structured interviews and bibliographic references. Data were collected from 12 (twelve) social assistants who work at Giselda Trigueiro Hospital in Natal (7) and Rafael Fernandes Hospital in Mossoró (5). The central hypothesis that guided this study is that the social inclusion/exclusion process experienced by the HIV/Aids positive on society implies a demand for the Social Service that is inserted in the public health context (specially in HIV-referred public hospitals), whose agents, however, when attempting to answer those demands, meet obstacles due to both the precariousness of public health services and the social complexity that concerns the HIV/Aids epidemic. Results point out that, de facto, the HIV/Aids epidemic, because of the social exclusion/inclusion process to which the holder is subject results a demand for the social agents at hospitals. Demands rise principally from the patient s life condition, considering the increasing pauperization in the epidemic context. As to what it is concerned, social assistants, responding to the needs, come across concrete twofold challenges: the illness in itself, for all social, negative aspects that make part of quotidian life of holders; and the precarious state of the public health service in RN State, since that working conditions are unsatisfactory