A relação entre os determinantes sociais em saúde e os investimentos setoriais e a mortalidade infantil em municípios brasileiros com mais de 80 mil habitantes

Investments in health have controversial influence on results of the health of populations, besides being subject rarely explored in literature. Moreover, from the 1970s, the social determinants of health have been consolidated in the disease process as multifactorial factors (social, economic, cultural, etc.) that directly or indirectly influence the occurrence of health problems of populations, as well as mortality rates. This study aimed to evaluate the influence of these investments and the social determinants of health on infant mortality and its neonatal and post-neonatal mortality. This is an ecological study, in which the sample was composed of Brazilians cities with over 80,000 inhabitants, avoiding fluctuations in mortality rates for common small populations, and ensure greater coverage of information systems on mortality and births Brazilians and, therefore, increase data consistency. To isolate the effect of investments in health, we used multiple linear regression. The socioeconomic indicators (p <0.001, p = 0.004, p <0.001), the inequality index (p <0.001, p = 0.001, p = 0.006) and coverage of prenatal visits (p <0.001, p <0.001; p = 0.005) were associated with infant mortality rate total, neonatal and post-neonatal, and the Gross Domestic Product per capita only influenced the overall infant mortality rate and neonatal (p=0.022; 0.045). Investments in health, in this model, lost statistical significance, showing no correlation with mortality rates among children under one year. We conclude that the social determinants of health has an influence on the variation in mortality rates of Brazilian cities, however the same was not observed for indicators of health investment

Avaliação das ações do Núcleo de Apoio à Saúde da Família (NASF) em Macaíba/RN

This research evaluated the contribution of the Support Center for Family Health (SCFH) in relation to its effect on the Family Health Units through perception of the Family Health Strategy (FHS) and SCFH professionals, in addition to the satisfaction of users in relation to that role. Data were collected in the public health services of the city of Macaíba-RN in 2012, through semi-structured questionnaire and non participant systematic observation and it counted as investigated subjects 272 individuals (60 FHS professionals, 12 SCFH professionals and 200 users representatives of 20 units). For analysis of the responses of the opened questions was used categorization process and, in relation to the observational method, that was based on checking the space organization, the characteristics of the participating subjects and the specific set of activities performed by SCFH teams through an observation guide. The results point to a good acceptance of the SCFH teams role by most FHS professionals who reported active participation in the health units routine, its integration activities to the FHS teams with resolving based health promotion actions. Regarding the SCFH professionals, they also reported positive contribution by participating actively in the units routine with integrated activities to the ESF teams and developing resolute actions. For users, the SCFH brought assurance services with better access to specialized, resolving and welcoming care. Systematic observation ratified data obtained by questionnaire. It was perceived the need to implement actions related to man`s health, to invest in expanding the number of the SCFH teams, the greater supply of medications, improving the regulatory process and planning together as a key strategy to promote a more effective integration between teams SCFH / FHS

Iniciação sexual e fatores associados: um estudo com adolescentes escolares

A iniciação sexual é um marco significativo na vida do indivíduo, ocorrendo geralmente na adolescência. Importantes transformações biopsicossociais ocorrem nesta fase, denotando vulnerabilidades à vida do adolescente, dentre elas, as decorrentes da iniciação sexual, sendo o risco de infecção pelo HIV/aids a mais grave. A infecção pelo HIV/aids constitui atualmente um importante problema de Saúde Pública, estando os jovens no centro da epidemia mundial. No Brasil, dados do último boletim epidemiológico, lançado em 2013, apontam para a tendência de aumento de sua prevalência na população jovem. Desta forma, o presente estudo teve por objetivo investigar a associação entre iniciação sexual e o perfil sociodemográfico, o indicador de conhecimento das formas de transmissão do HIV/aids e fatores biopsicossociais autoestima e habilidades sociais, em adolescentes de 16 a 19 anos, de ambos os sexos, estudantes do nível médio técnico integrado, do Instituto Federal de Educação, Ciências e Tecnologia do Rio Grande do Norte, Campus Natal. Trata-se de um estudo transversal, cuja amostra foi constituída aleatoriamente por 200 alunos que responderam de forma anônima a quatro instrumentos: perfil sociodemográfico, questionário da Pesquisa de Conhecimentos, Atitudes e Práticas na População Brasileira (PCAP), Escala de Autoestima de Rosenberg e o Inventário de Habilidades Sociais para Adolescentes de Del-Prette (IHSA). A análise estatística dos dados foi realizada através do teste qui-quadrado de Pearson e do exato de Fisher (α <5%). A média de idade para a primeira relação sexual foi de 15,96 anos, com o início mais cedo para o sexo masculino. Verificou-se associações estatisticamente significativas entre iniciação sexual e as seguintes variáveis: idade, sexo, situação conjugal, religião, renda familiar, autoestima e o repertório de habilidades sociais. Observou-se ainda que apenas 11% dos adolescentes possuíam conhecimento correto acerca das formas de transmissão do HIV/aids. Conclui-se que os esforços para a prevenção das DST/aids precisam ser direcionados a campanhas e programas mais eficazes, que considerem não somente o caráter informativo, mas também os fatores psicossociais já que estes mostraram-se associados ao início da vida sexual

Violência Sexual Infanto-Juvenil em Natal: uma avaliação do Programa Sentinela

Analyze the problem of sexual violence suffered by children and adolescents in the city of Natal / Rio Grande do Norte (RN), attended by the Programa Sentinela, a service aimed at combating sexual violence children and teenagers who serves on the council of Natal. Thus aims to review the implementation of the Programa Sentinela in Natal / RN, in the period 2001 to 2006, verifying that the program has contributed to the access of children and adolescents who are victims of abuse and sexual exploitation to fundamental rights under the Statute Children and adolescents (ECA) and the Local Plan and the National gainst Infanto-Youth Sexual Violence. It has a theoretical and methodological approach quantitative and qualitative, covering the issue of sexual violence against children and adolescents, as one of the expressions of economic relationships, gender, race and culture that make up the material and symbolic structure of society. It methodological procedure: review of literature on the subject and conducting interviews with professionals and families of children and adolescent victims of sexual violence. Investigate as the unit of analysis the Sentinel Program. The analysis on the governmental actions of this period on this social problem points to the continuity and little change in the care of victims of sexual violence: despite maintain features and palliative assistencialistas, favoring the "Network of Sexual Tourism", go through some innovations in terms of securing rights from the ECA, which is the need for transparency and democratization in the management of government policies. In research undertaken, Brazil will only be combating this type of crime when each of the social actors are actually doing their share, down taboos, facing corruption and strengthening a system of guarantee of rights, which target children and adolescents are unprotected, and often ignored by Brazilian society

O cotidiano do(a) Assistente Social frente as demandas apresentadas pela paciente portadora do câncer de mama em tratamento no Hospital Doutor Luiz Antônio em Natal/RN

This work deals with an analysis related to the social worker s practice in the oncology area. It aims to identify demands, work conditions as well as current challenges related to this profession. It considers the specificities of breast cancer and relates it to political decisions in the health sector considering the concept of contemporary capitalism. The study analyzes professional action and the demands presented by breast cancer patients who are currently in treatment in Hospital Dr. Luiz Antônio em Natal-Rio Grande do Norte-Brazil. The methodological procedures considered of documental analysis, semi-structured interviews (with two social workers that work with fifteen breast cancer patients) as well as participant observation; which was done counting with my own professional practice in the oncology area. Thus, the research also discusses the breast cancer issue in the life of the users considering their social-economical, cultural and political determinants. Factors such as age in which the diagnosis was known, the relation user/social workers, number of children, rights of the oncology patient, place where he/she lives, education, civil status, (re)insertion of the professional in the work field, perception of self-esteem and bio-psycho-social representation of breast cancer in the lives of these women, all of which were dealt with in this research

O Serviço Social nas operadoras de planos privados de assistência à saúde: demandas, atribuições e respostas profissionais

The present study deals with the exercise of professional social workers in private health care plans registered with the Regional Council of Medicine/RN, in the city of Natal/RN, with regards to the demands/tasks, work conditions, and the professional response, given the climate of restructuring the capital. The set of socio-historical transformations, as a results of the dynamic capitalist, is a process of new configurations in relation to state and society that interfere directly in relation to working conditions, social rights historically won by workers. In this context, the operator of health plans arises as a possibilities to provide services in health, through the logic of the market, in which the subjects of law, become consumers contributing to the displacement of the responsibilities of the State. Obligating workers to lessen the burden with the reproduction of their workforce. This involves changing societal context for social service, since it is one of the professions that are active in terms of the immediate social issue, and come as part of the collective worker. From qualitative research based on a theoretical and methodological perspective and critical dialectics, it was possible to unveil some features and trends of the exercise of(a) social operators in private health care plans. The survey results indicated that : a) the demands and duties for certain social service, are associated with the redevelopment of the capital, whose requirements and responsibilities professionals have with their needs, particularly the guarantee of profit, services rendered; b) in the conditions of work there is a trend of insecurity uncertainty and dismantling of professionals; c) the answers professionals suffer the limits and contradictions present in the daily training, mainly depending one the characteristics of management and operation of the operators, which has professional relative autonomy

As organizações não-governamentais (ONGs) de atenção à criança e ao adolescente em Natal/RN: contribuição na garantia de direitos?

In contemporaneousness watches in Brazil the emergence of a "new" relationship between State and society based on partnership, which will allow the growing playacting organizations "non-profit" and "public interest" in the management of social public policies. In that sense, as part of a logic of global restructuring of the Capital, under the aegis of the neoliberal project, starting from the years of 1990, an administration model is had in favor of the market that looks for to minimize the actions of the State, reinforcing the outsourcing of the social public politics, and consequently, debilitating rights legally conquered. In that way, with this study it was pursued as general objective to apprehend the actions developed by Non-governmental Organizations NGOs in the child's area and of the adolescent in Natal / RN, verifying in that measured, these contribute to the warranty of rights or they reproduce practices of welfare work, and as specific objectives: to identify the group of the actions developed by NGOs in the child's area and of the adolescent in Natal / RN; to analyze the practice of NGOs of the point of view of the human resources, of the administration, of the financing, of the user's participation in the decision processes, as well as the quality of the services and the continuity of the actions of these organizations; and to apprehend the relationship between the researched organizations and users in the process of implantation of the actions, in order to identify the perspective that guide the practice of NGOs is going in the direction of contributing in the warranty of rights or in the reinforcement to the welfare work. In summary the results showed two trends in the actions of the NGOs, in the direction of the provision of services, which still unfurls in two perspectives of handouts. The other trend will give priority to the defense of rights of children and adolescents, with actions of political impact strengthen the promotion of public policies state, thus contributing to guarantee rights

A assistência técnica e extensão rural no assentamento modelo: proposição e realidade

This discourse analyzes the technical assistance concerning the rural settlement, which is seen as a demand of the social movement that claims for agrarian reformation, and is a goal of II PNRA, launched in may 2004, as a essential national public politics on process of building and consolidation of settlement and familiar agriculture, proposing the return of technical assistance service and rural extension in Brazil, which were started in the and of 1940 s. We analyze, in particular, the technical assistance program, social and environmental agrarian reformation, on model settlement, a program created, especially, to the rural settlements, coordinated by INCRA. Based on the documental analyze and local study, it is noticed that the experience of technical assistance implemented on model settlement shows the non continuation and fragility on technical assistance actions to rural workers. This context goes against the lately technical assistance governmental apparatus, which ensures to make settlements stronger, to support and to get important the familiar agriculture system. This way, technical assistance execution, trough the tertiary service, follows the neoliberal strategy and, the State, besides decreases the estimate to public politics, takes its actions control from the State to the shared control through partnership and transferring of responsibility, expressing its historic lack of attention to the worker class demands. In spite of workers resistance, expectative and hope, the lack of these services, as well as the other politics deficiencies, which are necessary to the settlements, are endangering its activities and threatening its survival in the settlement

Processo de trabalho em saúde: uma análise das condições de trabalho dos assistentes sociais no âmbito hospitalar

This paper presents the survey results: PROCEDURE FOR WORK IN HEALTH: an analysis of working conditions of social workers in hospitals. Analyzes the inclusion of social workers in work processes in healthcare, specifically in the public hospital, from the objective conditions of work, according to which materializes professional action. The aim is to understand them from the point of view of its relationship with users and other health professionals through the privatization of health, which prevents the Unified Health System (SUS), limiting the operation of the services and the guarantee of rights. The approach to the reality studied was through theoretical and methodological procedures based on the qualitative and quantitative research, focusing on documentary research, observation, semi-structured interview and the theoretical foundation. It is observed that the inclusion of social workers in this context arises from the demands derived from expressions of social issues, "raw material" of professional work, and the gaps resulting from contradictions in the process of rationalization / reorganization of the SUS, meaning that the needs the population are confronted with the content and form of organization of services. At the hospital, the professional actions are developed through the shift, space contradictory clash between the collective and individual, in which individual activities are prioritized and ad hoc unplanned and reduced to the solution of "problems" of users, through actions assistance in an emergency and bureaucratic. These findings emphasize the inadequacy of space and lack of minimum conditions of service to users, which undertakes the professional with regard to ethical and political principles of the profession, since it is the responsibility and duty of the social guarantee the secrecy and privacy of users what is revealed during the process of professional intervention. The professional social workers is permeated by the diversity of skills and competence; lack of planning activities, by incorporating the institutional discourse at the expense of professional goals, by knowing the Code of Professional Ethics, for small number of professionals, the increasing number informality; by poor working conditions and wages; by discouraging research and participation in social policy councils, as well as professional training

A dimensão educativa do serviço social: uma análise do processo interventivo da profissão no âmbito da política de assistência social do município do Natal/RN

Can be declared that throughout the historical trajectory of the Brazilian Social Work, the men in the Social Work profession, women in the Social Work profession in his/her professional activity, present an educational dimension that runs through various social and occupational spaces, particularly in the area of Social Assistance Policy. Based on this premise, this present Dissertation, problematize the educational dimension present on the interventional process, in Social Work on the ambit of the Social Assistance Policy in Natal / RN city Brazil in the contemporary scene. Having thus, specific objectives that orientate the research of the interventional process of Social Work in the social assistance policy, analyzing of the apprehension of Social Work professionals on the educational dimension, in their daily work professional and the verification of the relationship between the educational dimension, to the professional action of both men in the Social Work profession and women in the Social Work profession and the concretization of social rights on the ambit of the social assistance policy. In this sense, the theoretical and methodological procedures used for this research, are substantiated on a critical-dialectical perspective and a qualitative and quantitative approach, from of the application of field research, of the non-participant observation, of the semi-structure, of the review of literature bibliographic and documental. Thus, considering that both women in the social work profession and men in the social work profession are an organic intellectuals who in their daily professional work promotes an intellectual and moral reform of their users, the results of this research, synthesize and show that the educational dimension in both professional work and social assistance, which have partner-historics, whose imbrication allows, contradictorily, by a side, a reaffirmation of the dominant culture, and by other side, a direction linked to the construction of an emancipatory culture in the pursuit of the materializing of social rights and a new sociability

Extensão universitária: concepções e ações na UFRN sob a temática direitos humanos e justiça no período 2008 a 2010

This paper concerns a study on the University Extension, by reference to the research extension activities under the theme human rights and justice, developed in the period 2008 to 2010 in UFRN. To do so, it tried to learn the concepts of extension in Brazil from the 1970s until the 2000s in contemporary times. This study considered the neoliberal social context of the University, dominated by educational policies focusing on the hegemony of liberal ideas about society, reflecting the great advances of capital on the organization of workers in the last decades and intensified in the 1990s. This research was guided by two great motivations: the opportunity to apprehend a way to enforce the commitment of public institutions of higher education to the disadvantaged sections of society and what role the university extension space plays as a socially committed public university. The general aim of this study is to identify inside the university extension education what does it mean for practitioners and extension activities and what results it produces to society and to the academic training of future professional citizens in the current neoliberal context. The research has been developed from an analytical and critical approach based on quantitative and qualitative data, using observation techniques and semi-structured interviews. We sought to investigate and understand the social reality, the main object of this work, with an interest in identifying the need for a new teaching/learning process and for a new university practice, in order to effectively improve an advanced academic formation. For this, some interviews have been conducted with teachers, students and the external community involved in extension actions in the period defined by the work, i.e., from 2008 to 2010. In this stage, it was observed that the academic work of university extension is essential to civic education. It was recognized too as a privileged space where university fulfills its social commitment towards society, as long as it joins scientific and popular knowledge having in view a new science and a new social order

O financiamento da política de assistência social no contexto do SUAS: tendências e particularidades do município do Natal-RN

This dissertation analyzes the configuration of the financing of Social assistance in the municipality of Natal-RN in the context of their particular expressions of the problematizando municipal budget against neoliberal adjustment macroeconomic policy. The current trends of "disclaimer" and "desfinanciamento" of social protection by the State, in the context of contemporary capitalism, bring strong implications for Social Security, especially through the redirection of public resources to the international capital, which highlights the overlapping economic interests on social needs. Whereas the changes and innovations occurring in connection with the financing of Social assistance policy, the goal of this documentary research is to identify the characteristics and trends of funding this policy in Natal-RN, from the secondary data analysis from the City of Natal, the Ministry of Social development and hunger and Portal of transparency. In the light of the theoretical, research now presented, shows trends of investment in Social assistance in the municipality of Natal-RN, in the period 2005 to 2009, which are: the tiny role membership (08) Social assistance in the municipal budget; the dispersion and fragmentation of the resources of Social assistance in other organs and/or secretariats of municipal administration; the participation of just 47.5% in expenditure from own organ Manager; the low percentage of implementation of resources foreseen in the Annual Budget Laws; the low allocation of resources in Municipal Social Assistance Fund (FUMAS), which contradicts the national policy for Social Assistance-PNAS/2004; and the predominance of government transfers in the composition of the resources of Social assistance in the municipality. The results of this research suggest that the process of financing of Social assistance in Natal is distant from the principles and guidelines pointed by PNAS/2004. In addition to the effort to understand the complexity of the financing of Social assistance in Natal, this work seeks to contribute to a political analysis in the direction of strengthening social control and the struggle for the expansion of investment in social spending

A gestão do Sistema Único de Assistência Social em Currais Novos (RN)

The present paper analyses the social assistance management in small cities, starting from the reality of Currais Novos City. Its main objective is to analyse the management of this politic in the context of the Nacional Sistem of Social Assistance (SUAS) through the management instruments materialized in the city: Social Assistance Plan, Budget, Management Report, Information Management, Monitorizing and Evaluation. It reveals a discrepancy between the instruments purpose and their concretude, and it identifies the main challenges in order to make them real, revealing the contradictions of such politic, through which the advances relate with the retrocesses. It remarks, in this context, the debate about Public Management and some aspects of the trajetory of the Social Assistance management in the brazilian context and the configurations of (SUAS) and of the politics in Currais Novos city. Such path allows us to identify the feebleness in the city ways to adopt the (SUAS) criteria, which is much more effective in burocratic aspects than in the change of the Social Assistance conception and in the effective incorporation of the (SUAS) principles and guidelines. Thus, problems are identified in what concerns to the important aspects for its effectivation, with the human resources, financing and social control mechanisms. It makes possible to reafirm the importance of the analysed management instruments for the effectivation of one participative and democratic management, as well as the urgency of its materialization as one of the important ellements for this politic to happen as a right and to make a stop to the unconformities between the (SUAS) determinations and its materialization

Assentamento Hipólito: realidade e perspectivas dos jovens assentados

Analisa a inserção da população jovem em assentamentos rurais, tomando como referência o Assentamento Hipólito, no município de Mossoró, no Estado do Rio Grande do Norte (RN). O contato com alguns jovens assentados levou à inquietação frente à problemática situação por eles descrita, em relação aos seus cotidianos e às suas perspectivas, o que aponta para o entendimento de que faltam políticas públicas, ou estas não estão sendo adequadas para a população em estudo. As políticas de juventude são, além de recentes, ainda muito escassas; sobretudo, quando se trata da juventude rural. Nessa perspectiva, procura rastrear a trajetória dos jovens no referido Assentamento, visando a uma melhor percepção da inserção social destes na condição de assentados, com a atenção voltada para as suas relações com o seu meio, e com o poder público (local, estadual e federal), as condições de vida, as perspectivas de futuro e as ações governamentais, frente às suas demandas. Os resultados dessa análise apontaram para a ausência de políticas públicas condizentes com a realidade dessa parcela da população, reforçando, mediante a precariedade das condições de vida em que se encontra, o argumento de que a luta pela terra não se encerra com a conquista desta. Pois a consolidação dessa posse vai depender da luta posterior em prol de melhores condições econômicas e sociais. Reforça ainda a necessidade de reconhecer a capacidade potencial dos sujeitos coletivos, na avaliação de seus problemas e necessidades, e fomentar a participação social e política dos trabalhadores, na conquista de seus direitos e na construção de sua cidadania. E ainda que a participação efetiva da juventude é fundamental a qualquer processo de transformação social. Portanto, os jovens rurais são atores inegavelmente importantes quando se pretende entender a dinâmica dos assentamentos rurais no seu contexto maior

A política de assistência estudantil no contexto de expansão do ensino superior: as particularidades do Programa de Pós-Graduação em Serviço Social da UFRN

A dissertação versa sobre a Política de Assistência Estudantil e o processo de luta pela democratização do acesso à universidade, no contexto de expansão do ensino superior em tempos de crise estrutural do capital. Apresenta como unidade de análise as particularidades da pós-graduação em Serviço Social da UFRN e tem como objetivo principal apreender e analisar as condições de permanência disponibilizadas pela UFRN aos discentes de pós-graduação no contexto de expansão do Ensino Superior. O percurso teórico-metodológico de análise adotado na pesquisa se fundamentou numa perspectiva crítica do objeto de estudo a partir de uma concepção de totalidade, que pressupõe apreender as determinações socioeconômicas e políticas que incidem sobre a política de ensino superior e as condições de vida dos discentes do Programa de Pós-Graduação em Serviço Social (PPGSS). As análises fundamentaram-se em pesquisa bibliográfica como base teórico-metodológica da investigação, articulada com as reflexões que resultaram dos dados empíricos da pesquisa de campo na perspectiva de apreensão do objeto, em sua densidade histórica e num quadro de múltiplas determinações. Do ponto de vista metodológico foram entrevistados 26 discentes e realizada análise documental referentes a leis e documentos da política educacional em nível federal e dos organismos internacionais. A luta por ampliação do acesso à universidade está na agenda dos movimentos sociais no âmbito da educação, no entanto na conjuntura dos governos de Luis Inácio Lula da Silva (2003 a 2010) e Dilma Rousseff (2011 a 2012) a tendência tem sido seguir as orientações dos organismos internacionais e promover expansão de vagas sem assegurar estratégias de permanência compatíveis com as exigências de excelência acadêmica postas, por exemplo, na pós-graduação. Discentes entrevistados acessam o ensino superior e os cursos de pós-graduação e vivenciam dificuldades diárias para atender com qualidade às exigências acadêmicas em face de suas condições materiais de vida e de trabalho e dos limites da política de assistência estudantil que tem um perfil de programas e ações localizadas