Análise do licenciamento ambiental como instrumento de política do meio ambiente no Rio Grande do Norte Período 1992-2003

This analysis on the ambient licensing is based on a research that identifies the fragilities and advances of the application of this instrument of politics of the environment in the ambient politics of the Rio Grande do Norte, in the period of 1992 the 2003. The isolated urban area of Búzios, situated in the City of Nísia Floresta/RN, situated in the eastern coast of the State, where concentrates the boarding of the ambient question as a matter in the Brazilian process of urbanization, over all the institutionalization and implementation of the ambient licensing. They are distinguished in the used methodology in consultation to the diverse involved social segments with the ambient subject in study, the example of the managers, technician and specialists, as well as the application of the legislation and norms techniques, the forms of appropriation of the common wealth and the procedures of ambient licensing of the competent agencies. The results of the research designate that the ambient licensing while instrument of the ambient politics is one of the alternatives more efficient as techniques in the process of sustainable development, since it is beyond the prerogatives to conciliate the activities and enterprises with the conservation of the environmental resources and natural benefits to the societies. In the RN one evidenced progress in the ambient legislation and the instructions techniques, and that the imperfections and limitations in the system of ambient licensing are not directly on to the instruments, but in the implementation of mechanisms of the ambient agencies. This because they do not make use of operational structure to apply in practical and established abilities, as an ambient management, institutional joint and deliberations of the State Counselor for Environment

Avaliação do desenvolvimento neuropsicomotor em crianças na rede básica de saúde utilizando o teste de Denver II: identificação de fatores de risco materno

Alterations in the neuropsychomotor development of children are not rare and can manifest themselves with varying intensity at different stages of their development. In this context, maternal risk factors may contribute to the appearance of these alterations. A number of studies have reported that neuropsychomotor development diagnosis is not an easy task, especially in the basic public health network. Diagnosis requires effective, low-cost, and easy - to-apply procedures. The Denver Developmental Screening Test, first published in 1967, is currently used in several countries. It has been revised and renamed as the Denver II Test and meets the aforementioned criteria. Accordingly, the aim of this study was to apply the Denver II Test in order to verify the prevalence of suspected neuropsychomotor development delay in children between the ages of 0 and 12 months and correlate it with the following maternal risk factors: family income, schooling, age at pregnancy, drug use during pregnancy, gestational age, gestational problems, type of delivery and the desire to have children. For data collection, performed during the first 6 months of 2004, a clinical assessment was made of 398 children selected by pediatricians and the nursing team of each public health unit. Later, the parents or guardians were asked to complete a structured questionnaire to determine possible risk indicators of neuropsychomotor development delay. Finally the Denver II Developmental Screening Test (DDST) was applied. The data were analyzed together, using Statistical Package for Social Science (SPSS) software, version 6.1. The confidence interval was set at 95%. The Denver II Test yielded normal and questionable results. This suggests compromised neuropsychomotor development in the children examined and deserves further investigation. The correlation of the results with preestablished maternal risk variables (family income, mother s schooling, age at pregnancy, drug use during the pregnancy and gestational age) was strongly significant. The other maternal risk variables (gestational problems, type of delivery and desire to have children) were not significant. Using an adjusted logistic regression model, we obtained the estimate of the greater likelihood of a child having suspected neuropsychomotor development delay: a mother with _75 4 years of schooling, chronological age less than 20 years and a drug user during pregnancy. This study produced two manuscripts, one published in Acta Cirúrgica Brasileira , in which an analysis was performed of children with suspected neuropsychomotor development delay in the city of Natal, Brazil. The other paper (to be published) analyzed the magnitude of the independent variable maternal schooling associated to neuropsychomotor development delay, every 3 months during the first twelve months of life of the children selected.. The results of the present study reinforce the multifactorial characteristic of development and the cumulative effect of maternal risk factors, and show the need for a regional policy that promotes low-cost programs for the community, involving children at risk of neuropsychomotor development delay. Moreover, they suggest the need for better qualified health professionals in terms of monitoring child development. This was an inter- and multidisciplinary study with the integrated participation of doctors, nurses, nursing assistants and professionals from other areas, such as statisticians and information technology professionals, who met all the requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte

Percepção e realidade da política de atenção à saúde do idoso nas equipes de profissionais do programa de saúde da família do estado da Paraíba

Investigar os fatores relacionados á percepção que os profissionais das equipes do Programa de Saúde da Família (PSF) possuem frente à realidade da política de atenção à saúde do idoso nas Unidades Básicas de Saúde dos municípios litorâneos do Estado da Paraíba. Trata-se de um estudo observacional descritivo com uma amostra constituída por 120 profissionais de saúde de três categorias distintas (enfermeiro, médico e odontólogo), sendo 104 respondentes como profissionais e 16 respondentes como coordenadores de equipes. A coleta de dados foi realizada através de um questionário auto-aplicável de avaliação fechada e de questões de múltiplas escolhas. Os dados foram processados e armazenados no Programa Estatístico SPSS versão 15.0 e analisados à luz da estatística descritiva. Os resultados indicaram que os profissionais tiveram dificuldade em perceber a realidade da política integral e integrada de saúde do idoso junto aos serviços de saúde em que atuam. O estudo revelou ainda a necessidade de uma definição de estratégias para qualificação dos profissionais garantindo à atenção integral à saúde do idoso sob uma nova visão de atuação

Avaliação do cuidado na estratégia saúde da família em metrópoles do nordeste brasileiro

Objective: To evaluate the implementation of the Family Health Strategy (FHS) in Brazilian cities of the Northeast, expanding coverage, analyzing the progress, challenges and innovations. Methods: Multicentric Evaluation Research, Studies Baselines in urban centers, using as a case study method. Selected cases of Aracaju, being capital, advanced coverage with extended team, and Fortaleza, capital coverage incipient and minimal staff. In Fortaleza, purposive sample of 11 Units Primary (APS), 03 managers, 53 professionals and 109 users. In Aracaju, 09 units of APS, 02 managers, 36 professionals, and 90 users. Structured interviews for managers, and structured to professionals and users. Descriptive analysis focusing on the political and institutional dimensions, organization and comprehensive care. Results: There was consensus that the ESF is the preferred port users and acts as inducing changes in care. In the case of Fortaleza, the specificities were: care protocols and community activities aimed at chronic conditions (100%) , with greater participation of doctors and nurses (93%) ; conjunction with more complex services, but the teams reported difficulties with the examination center and experts, the long waits and poor access to local services were the main difficulties reported by users., As innovative practice, the therapeutic group of elderly caregivers mentioned by respondents; There was intersectoral initiatives and teams 87 % of users have participated in meetings about health problems. In the case of Aracaju, care protocols were directed to the lines of care and formulated locally, 85 % coverage of the population with FHS counterpart local financing; employees hired by public tender; 70 % of teams with expertise in public health center for continuing education acting; democratization in management; access technologies, welcoming and computerization in different integrated networks, and evaluation matrix. Conclusions: The ESF has promoted access to health care and inclusion of disadvantaged populations. Different perceptions and practices in the organization of care, with distinct trajectories of reorganization. In the case of Fortaleza, predominance of model programs valuing older, with evidence of advances in care practices and teamwork, but restricted to primary care practices and incipient in public policy perspective. In Aracaju, had network integration with technologies related to the family, in which the ESF is consolidated as public policy. It can be argued that the XII APS expanding coverage, exhibited efficacy, despite the challenges inherent to the different degrees of implementation

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

As práticas educativas na saúde da família: uma cartografia simbólica

This qualitative research aimed to understand the educational activities carried out in Family Health Units, of the municipality of Mossoró-RN. It was used symbolic cartography to organize and present data from reality. It started on the approach of Health Education and knowledge transformation practice, aiming at the development of autonomy and responsibility of individuals and healthcare, publicized by the appreciation of the interpersonal relations area established in services, such as educational emancipator practices contexts. Individual and collective interviews were realized, conducted with health professionals and users of ESF, about themes, activities, membership, the difficulties, the potential and the design of health education that permeate everyday Family Health Strategy. From what was apprehended, thematic maps were done with the analysis of educational practices of professionals belonging to the Family‟s Health. Links are built with the wires of conceptions of education reflected on themes and activities of family health teams. The storylines are rebinded by voices about the difficulties and the potential of educational processes for emancipator postures. For users, health education means proper care and information on disease prevention. Professionals understand that it is all information that is given to users, about health, social well-being, economic and general condition of human being as a way of preventing and treating disease. Mark printed on voices denote that activities and themes worked don‟t motivate users enough for their participation, being that physicians and dentists also get excluded themselves from educational practices. Elderly groups are those who get most involved with the activities. The size of the contained area and its seclusion from community make harder the access of users, as well as diminishing the quality of educational actions and links users-professionals. Therefore, the searching for medicines, medical consultations and wish to be well served are trademarks of voices from the users that interconnect with enlightening information and guidelines offered by professionals to users. It brings out practices that need to incorporate the social, the subjective and act with practices of prevention and health promotion, on the basis of lifestyles. The dialogical model, which needs to be approached since planning phase of health education actions could arouse interest of involved groups; promoting a relationship of dialogue and listening; discussing the local reality; stimulating practical methodological dialetics; promoting processes of deconstruction of concepts, values and attitudes, as more necessary than construction, using multiple languages. The defended thesis denotes paths to other studies aimed at understanding a dialogical template committed to exchanges of knowledge, and discover strategies that encourage formation of critical consciousness and the discovery of how is the training of new generations of healthcare professionals to belong to the project of society, in its technical, scientific, pedagogical, ethical, political and humanistic dimensions

Política de assistência social no Brasil: uma análise a partir das tipologias de políticas públicas

The study of public policy typologies is still a knowledge field which lacks more embracing and applicable studies to different sectors. On that perspective, this work, Social Assistance Policy in Brazil: an analysis from the typologies on public policy, pursues to add the relevant literature to social assistance what focus on the public policy ratings. Moreover, it concerns about a study on the the national policy of social assistance implemented by the Brazilian government from the theoretical referrence of the public policy typologies. For that reason, the referential framework of the public policies as well as the analisys of its fundamentals/principles that are indispensable for achieving a bigger goal, that is to tipify the social assistance policy based on the different public policy typologies and characterize it through the main elements which are intrinsec to the social political and economic reality of Brazil. Thus, the issue suggested for the work is: what is the profile and the political trajectory of the social assistance implemented by the Brazilian Government? How it presents, above all, the features of a distributive, focused and lawful policy, the work has been done througho the following hypothesis: the social assistance policy in Brazil has been of universal, assistance, and focusing aspects. For each of those features granted to the social assistance policy, there is a gathering of changes according to the social, political and economic moment of the country and that stands out due to the different institutions within every cyclical period. The work showed that besides the social policy has gone through meaningful changes during the last decades, even though the adoption of the Organic Law of Social Assistance and its rules, some of the mentioned characteristics still remain, as long as the State s primacy goes on being the economic policies over the dubbed social policies. Notwithstanding, the social assistance will build up itself from the materialization of the growing of the social rights related to the State, but also assuming an important role on the amplified reproducing process regarding the capitalist social relations

Avaliação multidimensional de pessoas idosas atendidas por equipes de saúde da família em Natal-RN: uma análise demográfica e epidemiológica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

O princípio constitucional do desenvolvimento sustentável: análise da sua concretização no Estado do Rio Grande do Norte

The Article 225 of Constitution of the Federative Republic of Brazil in its main body, stipulates that everyone is entitled to ecologically balanced environment and the use of common people and essential to the healthy quality of life, should be imposed on public authorities and the community the duty to defend it and preserve it for present and future generations. Following a universal trend, the letter raised the Brazilian environment the category of one of those values ideals of social order, dedicating it, along with a constitution of rules sparse, a chapter, itself, which definitely, institutionalized the right to healthy environment as a fundamental right of the individual. The national public policies and state should be in line with modern theories of Sustainable Development, outlined within the international society, and certainly instruments that should be made effective through the mobilization of civil society as a whole. The implementation of Human Rights, in fact, depends on a strong political action and not just a legal problem. Thus, this work of theoretical-descriptive nature we will address various dimensions of sustainable development, such as environmental education, water, sanitation, health and sustainable development plans, evaluating its current stage in our state

Tributação, finanças públicas e política fiscal: uma análise sob a óptica do direito e economia

In the Brazilian legal scenario, the study of taxation has traditionally been restricted to positivist analysis, concerned with investigating the formal aspects of the tax legal rule. Despite its relevance to the formation of the national doctrine of tax, such formalist tradition limits the discipline, separating it from reality and the socioeconomic context in which the Tax Law is inserted. Thus, the proposal of the dissertation is to examine the fundamentals and nature of taxation and tax legal rules from the perspective of Law and Economics (Economic Analysis of Law). For this purpose, the work initially reconnects the Tax Law and Science of Finance (or Public Finance) and Fiscal Policy, undertaking not only a legal analysis, but also economic and financial analysis of the theme. The Economics of Public Sector (or Modern Public Finance) will contribute to the research through topics such as market failures and economic theory of taxation, which are essential to an economic approach to Tax Law. The core of the work lies in the application of Law and Economics instruments in the study of taxation, analyzing the effects of tax rules on the economic system. Accordingly, the dissertation examines the fundamental assumptions that make up the Economic Analysis of Law (as the concept of economic efficiency and its relation to equity), relating them to the tax phenomenon. Due to the nature of the Brazilian legal system, any worth investigation or approach, including Law and Economics, could not pass off the Constitution. Thus, the constitutional rules will serve as a limit and a prerequisite for the application of Law and Economics on taxation, particularly the rules related to property rights, freedom, equality and legal certainty. The relationship between taxation and market failures receives prominent role, particularly due to its importance to the Law and Economics, as well as to the role that taxation plays in the correction of these failures. In addition to performing a review of taxation under the approach of Economic Analysis of Law, the research also investigates the reality of Brazilian tax system, applying the concepts developed in relevant cases and issues to the national scene, such as the relationship between taxation and development, the compliance costs of taxation, the tax evasion and the tax enforcement procedure. Given the above, it is intended to lay the groundwork for a general theory of Economic Analysis of Tax Law, contextualizing it with the Brazilian tax system

A missão política do Supremo Tribunal Federal: análise de sua importância como corte constitucional para o controle do poder no Brasil

The following study proposes an analysis of the politic process which the brazilian constitutional justice faces, emphasizing the Supremo Tribunal Federal . For that purpose, we start by examining the intimate relationship between Politics and Law, in view of the most recent social systems theories, so that the political system is distinguished by the exclusiveness of using the physical force, intending to make coletive tying decisions, and the juridical system as a congruent generalization of the expectations towards the rules and principles, brought together under an interdependence by which both gather legitimacy and effectiveness. In this manner we can notice the political effects of the constitutional interpretation conducted by Judges as well as by other juridical professionals, because these ones decrease the overload of expectations which are pointed to the Judicature. Constitutional interpretation is democratized since the participative democracy arises and stablishes a permanent state of awareness around the exercise of power and favours the preservation of the pluralism (counter-majoritary principle) where we can find the origin of the democratic nature of constitutional courts, once, in most cases, their members are not elected by the people. After that, we analyse the historical posture of the Supremo Tribunal Federal as a constitutional court in Brazil, so we can realize the attempts to make it vulnerable to the appeals of governability and economical aims, agains which this court somehow has resisted, stressing its particularities. At the end, it s concluded that even the so-called acts of government, whose judiciary control is mostly repelled, are subjected to a constitutional analysis, last frontier to be explored by the Supremo Tribunal Federal in its role of exposing our republican Constitution

A eficiência do gasto e da qualidade da saúde pública: uma análise nos municípios do estado do Rio Grande do Norte (2004 e 2008)

The overall objective of this study is to analyze the efficiency in the use of resources and the quality of public health in the municipalities of Rio Grande do Norte, from 2004 to 2008. It also seeks to identify the determinants of municipal inefficiency and measure the productivity of public spending on health. To this end, three methods of analysis are used: the DEA, the Malmquist index and the Tobit regression model. Among other findings, it appears that municipalities considered more inefficient in the measurement of expenditure on health make the largest expense in this function. On the other hand, from 2004 to 2008, only 13 municipalities showed an increase in the productivity of public spending. It is also noted that municipalities considered efficient in quality of health, although having more physical and human resources, offer fewer health services to the population. In all, the major determinants of health spending inefficiencies are the variables: age of the mayor, coalition, population density, literacy race and budget revenues. Regarding the inefficiency of the health quality, variables such as: coalition, literacy race have strong influence on this behavior. Thereby, the hypotheses proposed by the study have been fully accepted. In other words, for the efficiency of the quality and health spending it is needed more than resources, i.e., the expenditure shows itself as essential, but not enough, for political and economic aspects also interfere with the performance of spent and in the quality of health care offered to the population

Política de formação de professores: uma leitura a partir da análise do programa especial de formação de professores para a educação básica PROEB/UFMA

Study of Teacher Education Policy: a reading from the analysis of Programa Especial de Formação de Professores para a Educação Básica Proeb - aims to analyze the initial teacher training developed by the Universidade Federal do Maranhão - UFMA. Proeb is a policy of in-service training of teachers, formulated and implemented in the context of current educational policies for basic education. This work assumes that the guidelines developed in the last decades of the twentieth century are linked to international organizations that spread in Latin America continent a homogeneous model of training which has as main features to be held in service through the mode the distance and the school as a leading locus. In Brazil, these guidelines are supported on the Law of Directives and Bases of National Education No. 9.394/96 and Report 09/2001, which deals with the Syllabus Guidelines for the formation of Basic Education Teachers. To carry out the study was taken as reference, the syllabus developed for the deployment of Proeb from 1998 to 2002, specifically the proposal operationalized in the Degree Course of Mathematics in the city of Vitória do Mearim in Maranhão. To conduct the study, it was used literature as a way to deepen understanding, clarify and aim the conceptual aspect of the object researched. The documental research was consisted in the analysis of legal documents concerning the reform of education policies, teacher training and pedagogical project Proeb/UFMA and, finally, the semi-structured interviews were used to allow a better understanding of the subjects involved with research. The data analysis has shown that the curriculum designed to operationalize the course of undergraduate mathematics Proeb/UFMA, despite having guidelines that point to the separation of theory/practice dichotomy and establish as a principle work as an educational principle, has an disciplinary curriculum organization that reinforces the instrumental view of the syllabus, not enabling in practice, the execution of their initial proposal. Concerning to the view of graduates on the course, they highlight the weaknesses of the course, but also evidence that it has allowed an improvement of initial training, through the disciplines of the common core syllabus of courses and special training. It is possible seeing in graduates words, that the course have had repercussions in their teaching and improving their integration into the labor market and in the community of Vitória do Mearim. Overall, these developments have indicated evidence of teacher professionalization, although they are incipient. The work has shown that for the professionalization of teachers is introduced, the syllabus of undergraduate teacher education must overcome the traditional view of syllabus and implement contextualized curricula in a multidisciplinary approach involving, in equal proportions, the general education and training specific course. Accordingly, it is believed in need to review the role of the University in the formative process, as well as recovering as part of educational policies, the omnilateral size of teacher education

A banalização da injustiça social no cotidiano de trabalho : a propósito da violência no trabalho e ameaça à saúde do trabalhador

Analyzes the factors that unleash violence by banalization of the problems and health questions of workers in a federal public institution, in Natal/RN. It analyzes transformations in the world of the work, with its politic, social and economic determinatives and its relation to the worker health. Boarding the violence in the work enviroment and its implications to the worker health, focusing on the banalization of problems faced by the workers as a kind of violence in and with the work. It was chosen an analitic methodology with qualitative approach, through the collection tecnic and information analyzes according to the thematic oral history, with recorders of authorized personal narratives, through individual interview with a semi-structured guide. In the analyzis of results it were made empiric cathegories: the daily work enviroment and its influence to the worker profession and life; the violence presents in the work enviroment and its consequences to the worker life and health; the banalization of the social injustice, due to violence against the worker that broked their dreams concerned to the nursing contribution. The results revealed the ordinary work of these workers showing enviromental and organizational unhealthy conditions, caracterized by physical and tecnical insecurity; absence and disqualification of instrumental and human supplies; overload and complexity service; bad distribution of the duties and pressure to the deadline and productivity, producing tension, conflict and anxiety related to the users, colleagues, superiors and to the duties. In the work enviroment, it were identified a external violence, caracterized by physical and verbal aggresion, psychic suffering, worker depreciation; and internal, caracterized by: moral and psychological molestations and accupational structural violence. These kinds of violence bring consequences to the life, that is, professional, economic and moral order of factors and to the health by biological, mental and emocional factors. The banalization of social injustice during the daily work was discussed in the aspects of banalization of problems and work conditions, the health, qualification banalizations and professional valorization. The workers expectatives pointed out to the necessity of: secure conditions of work; trainning and tecnical assistance; politics of attention to the physical, mental and social health to the workers and their family. We conclude the enviromental and organizational conditions of the workers interviewed do not offer physical and tecnical security that they need to the execution of their activities, neither offer comfort or physical and psychological satisfactions. The politic the instituition has used points out to the depreciation and inhumanization of them producing feelings as unsatisfaction, frustation and indignation related to the institution and the work, bringing suffering and physical and mental sicking. We noticed the most terrible violence found in the work enviroment is the banalization of social injustice related do the problems and health of these workers, producing a slowly debility and simbolic death of their lifes. Therefore, it is necessary the implementation of a politic that promotes assurance, health and integral education, valorization and humanization of these workers

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