Ana Valéria Machado Mendonça

Percepção dos usuários e profissionais de saúde no Distrito Federal: os atributos da atenção primária

ABSTRACT The present article analyses the attributes of Primary Health Care in two regions of the Federal District, focusing on integral care to child. It compares them from users and pro-fessionals of Traditional Basic Units and Family Health Strategy. The method used was qua-li-quantitative. Data were collected by means of survey, through the PCATool-Brazil, proposed to professionals and users. Participants pointed out dissatisfaction with the care to the inte-gral health of the child in the two regions. Access, longitudinality, entirety and coordination are limited in theory and practice of the professionals, in the two models of attention. Both demand deepening the organizational processes of the integral health of the child . EORDS Primary Health Care; Family Health Strategy; Integrality in health . SAUDE DEBATE | rio de Janeiro, v. 39, n. 105, p.387-399, aBr-JUn 2015 387 Perceo dos usurios e rofissionais de sade no Distrito ederal: os atriutos da ateno riria perception of users and health professionals in the Federal district: the attributes of primar care

Alimentação e nutrição na Estratégia Saúde da Família em cinco municípios brasileiros

This work is part of a national study seeking to understand the difficulties and the potential for overcoming the challenges faced in the quest to improve food and nutrition campaigns developed under the aegis of the Family Health Strategy. It is examined from the standpoint of professional teams of the Family Health Strategy and Family Health Support Centers of five major Brazilian cities. A qualitative approach was used to design a multiple case approach and the technique of focus groups was conducted to collect data. The instrument used was a semi-structured pre-tested and validated script with two leading questions. The Collective Subject Discourse technique was used for data analysis, based on which the synthesized discourses were created using the Qualiquantisoft program. Sixty health professionals from various training areas were interviewed, including dietitians, nurses and physicians. The results showed that the difficulties encountered for the provision of food and nutrition campaigns and the lack of professionals in this area have hampered compliance with the principles of comprehensiveness, universality and resolubility of health care.This work is part of a national study seeking to understand the difficulties and the potential for overcoming the challenges faced in the quest to improve food and nutrition campaigns developed under the aegis of the Family Health Strategy. It is examined from the standpoint of professional teams of the Family Health Strategy and Family Health Support Centers of five major Brazilian cities. A qualitative approach was used to design a multiple case approach and the technique of focus groups was conducted to collect data. The instrument used was a semi-structured pre-tested and validated script with two leading questions. The Collective Subject Discourse technique was used for data analysis, based on which the synthesized discourses were created using the Qualiquantisoft program. Sixty health professionals from various training areas were interviewed, including dietitians, nurses and physicians. The results showed that the difficulties encountered for the provision of food and nutrition campaigns and the lack of professionals in this area have hampered compliance with the principles of comprehensiveness, universality and resolubility of health care.

Promoção da saúde da mulher brasileira e a alimentação saudável: vozes e discursos evidenciados pela Folha de SP

The study identifies the discourse and opinions about women’s health in relation to their eating habits by means of qualitative research using the journalistic discourse analysis method of the Folha de Sao Paulo newspaper. Based on the selection of texts on health, women’s health and nutrition published throughout the year 2013, the sample resulted in seven journalistic texts, in which voices from the scientific universe related to research, quotes from journals, scientific associations and the opinion of health professionals and researchers were predominantly identified. However, the discourse of women in general about their health rarely appears in the sample analyzed. The main topics were related to health risks and the connection with diet or supplements, as well as pregnancy. The predominant content discourse related to health risk and its relationship with eating habits, nutrition or supplements, as well as pregnancy and/or the manner of delivery; health as a commodity associated with products or procedures, such as diets, dietary supplements, drugs and bariatric surgery, with no room for the promotion of health and healthy eating.The study identifies the discourse and opinions about womens health in relation to their eating habits by means of qualitative research using the journalistic discourse analysis method of the Folha de São Paulo newspaper. Based on the selection of texts on health, womens health and nutrition published throughout the year 2013, the sample resulted in seven journalistic texts, in which voices from the scientific universe related to research, quotes from journals, scientific associations and the opinion of health professionals and researchers were predominantly identified. However, the discourse of women in general about their health rarely appears in the sample analyzed. The main topics were related to health risks and the connection with diet or supplements, as well as pregnancy. The predominant content discourse related to health risk and its relationship with eating habits, nutrition or supplements, as well as pregnancy and/or the manner of delivery; health as a commodity associated with products or procedures, such as diets, dietary supplements, drugs and bariatric surgery, with no room for the promotion of health and healthy eating.

Programa Mais Médicos: panorama da produção científica

Despite the progress achieved by the Primary Health Care and Family Health Strategy in the Unified Health System (SUS) challenges still remain with regard to the universality of access and the quality of services, one of the factors being the unequal distribution of physicians. The Brazilian Government established the Mais Medicos Program (More Doctors Program), in order to move forward in the provision, placement and training of physicians in the SUS. This study consists of a review of the literature of the Mais Medicos Program, in order to map and assess the scientific production on the Program, as well as summarize the findings and present the results of the analysis. Fifty-four publications were selected, which evaluate the Program in terms of effectiveness, analysis of the implementation process, the media and the statements of the actors and assessment of the legal and constitutional precepts. The criticisms and limitations found were also systematically analyzed. With respect to the analysis, evaluations of the Program are overwhelmingly positive, showing important changes in the work processes in services and training. The studies that show the Program as being an important instrument for the effective implementation of the right to health are highlighted.Despite the progress achieved by the Primary Health Care and Family Health Strategy in the Unified Health System (SUS) challenges still remain with regard to the universality of access and the quality of services, one of the factors being the unequal distribution of physicians. The Brazilian Government established the Mais Médicos Program (More Doctors Program), in order to move forward in the provision, placement and training of physicians in the SUS. This study consists of a review of the literature of the Mais Médicos Program, in order to map and assess the scientific production on the Program, as well as summarize the findings and present the results of the analysis. Fifty-four publications were selected, which evaluate the Program in terms of effectiveness, analysis of the implementation process, the media and the statements of the actors and assessment of the legal and constitutional precepts. The criticisms and limitations found were also systematically analyzed. With respect to the analysis, evaluations of the Program are overwhelmingly positive, showing important changes in the work processes in services and training. The studies that show the Program as being an important instrument for the effective implementation of the right to health are highlighted.

Discourses in health public hearing and their impact on the decisions of the supreme court: an analysis to the theory of social systems

O fenomeno social denominado judicializacao da saude levou o Supremo Tribunal Federal (STF) a convocar uma audiencia publica, em 2009. A oitiva da sociedade, em seus diferentes segmentos, deveria prover os julgadores de embasamento para suas decisoes. Os discursos proferidos no evento foram investigados, com o intuito de responder se a Audiencia Publica da Saude apresentou argumentos que foram incorporados pelo STF em sede de suas decisoes, de modo a denotar alteracoes no subsistema judicial. A pesquisa foi realizada por meio da base de dados do STF, disponivel na internet. Foi utilizado o metodo da Analise de Discurso e matrizes comparativas de decisoes judiciais. Os resultados concluiram que a audiencia se revelou estrategica e que os discursos apresentaram teses distintas conforme os segmentos participantes, demonstrando que o direito a saude nao apresenta significado hegemonico na sociedade. Conclui-se que os dois subsistemas sociais - saude e direito - tiveram oportunidade de mutua aprendizagem. O subsistema juridico incorporou, nas decisoes analisadas, 20% dos argumentos apresentados na Audiencia Publica da Saude.

Informação, educação e comunicação em saúde: análise das concepções dos coordenadores das campanhas de voz no distrito federal

ABSTRACT Purpose: to understand and discuss the conceptions of information, education and health communication (IEC) of speech therapists who coordinated and developed the Voice Campaigns in Brasilia, in the years 2009 and 2010. Methods: the study used a qualitative approach in which semi-structured questions were used to collect data. The data analysis followed the steps of content analysis and the discussion was based on information, education and health communication theories. Results: it showed that, health Information is seen only as the description of the vocal tract functions and not as data that could be helpful triggers for planning and implementing effective action for the Voice campaigns; the Health Education is seen as a transference of information and not as a collective process with regards to the needed care for vocal and well-being; and Communication in health is limited to press media and not as a strategy for construction of a communication based on the population’s knowledge about the subject.

Digital Inclusion of Health Workers in Goiás State: An Account of an Educational Initiative

This chapter provides an account of the Community Health Workers’ Digital Inclusion Project concerning the knowledge management and capacity building in their skills and attitudes for preventing, caring, and promoting health of individuals, families, and communities. Distance learning was the pedagogical-didactic approach adopted for the training of these health workers, building on the technological setting using the Moodle online platform. Results achieved so far suggest that participants are still alien to the universe of information and communication technologies, despite their mid-level of schooling and the scope of digital inclusion in Brazil. Transforming these workers into managers of information they acquire or generate is to promote social justice through technological inclusion as well as improve the quality of work they provide focused on improving population health. Initiatives like this one directly influence access to information and consequently assistance to users of the public health system in their areas. Participants’ feedback recognized the merits of the ongoing project. Strategies of this nature should be adopted by municipal health managers especially given Brazil’s complex economic, political, and sociocultural characteristics.

A integralidade no Brasil e na Venezuela: similaridades e complementaridades.

This study aims to compare Primary Health Care (PHC) in Brazil and Venezuela, considering its characteristics as to integrality. It has a qualitative approach, using documental analysis, semi-structured interviews with key informants and field diary notes. We observed the three realms of integrality inherent to the health work process: comprehensive and holistic care, the individual viewed as a complex being with multiple needs, requiring the connection of various health knowledge; continuity of care in institutional micro-policy with interprofessional articulation, in order to consider individual care; continuity of care in macro-policy, when a shift to other levels of care is needed; intersectoriality was also included, when the needs of an individual and community require a cross-sectoral coordination, with action on determinants and conditionants of the health-disease process. It is worth highlighting the natural tendency to include a comprehensive community medical training. We conclude that those countries strengthened by democracy draw their integrality practices closer, as well as the construction of social and health policies for underprivileged populations to achieve equity.

O pensamento dos gestores municipais sobre a ouvidoria como um potencial instrumento de gestão participativa do SUS

The study, of qualitative approach, aimed, from the discourse of municipal health managers, to identify potential for the community participation in the management of the Brazilian Unified Health System (SUS), as well as understand how these managers use the ombudsman for decision-making. Were interviewed 12 managers, from four regions of the Country, with subsequents transcription and speech analysis. Understanding participation as constitutional right, the ombudsmen of the SUS have key role in the management, because they stimulate the individual participation of the user and, in counterpart, enable the manager to know the opinion of the population regarding the actions and health services offered in the municipality.

Agents communautaires de santé : un modèle de santé sans murs

The aim of this commentary is to respond to a published Canadian Journal of Public Health article on Brazils family health strategy, in order to clarify some aspects - in particular, the work of community health workers - that make the strategy a unique experience. In the same vein, the authors explore the similarities, differences and peculiarities between Brazil and Québec with regard to the organizational model for primary health care.