Cátia Martins de Oliveira

Implementing health surveillance at the primary care level.

This paper discusses the possibilities of re-orienting work processes at the primary care level in the light of the concepts and pre-suppositions of the health surveillance system. In addition, it presents some key concepts that could help putting into operation a health surveillance system at the local level. One of these concepts is the idea of the territory as a privileged space of primary care, helping to define and identify health needs. The study further emphasizes the heuristic value of integrating knowledge and practices in the various fields of health care so as to ensure a broader vision of problems and comprehensive health care. Finally, it analyzes the contributions from epidemiological, environmental, and health surveillance for consolidating health surveillance into a system not only limited to these three areas of action. Integrated actions of epidemiological, sanitary, and environmental surveillance can favor risk management and allow for innovative and more effective answers to the demands emerging from the health area. In addition, the local teams can acquire practical experience in internal and inter-sectorial actions which, though their importance is recognized in theory, were rarely put into practice.

Sistema de Vigilância em Saúde no Brasil: avanços e desafios

O objetivo deste artigo e refletir sobre o percurso politico e organizacional do Sistema de Vigilância em Saude no Brasil. Trata-se de um estudo exploratorio e descritivo, realizado por meio de uma revisao narrativa em bases de dominio publico, no periodo compreendido entre 1998 e 2013. Os autores apresentam uma breve trajetoria do campo das vigilâncias epidemiologica, ambiental e sanitaria em direcao a um sistema mais integrado e resolutivo. Por fim, faz-se um debate acerca dos avancos e dos desafios de articulacao das propostas de mudanca organizacional e da integracao de praticas em busca de respostas mais efetivas no âmbito da Vigilância em Saude.

Avaliação das práticas de promoção da saúde: um olhar das equipes participantes do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica

As praticas de Promocao da Saude das equipes de Atencao Basica no Brasil e macrorregioes foram analisadas a partir do PMAQ-AB (2012). Foram estudadas as frequencias de variaveis nos eixos: Reorientacao de Servicos; Acoes Comunitarias; Ambientes Saudaveis; Habilidades Pessoais (n=17.202 equipes). A abordagem territorial restringe-se aos aspectos geograficos; reconhece-se a vulnerabilidade de beneficiarios do Bolsa Familia; na escola ha predominio das acoes clinicas (saude bucal); educacao para sexualidade/reproducao; informacoes do ambiente foram restritas. Conclui-se que as praticas sao fragmentadas e focalizadas; urge integrar, equilibradamente, cuidado clinico, prevencao e promocao da saude.The Health Promotion practices of the basic attention teams in Brazil and macro-regions were analyzed from the PMAQ-AB (2012). The variable frequency axes were studied: Services Reorientation; Community Actions; Healthy Environments; Personal Skills (n = 17,202 teams). The territorial approach is restricted to geographic aspects; the vulnerability of the “Bolsa Familia Program” beneficiaries; there is a predominance of clinical actions at school (buccal health); sexuality/reproduction education; environmental information were restricted. It is concluded that the practices are still fragmented and focused; an even integration of clinical care, prevention and health promotion shall be urged.

Estudo avaliativo do processo de trabalho das Equipes de Atenção Básica a partir do PMAQ-AB

O estudo objetivou analisar a organizacao do processo de trabalho das Equipes de Atencao Basica das regioes de saude do estado do Rio de Janeiro, a partir dos resultados do primeiro ciclo da Avaliacao Externa do PMAQ-AB. Foram consideradas para analise quatro subdimensoes do modulo II, cotejadas com as caracteristicas do processo de trabalho da Politica Nacional de Atencao Basica. Observou-se que o processo de Avaliacao Externa estimulou o planejamento das acoes das equipes, contudo ainda possuem entraves tanto para a gestao quanto para as equipes sobre o aproveitamento das informacoes em saude, a precariedade de recursos humanos e a institucionalizacao da avaliacao propriamente dita.

Evaluability of the Program to Value Primary Healthcare Professionals (PROVAB): management challenges

The objective of this article is to present the results of a study on the evaluability of the Program to Value Primary Healthcare Professionals (PROVAB in the Portuguese) that was created by the Brazilian Ministry of Health in 2011. The Program is part of the Manage Healthcare Work and Educationstrategy which seeks to invest in a number of measures aimed at improving and valuing the work carried out by primary healthcare teams. The research, which used qualitative methods, was carried out between February and November 2013 and involved five stages: (a) analysis of documents; (b) identification of potential users; (c) strategic analysis; (d) modelling of the intervention; (e) sharing of lessons learned. Data collection took place in three iterative phases: document analysis, key informant interviews and a workshop. The activities of the program were grouped into three areas: functional and working conditions, teaching/learning and management. The results showed that the program can be evaluated, since it was possible to specify its feasibility by means of a logical model. The potential and priority areas were mapped for future evaluations, whose central focus is to address the problem of unequal distribution of Brazilian health professionals.

Estudo de avaliabilidade do Programa Academia Carioca da Saúde: desafios para a promoção da saúde

ABSTRACT This article aims to present the results of the evaluability study of the Carioca Health Academy Program in order to expand the comprehension about the intervention and to maxi-mize the utility of the evaluation. The study was divided into the following steps: documental analyses, interviews with key informants, intervention modeling and elaboration of the evalua-tive questions. The construction of the Logic Model allowed to describe the dimensions and com -ponents of the program, the strategic actions and expected results with emphasis on the regular access to body practices and physical activities, on the health promotion groups and on the stren -gthening of community participation. ERDS Program evaluation; Health promotion; Health programs and plans. SAUDE DEBATE | rio de Janeiro, v. 39, n. 105, p.375-386, aBr-JUn 2015 375 Estudo de avaliailidade do rograma Academia Carioca da Sade desafios para a promocao da sade evaluabilit stud o the Carioca ealth academ proram: challenes or health promotion

Avaliação das práticas de promoção da saúde: um olhar das equipes participantes do Programa de Melhoria do Acesso e Qualidade da Atenção Básica – PMAQ-AB

As praticas de Promocao da Saude das equipes de Atencao Basica no Brasil e macrorregioes foram analisadas a partir do PMAQ-AB (2012). Foram estudadas as frequencias de variaveis nos eixos: Reorientacao de Servicos; Acoes Comunitarias; Ambientes Saudaveis; Habilidades Pessoais (n=17.202 equipes). A abordagem territorial restringe-se aos aspectos geograficos; reconhece-se a vulnerabilidade de beneficiarios do Bolsa Familia; na escola ha predominio das acoes clinicas (saude bucal); educacao para sexualidade/reproducao; informacoes do ambiente foram restritas. Conclui-se que as praticas sao fragmentadas e focalizadas; urge integrar, equilibradamente, cuidado clinico, prevencao e promocao da saude.The Health Promotion practices of the basic attention teams in Brazil and macro-regions were analyzed from the PMAQ-AB (2012). The variable frequency axes were studied: Services Reorientation; Community Actions; Healthy Environments; Personal Skills (n = 17,202 teams). The territorial approach is restricted to geographic aspects; the vulnerability of the “Bolsa Familia Program” beneficiaries; there is a predominance of clinical actions at school (buccal health); sexuality/reproduction education; environmental information were restricted. It is concluded that the practices are still fragmented and focused; an even integration of clinical care, prevention and health promotion shall be urged.

Evaluation of health promotion practices: a look from the participating teams of the National Program for Access and Quality Improvement in Primary Care

As praticas de Promocao da Saude das equipes de Atencao Basica no Brasil e macrorregioes foram analisadas a partir do PMAQ-AB (2012). Foram estudadas as frequencias de variaveis nos eixos: Reorientacao de Servicos; Acoes Comunitarias; Ambientes Saudaveis; Habilidades Pessoais (n=17.202 equipes). A abordagem territorial restringe-se aos aspectos geograficos; reconhece-se a vulnerabilidade de beneficiarios do Bolsa Familia; na escola ha predominio das acoes clinicas (saude bucal); educacao para sexualidade/reproducao; informacoes do ambiente foram restritas. Conclui-se que as praticas sao fragmentadas e focalizadas; urge integrar, equilibradamente, cuidado clinico, prevencao e promocao da saude.The Health Promotion practices of the basic attention teams in Brazil and macro-regions were analyzed from the PMAQ-AB (2012). The variable frequency axes were studied: Services Reorientation; Community Actions; Healthy Environments; Personal Skills (n = 17,202 teams). The territorial approach is restricted to geographic aspects; the vulnerability of the “Bolsa Familia Program” beneficiaries; there is a predominance of clinical actions at school (buccal health); sexuality/reproduction education; environmental information were restricted. It is concluded that the practices are still fragmented and focused; an even integration of clinical care, prevention and health promotion shall be urged.