Marcia Gomide

Rede social e desempenho de programas de saúde: uma proposta investigativa

Para alcancar a descentralizacao dos servicos de saude no Brasil, tem sido necessario um grande esforco. Este implica essencialmente a construcao de praticas inovadoras. Diversos pesquisadores tem enfrentado o desafio de produzir estudos para avaliar a implantacao dos programas de saude. Algumas pesquisas, em andamento atualmente, tem apontado as relacoes interpessoais como responsaveis importantes que explicam os diferentes desfechos. Pretende-se neste artigo desenvolver uma discussao sobre a importância das relacoes interpessoais na implementacao de programas de saude a partir do aporte da analise de redes sociais, propondo que as investigacoes voltadas a compreensao das flutuacoes de performances dos programas de saude incorporem tal perspectiva.

Agrotóxicos e saúde: realidade e desafios para mudança de práticas na agricultura

Este artigo apresenta os resultados de uma pesquisa que teve como objetivo principal caracterizar o contexto e as praticas relacionadas ao uso de agrotoxicos entre agricultores residentes na Serrinha do Mendanha, comunidade agricola situada em Campo Grande, municipio do Rio de Janeiro. A proposta metodologica teve uma abordagem qualitativa, sendo a principal fonte de dados a aplicacao de questionario semiestruturado. Participaram da pesquisa 38 agricultores familiares. O perfil socioeconomico mostra uma realidade de idosos no trabalho agricola, percentuais expressivos de analfabetismo e baixa renda. O uso de agrotoxicos e uma rotina para essas familias. Apesar de existir uma naturalizacao do uso, a maioria dos informantes acredita que agrotoxicos podem afetar sua saude, apresenta preocupacao com o consumidor e gostaria de conhecer formas alternativas de cultivo. Tais achados apontam para a possibilidade de busca de mudanca de praticas. Nao se trata de repasse de conhecimento, pois este tipo de informacao de alguma forma eles ja possuem. Trata-se de desenvolver estrategias objetivando a minimizacao dos riscos ou mesmo o desuso de agrotoxicos na lavoura.

Análise de Redes Sociais e práticas avaliativas: desafios à vista

The possibility of incorporating the Analysis of Social Networks (ASN) into health evaluation practices is discussed. As discursive basis, some propositions of evaluative practices were related to tangential matters from universe of the networks. Thus, we discuss with authors that support the incorporate the ASN into the process of health evaluation. From this dialectical approach, and analyzing a case study, we reflect on the possibility of such integration, concluding that there is huge object-methodological affinity between both practices.

Organização do serviço e análise de redes sociais: estudo de caso na Vigilância em Saúde Ambiental

Discute-se a relacao entre as redes sociais em ambientes de trabalho e sua influencia na organizacao do servico. Como cenario, investigou-se o contexto da Vigilância em Saude de Populacoes Expostas a Substâncias Quimicas (VIGISOLO), um subsistema da Vigilância em Saude Ambiental (VSA). Essa escolha visou aproveitar o momento propicio a incorporacao de ajustes pelo qual passa a VSA. Para a construcao das redes sociais, levantaram-se dados secundarios sobre o subsistema; realizaram-se observacoes da dinâmica de trabalho, entrevistas e questionarios on line. Os dados facultaram identificar as cadeias de relacoes entre os profissionais e construir os sociogramas representativos dessas ligacoes para as esferas federal, estadual e municipal de governo. A integracao dos sociogramas permitiu a construcao da rede coletiva. Esta, constituida por 25 atores, caracterizou-se por apresentar poucas ligacoes interpessoais dentre as possiveis, indicando ser uma rede de baixa densidade. Destacaram-se as ligacoes informais e em pequenos grupos, normalmente associadas a confianca entre os individuos. Essa caracteristica dificultou o repasse de informacoes, comprometendo alguns processos de trabalho. A possibilidade de identificar fragilidades na rotina operacional faz da Analise de Redes Sociais uma abordagem metodologica capaz de contribuir com o servico, prestando-se como ferramenta balizadora para a gestao.

Caminhos Virtuais e Autismo: acesso aos serviços de saúde na perspectiva da Análise de Redes Sociais

The prevalence of Autism Spectrum Disorder in the world population and in Brazil is increasing. The Internet has become an important source of information regarding access to health services, including mental health. It remains to be seen if the virtual paths in search of information are related to the outcomes of the line of care for mental disorders advocated by the SUS, such as Autism. Therefore, this article sets out to analyze the virtual network of access to information about care for Autism in the municipality of Rio de Janeiro in 2017 through the perspective of Social Network Analysis. In this regard, virtual data were collected, such as: virtual information sources; care services cited by the virtual sources and type of service (Public, Private or NGOs). Through the use of Gephi software, a sociogram was generated and analyzed. The results point to a predominance of NGO services in the network, greater centrality of degree and power of intermediation in NGO services, in addition to the isolation of public health services. The result implies that the information system about access to public health services for the treatment of ASD is expanded to the general population by contributing to improved access to these services.

Performance indicators and social networks: is there something in common?

Introduction: The aim of this study is to identify the relation between the performance of a Leprosy Control Program (LCP) and the social network, in a municipality of the brazilian north/northeast region. Method: The social network analysis methodology was used. The criteria for choosing the municipality were defined based on low performance of its LCP. The researchers visited the municipality to conduct observations, interviews and secondary data collection. The interviews began with the local coordinator of the program (LCP), the health secretary and two other coordinators. Further interviews were performed with the professionals cited by the “key-informants”, resulted by the use of the name generator technique. Sixteen interviews were conducted with professionals that work directly with the LCP, and it allowed the elaboration of six personal networks and three collective networks. From these, the scenario of the program in three stages were drew up, based on the social network structures: (I) problem identification, (II) statement of problem, and (III) restructuring. Results: It was found a “double-centrality”, what means that the general coordinator of the LCP and general coordinator of Epidemiologic Surveillance shared functions in the program, with very strong personal ties. Other relations were characterized as strong or weak and professional. Conclusion: It was identified a relation between the LCP performance and the different times of the social networks, which influenced the functionality of this.

O Programa Nacional de Controle do Tabagismo (PNCT) na perspectiva social: a análise de redes, capital e apoio social

In 1986, the Ministry of Health launched the National Program for Tobacco Control (NPTC) that aimed to prevent the early use of tobacco among children and adolescents, as well as encourage smoking cessation of those already dependent. Despite the continued decline in prevalence since then, there have been signs of recovery of these numbers. Since smoking is a sign of “social contamination” and is not infectious-biological, we sought to assess the NTCP actions towards these relapses. The assumptions taken from social networks analysis (SNA) theories and social capital in the context of social supported by fictitious examples are used to support the discussion. In conclusion, the NTCP investment on support networks and the individuals insertion in these, encouraging them to establish their own personal networks, are essential prerequisites to increase the social capital of the smokers and therefore preventing relapses.