Maria Fátima de Sousa

Programa Saúde da Família no Brasil: uma agenda incompleta?

Este artigo trata de uma analise longitudinal da experiencia brasileira com o Programa Saude da Familia (PSF), ao longo dos doze anos da sua implantacao e implementacao. Toma como ponto de partida o proposito fundamental desta estrategia, que e a reorganizacao da atencao basica de saude, contextualizando a luz da experiencia que e unica e peculiar ao Sistema Unico de Saude (SUS). Evidencia os avancos e desafios do PSF, apontando nesse sentido as necessidades mais urgentes em termos de incorporacao tecnologica, formacao da forca de trabalho, estabelecimento de novos mecanismos e pactos em torno do financiamento da atencao basica e encaminhamento de novas estrategias e tecnologias nos processos de monitoramento e avaliacao. Finaliza apontando elementos para subsidiar um debate sobre as questoes em pauta, o qual deve ser permanente e lucido na perspectiva da construcao do SUS e do direito a saude.

O Programa Saúde da Família no Brasil: análise do acesso à atenção básica

This article shows a research about the implantation of the Family Helath Program, carried through 12 pioneer cities, related to the access to the basic health services. It was based in the context of social sciences, in the method of the hermeneutics-dialectics. Scripts of interview and focal groups for data collection were used. The study highlights regarding to the primary care accessibility to health sercives, that the PSF has contributed on the reduction of inequalities. However, it faces a sort of social, political, institutional, economic and cultural challenges, that are materialized in the deficiencies of coordination, management, financing, and mainly in medical practical assistance, strongly present in the daily professional practice of the PSFs teams.This article shows a research about the implantation of the Family Helath Program, carried through 12 pioneer cities, related to the access to the basic health services. It was based in the context of social sciences, in the method of the hermeneutics-dialectics. Scripts of interview and focal groups for data collection were used. The study highlights regarding to the primary care accessibility to health sercives, that the PSF has contributed on the reduction of inequalities. However, it faces a sort of social, political, institutional, economic and cultural challenges, that are materialized in the deficiencies of coordination, management, financing, and mainly in medical practical assistance, strongly present in the daily professional practice of the PSFs teams.

A enfermagem reconstruindo sua prática: mais que uma conquista no PSF

o processo de construção do Sistema Único de Saúde, regulamentado pela Constitu ição de 1 988, ao ser desenvolvido sobre os p i lares da u n i ve rs a l i zação , d a descen t ra l i zação e da integral idade da assistência, v isa reduzir o h iato ainda existente entre os d i reitos sociais garantidos em lei e a capacidade efetiva de oferta dos serviços públ icos de saúde à população bras i le i ra . O modelo assistencial a inda predominante Maria Fátima de Sousa2

Como o Brasil tem enfrentado o tema provimento de médicos

Analisa-se como o Brasil tem enfrentadoa carencia de medicos nas tentativa desuperar a situacao de forma articuladacom as politicas de saude e estrategias deformacao e fixacao desses profissionais,de acordo com as necessidades doSistema Unico de Saude (SUS). Tomou-secomo estudo de caso o Programa deValorizacao da Atencao Basica (PROVAB)criado pelo governo federal em 2011,que busca prover profissionais de saudepara as localidades necessitadas,destacando-se as seguintes ofertas doprograma: pontuacao de 10% nas provasde residencia apos avaliacao doprofissional e atividades estruturadas deeducacao a distância e supervisao. OPROVAB foi analisado dentro docontexto atual da politica de Gestao doTrabalho e da Educacao na Saude, natentativa de compreender suaimplementacao mediante discursos,movimentos, acontecimentos e dadosqualitativos e quantitativos,disponibilizados pelo Ministerio daSaude.Dessa forma, apontam-secaminhos para o desenvolvimento daGestao do Trabalho e da Educacao naSaude no Brasil.Palavras-chave: PROVAB. Atencao Basicaa Saude. Educacao medica. Praticaprofissional. Educacao permanente.The aim was to analyze how Brazil hasdealt with the shortage of physicians andthe attempts to overcome the situation incoordination with healthcare policies andstrategies for training and establishmentof these professionals in accordance withthe needs of the Brazilian National HealthSystem (SUS). PROVAB (Program forPrimary Care Enhancement), created bythe federal government in 2011, wasused as a case study. This seeks toprovide healthcare professionals tolocalities in need. The program offers ascore of 10% in residency examinationsafter evaluation of the professional andstructured distance education activitiesand supervision. PROVAB was analyzedwithin the current context of the workmanagement and healthcare educationpolicies, in order to comprehend itsimplementation through discussions,movements, events and qualitative-quantitative data available from theMinistry of Health. Ways to develop workmanagement and healthcare education inBrazil are indicated.Keywords: PROVAB. Primary health care.Medical education. Professional practice.Continuing education.Se analiza como ha enfrentado Brasil la carencia de medicos y los intentos de superar la situacion de forma articulada con las politicas de salud y estrategias de formacion y fijacion de esos profesionales, de acuerdo con las necesidades del Sistema Unico de Salud (SUS). Se considero como estudio de caso el PROVAB (Programa de Valorizacion de la Atencion Basica) creado por el Gobierno Federal en 2011, cuyo objetivo es proporcionar profesionales de salud a las localidades que los necesitan, destacandose las siguientes ofertas del programa: puntuacion del 10% en los examenes de practicas despues de evaluacion del profesional y actividades estructuradas de educacion a distancia y supervision. El PROVAB se analizo dentro del contexto actual de la politica de Gestion del Trabajo y de la Educacion en la Salud, buscando entender su implementacion mediante discursos, movimientos, acontecimientos y datos cualitativos y cuantitativos puestos a disposicion por el Ministerio de la Salud. Se senalan caminos para el desarrollo de la gestion del Trabajo y de la Educacion en la Salud en Brasil.1 Doutoranda, Universidade de Brasília (UnB). Faculdade de Ciências da Saúde, Campus Universitário Darcy Ribeiro. Brasília, DF, Brasil. 70910-900. monicarvalho19@ gmail.com 2 Departamento de Saúde Coletiva, UnB. Analisa-se como o Brasil tem enfrentado a carência de médicos nas tentativa de superar a situação de forma articulada com as políticas de saúde e estratégias de formação e fixação desses profissionais, de acordo com as necessidades do Sistema Único de Saúde (SUS). Tomou-se como estudo de caso o Programa de Valorização da Atenção Básica (PROVAB) criado pelo governo federal em 2011, que busca prover profissionais de saúde para as localidades necessitadas, destacando-se as seguintes ofertas do programa: pontuação de 10% nas provas de residência após avaliação do profissional e atividades estruturadas de educação a distância e supervisão. O PROVAB foi analisado dentro do contexto atual da política de Gestão do Trabalho e da Educação na Saúde, na tentativa de compreender sua implementação mediante discursos, movimentos, acontecimentos e dados qualitativos e quantitativos, disponibilizados pelo Ministério da Saúde.Dessa forma, apontam-se caminhos para o desenvolvimento da Gestão do Trabalho e da Educação na Saúde no Brasil.

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

Quais são os desafios para a qualificação da Atenção Básica na visão dos gestores municipais

Nos ultimos anos, a Atencao Basica proporcionou muitos avancos na saude da populacao, porem, muitos desafios ainda persistem. Este trabalho busca analisar os principais desafios da Atencao Basica na visao dos gestores municipais de saude, identificando e analisando descritivamente os cinco mais frequentes nos âmbitos nacional, regional e por estrato de municipios. Realizou-se uma abordagem quantitativa com analise de dados secundarios da Atencao Basica a saude, oriundos das bases de dados do Ministerio da Saude (MS). Observou-se que muitos desafios sao recorrentes e outros evidenciados em alguma regiao ou estrato, sugerindo sua dimensao no contexto local.

Práticas de longitudinalidade no âmbito da Estratégia Saúde da Família no Distrito Federal

This article aims to know the health practices oriented to the longitudinality referred by local professionals and managers of Family Health teams from the Distrito Federal, Brazil, analyzing them in relation to its dimensions. This is a case study in which individual interviews and focus group were conducted with subjects from the research, and then it was performed analysis of the Collective Subject Discourse. It was observed that the dimensions Regular source of care and Interpersonal relationship are present in the discourse of the subjects, showing the mechanisms adopted to ensure continuity of care. However, the teams should expand the field in developing their work processes in order to effectively build health practices as social practices, beyond the limits of programmatic activities and individualized for recognizing and acting on social determinants of health. It was not possible to observe the dimension of Informational continuity.

Green, healthy environments: training of community health agents in the city of São Paulo, Brazil

The aim of this article is to describe the training of community health agents (ACSs) in the context of an intersectorial initiative (Green, Healthy Environments Project: Building Integrated Public Policies in the City of São Paulo). The initiative was developed by four city departments--Environment, Health, Social Support and Development, and Education--in collaboration with the citys 31 superintendencies and five regional health administrations. In addition to these municipal bodies, a network of partners was established, including institutions involved in multilateral international technical cooperation and academic institutions. The training of ACSs and social support agents, and the development of community programs that take into account local potential and characteristics was the main objective of the network. The locally integrated management for the development of an agenda of protection and promotion of green, healthy environments was carried out inside the previously existing networks operating in the territories close to public primary care health units serving populations covered by the Family Health Strategy. There currently are 705 programs created by the Green, Healthy Environments Project. These programs serve as evidence of the positive results obtained locally through intersectorial management efforts.

Educação permanente em alimentação e nutrição na Estratégia Saúde da Família: encontros e desencontros em municípios brasileiros de grande porte

This study sought to ascertain the facilitating and inhibiting factors and strategies used by 28 major Brazilian cities in conducting ongoing food and nutrition education within the Family Health Strategy. It involved a qualitative study of multiple cases. The data collection technique was conducted in interviews with municipal coordinators of food and nutrition campaigns from the five regions of the country. The study was conducted between 2009 and 2010. NVivo 10 software was used and content analysis was divided up into thematic categories. Forty-four professionals were interviewed, 19 of which were nutritionists. Most cities were from the Northeast and Southeast; 14 were capitals, 7 were metropolises and 14 had Family Health Suppor Units. The most frequently mentioned facilitating factors for Ongoing Education in Nutrition were partnerships and the availability of funds. The most frequent inhibiting factors were difficulty in scheduling and a lack of professionals in management of nutrition actions. The strategies most commonly used were conducting training at the local level, in groups and planning and programming. The conclusion drawn is that more investment is needed for Ongoing Education in Feeding and Nutrition to be effectively implemented.This study sought to ascertain the facilitating and inhibiting factors and strategies used by 28 major Brazilian cities in conducting ongoing food and nutrition education within the Family Health Strategy. It involved a qualitative study of multiple cases. The data collection technique was conducted in interviews with municipal coordinators of food and nutrition campaigns from the five regions of the country. The study was conducted between 2009 and 2010. NVivo 10 software was used and content analysis was divided up into thematic categories. Forty-four professionals were interviewed, 19 of which were nutritionists. Most cities were from the Northeast and Southeast; 14 were capitals, 7 were metropolises and 14 had Family Health Suppor Units. The most frequently mentioned facilitating factors for Ongoing Education in Nutrition were partnerships and the availability of funds. The most frequent inhibiting factors were difficulty in scheduling and a lack of professionals in management of nutrition actions. The strategies most commonly used were conducting training at the local level, in groups and planning and programming. The conclusion drawn is that more investment is needed for Ongoing Education in Feeding and Nutrition to be effectively implemented.

Percurso do idoso em redes de atenção à saúde: um elo a ser construído

We aimed to understand the continuity of care provided to the elderly in health care networks in Fortaleza-CE, Brazil. This is a descriptive qualitative study that used focus groups, semi-structured interviews and discourse of the collective subject for data collection and organization. In Family Health Care Network, we observed deficits in infrastructure and professionals. In Specialized Care, we verified repressed demand due the shortages in specialized services. In Hospital, the flow of information is deficient. In Urgency and Emergency, the mobile service prioritizes the removal and in the hospital the care according to severity. The close relationship between the Mental Health and Family Health Networks contributes to the effective continuity of care. We conclude that the care for the elderly in the network is fragile and discontinued, and impairs the consolidation of integral care.