Silvone Santa Bárbara da Silva Santos

Avaliação da capacidade de gestão descentralizada da vigilância epidemiológica no estado da Bahia

Evaluative research into the capability of decentralized management of epidemiological vigilance (EV) was conducted in the operational, organizational and sustainable dimensions in the state of Bahia, Brazil. The quantitative approach was used in the construction of a baseline, with primary data obtained through an online questionnaire answered by thirty-eight municipal EV managers. In the qualitative approach to analyze the context and assess the management capability of municipalities in two case studies, techniques adapted to the analysis of discursive practices were used. This was done through semi-structured interviews with managers of regional and municipal government, health workers and representatives of the municipal health council. The case studies showed that the municipality with enhanced management capability is that in which the manager has the greatest potential of using the resources of his position, in addition to his ability to control, negotiate and coordinate with other actors. Due to decentralization of EV, considering the shared nature of management between the three spheres of government, there is a marked variation in the management capability of municipalities, determined by social, economic, political inequalities and management mechanisms adopted.

Estudo de linha de base avaliativa sobre capacidade de gestão descentralizada da Vigilância Epidemiológica

Quantitative approach study with the aim of building an evaluative baseline of the management capacity of Epidemiological Surveillance in the state of Bahia, Brazil. The primary data were obtained through online questionnaire, and the secondary data through document analysis, being considered three dimensions of analysis: organizational, operational and sustainability of the results. It was concluded that the decentralized management of the Epidemiological Surveillance is unable to sustain the results obtained in relation to the health indicators of the population, being necessary the sharing of the decision-making process and a planning oriented by local priorities.

Representações da enfermeira e pessoa em sofrimento psíquico na mostra fotográfica USAnatomy de Steven KleinRepresentaciones de la enfermera y la persona en sufrimiento psíquico en exposición fotográfica USAnatomy de Steven Klein

Objectives To analyze the representations of the nurse and individual in mental suffering portrayed in the photographic work by Steven Klein, in the USAnatomy exhibit held at the Museum of Sculpture (Museu da escultura) in Sao Paulo, in 2011. Methods Qualitative study carried out in 2012. Three photographs were submitted to iconographic analysis. The interpretation of the findings was based on theoretical frameworks of Foucault and Bourdieu on power relations. Results The nurse is represented as a sensual, insensitive person, with the power to control and torture while the person in psychological distress is represented as dirty, imprisoned and subjected to an asymmetrical relationship of power with the nurse. Final considerations Relationships of submission and symbolic dominance, in which the person in psychological distress has their body molded by discipline imposed by the nurse. Stereotypes of the image of the nurse oppose the ideology of the profession, which is to ensure the integrity of those being cared for.Objectives To analyze the representations of the nurse and individual in mental suffering portrayed in the photographic work by Steven Klein, in the USAnatomy exhibit held at the Museum of Sculpture (Museu da escultura) in São Paulo, in 2011. Methods Qualitative study carried out in 2012. Three photographs were submitted to iconographic analysis. The interpretation of the findings was based on theoretical frameworks of Foucault and Bourdieu on power relations. Results The nurse is represented as a sensual, insensitive person, with the power to control and torture while the person in psychological distress is represented as dirty, imprisoned and subjected to an asymmetrical relationship of power with the nurse. Final considerations Relationships of submission and symbolic dominance, in which the person in psychological distress has their body molded by discipline imposed by the nurse. Stereotypes of the image of the nurse oppose the ideology of the profession, which is to ensure the integrity of those being cared for.

Contextual determinants of decentralization of epidemiological surveillance for the family health team

This study examines the contextual determinants of implementing decentralization of epidemiological surveillance for the family health team, in a municipality in the state of Bahia, Brazil. This was an evaluative study using the political model of implementation analysis. Data were obtained through document analysis and semi-structured interviews with managers and healthcare workers. Five themes emerged: planning; training of human resources; organization of the work process; linkage within institutions; and organization of family healthcare units. The results revealed that there are difficulties such as poor infrastructure of healthcare units, creation of flexibility in labor relations and healthcare worker turnover. The study shows that there is a need for stakeholder participation in the process of implementing the policy of decentralization of epidemiological surveillance for the micro-area of intervention that comprises the family health program.Este estudo analisa os determinantes contextuais da implantacao da descentralizacao da vigilância epidemiologica para a Equipe de Saude da Familia, em um municipio do estado da Bahia, Brasil. Trata-se de pesquisa avaliativa, adotando-se o modelo politico da analise de implantacao. Os dados foram obtidos mediante a analise de documentos e entrevistas semiestruturadas aplicadas a gestores e trabalhadores da saude. Emergiram cinco temas: Planejamento; capacitacao de recursos humanos; organizacao do processo de trabalho; articulacao intrainstitucional; organizacao da Unidade de Saude da Familia. Os resultados revelam dificuldades tais como: precaria infraestrutura das unidades de saude, flexibilizacao das relacoes de trabalho, rotatividade dos trabalhadores da saude. O estudo aponta para a necessidade de participacao dos atores no processo de implementacao da politica de descentralizacao da vigilância epidemiologica para um micro-espaco de intervencao que e o Programa de Saude da Familia.