[Environmental and workers' health, within the framework of primary health care in the Brazilian National Health System (SUS): opportunities and challenges].
01 Nov 2009-Ciencia & Saude Coletiva (ABRASCO - Associação Brasileira de Saúde Coletiva)-Vol. 14, Iss: 6, pp 2061-2070
TL;DR: Historical and conceptual aspects of those fields are described in a summarized manner, as well as some shared features and expected actions of the Health System, with emphasis to the role of Primary Health Care and to the importance of the dialogue with the social movement.
Abstract: This paper has the purpose of contributing to the discussion of the crossing areas between Environmental Health and Workers Health, in the Brazilian context of Labor, Production, Environment and Health. This paper emerges in the context of the current organizational changes of the Brazilian National Health System (SUS), with a major focus on Primary Health Care, having in mind, also, the preparation of the 1st National Environmental Health Conference (1 feminine CNSA) to be held in December of 2009. So, historical and conceptual aspects of those fields are described in a summarized manner, as well as some shared features and expected actions of the Health System, with emphasis to the role of Primary Health Care and to the importance of the dialogue with the social movement. Finally, some topics for a common agenda were identified by the authors.
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TL;DR: The study analyzed work and environment-related processes in the primary health care area and their repercussions on the health of workers and the community in a rural city in Ceara, whose economy is based on agriculture for export.
Abstract: Territorially-based participative analytical methodologies taking the environmental question and work into consideration are essential for effective primary health care. The study analyzed work and environment-related processes in the primary health care area and their repercussions on the health of workers and the community in a rural city in Ceara, whose economy is based on agriculture for export,. It sought to redeem the area and the proposal of actions focused on health needs by the social subjects through the making of social, environmental and work-related maps in workshops within the framework of action research. Examining the situation from a critical perspective, based on social participation and social determination of the health-disease process with regard to the relations between production, environment and health, was the most important step in the participative map-making process, with the qualitative material interpreted in light of discourse analysis. The process helped identify the health needs, the redemption of the area, strengthened the cooperation between sectors and the tie between the health of the worker and that of the environment, and represented an advance towards the eradication of the causes of poor primary health care services.
31 citations
TL;DR: The Reference Center in Workers' Health of Amparo in the State of Sao Paulo promotes actions directed to workers' health in primary care as discussed by the authors, where the main matricial support activities are thematic meetings, informative bulletins and systematic support.
Abstract: The Reference Center in Workers' Health of Amparo in the State of Sao Paulo promotes actions directed to workers' health in primary care. In order to understand the process, we conducted research in Matricial Support in Workers' Health, its trajectory, difficulties and potential, using a qualitative case study approach. The main matricial support activities are thematic meetings, informative bulletins and systematic support. The exchange of knowledge and experience leads to a closer bond between the professionals. Horizontal technical support brings about a reorganization of work in health, mutual responsibility for cases and a new outlook on illness by integrating assistance and surveillance actions. An excess workload, rotation of health professionals, undernotification of Work-Related Accidents and Diseases and regional organization are the challenges to be tackled. Matricial Support in Workers' Health is strategic for the insertion of such actions in primary care and represents a step forward in the reorientation of the assistential medical model, with the introduction of the work-health relationship in family health.
29 citations
01 Jun 2013
TL;DR: In this paper, a revisao bibliografica e documental, abordamos o fluxo e os impedimentos das acoes atuais nessa area, no contexto do Sistema Unico de Saude, enfocando a distância entre conhecimento teorico, sua apreensao e sua aplicacao.
Abstract: No contexto atual do mundo do trabalho, e fundamental que a Vigilância em Saude do Trabalhador possa, por meio de mecanismos de investigacao, analise e intervencao sobre os processos, os ambientes, as organizacoes e as relacoes de trabalho, promover a saude dos trabalhadores e a prevencao de acidentes e de doencas relacionadas ao trabalho O objetivo deste ensaio e refletir sobre o processo de Vigilância em Saude do Trabalhador com enfase no municipio de Sao Paulo Com base em revisao bibliografica e documental, abordamos o fluxo e os impedimentos das acoes atuais nessa area, no contexto do Sistema Unico de Saude, enfocando a distância entre conhecimento teorico, sua apreensao e sua aplicacao Iniciamos por uma retrospectiva historica e conceitual do campo da Saude do Trabalhador Na sequencia, fazemos uma reflexao sobre as politicas de governo para Vigilância em Saude do Trabalhador e sobre os conceitos de Vigilância em Saude e Vigilância em Saude do Trabalhador Complementando a reflexao, a Vigilância em Saude do Trabalhador e analisada a partir da perspectiva de diferentes autores Concluimos que e preciso requalificar a estrutura organizacional da saude publica no Brasil, incluindo indicadores qualitativos de avaliacao do impacto das acoes e contemplando os diferentes processos de trabalho e a diversidade de necessidades de cada servico voltado a ST no âmbito do SUS
25 citations
TL;DR: There is a need for intersectorial VISAT action to reduce excessive working hours, organization of the Unified Health System (SUS) for acknowledgement of occupational illnesses and guaranteeing social security rights through actions focused on health education.
Abstract: There are approximately a million subsistence fishermen in Brazil whose activities expose them to severe occupational hazards without adequate health protection. This article conducts an analysis of working conditions and health risks faced by subsistence fishermen and outlines challenges to the implementation of Occupational Health Surveillance (VISAT) actions. The methodology is based on qualitative analysis of risks and working conditions through observation and interviews, and diagnosis of occupational illnesses with clinical evaluation. Mobile teams conducted eight years of activities together with fishing communities throughout the state of Bahia. The results revealed the challenge of surveying a traditional self-employed category with relative management autonomy. Fishermen face precarious living conditions without access to occupational health services. They are exposed to thirty work-related illnesses without protection, diagnosis, treatment and social security coverage. The conclusion reached is that there is a need for intersectorial VISAT action to reduce excessive working hours, organization of the Unified Health System (SUS) for acknowledgement of occupational illnesses and guaranteeing social security rights through actions focused on health education.
24 citations
01 Jun 2017
TL;DR: Atencao Primaria a Saude as discussed by the authors presented a pesquisa quantitativa e de carater exploratorio, transversal, to conhecer o nivel de satisfacao e a importância do trabalho for a equipe multiprofissional de Atencaras.
Abstract: RESUMO Esta pesquisa objetivou conhecer o nivel de satisfacao e a importância do trabalho para a equipe multiprofissional de Atencao Primaria a Saude. Trata-se de pesquisa quantitativa e de carater exploratorio, transversal. O nivel de satisfacao dos profissionais foi classificado no escore bom, porem, algumas questoes indicaram baixo grau de satisfacao. O grau de importância do trabalho destacou-se em nivel mais elevado nas questoes relacionadas a qualidade do trabalho desenvolvido e a comunicacao com a equipe. Conclui-se que existe a necessidade de mudancas na gestao organizacional, especialmente no que diz respeito a ampliacao de recursos humanos e materiais, pois identificam-se como indicadores expressivos que contribuem para menor satisfacao com o trabalho e alto impacto sobre a saude do trabalhador.
18 citations
References
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TL;DR: The authors discusses the underlying theoretical and operational premises in the fields of workers' health and occupational health, highlighting their respective frameworks and epistemological differences, based on Foucaultian archeology.
Abstract: This article discusses the underlying theoretical and operational premises in the fields of workers' health and occupational health, highlighting their respective frameworks and epistemological differences, based on Foucaultian archeology. The theme is particularly relevant, due to: the apparently limited attention to interdisciplinary research approaches in workers' health; various setbacks in public health measures at the social policy level; related weaknesses in the Brazilian trade union movement; and the conceptual misinterpretations drafted into the final report of the 3rd National Workers' Health Conference in November, 2005, convened by the Ministries of Social Security, Health, and Labor. The event resulted from the Workers' Health Conferences held in various States and Municipalities, mobilizing some 100,000 activists throughout Brazil and electing the delegates to the 3rd National Conference.
154 citations
TL;DR: In this article, the authors focus on the experience with primary health care as a strategy for reorganizing the health care model, based on reforms in this direction and their implementation in the Brazilian case.
Abstract: This paper focuses on the experience with Primary Health Care as a strategy for reorganizing the health care model, based on reforms in this direction and their implementation in the Brazilian case. The article identifies a shift in the discourse concerning health sector reforms, with a return to emphasis on primary care and integration of services. The Brazilian context demands reflection on the possibilities for synergy between this strategy and other social policies and the factors needed to ensure adequate performance. Evaluation research has suggested that primary care activities are slightly superior as compared to traditional health care units, despite persistent difficulties in access, physical infrastructure, team formation, management, and organization of the network. These difficulties correlate with a low level of public financing, persistent segmentation of the system, and weak integration of primary care services with other levels of care. From the technical perspective, a reasonable target is to guarantee the strategy's continuity with the necessary adjustments, conditioned by the dynamics of the health care technical models involved in the dispute.
141 citations
01 Jan 2008
TL;DR: The article identifies a shift in the discourse concerning health sector reforms, with a return to emphasis on primary care and integration of services, and reflects on the possibilities for synergy between this strategy and other social policies and the factors needed to ensure adequate performance.
Abstract: This paper focuses on the experience with Prima-ry Health Care as a strategy for reorganizing the health care model, based on reforms in this direc-tion and their implementation in the Brazilian case. The article identifies a shift in the discourse concerning health sector reforms, with a return to emphasis on primary care and integration of services. The Brazilian context demands reflec-tion on the possibilities for synergy between this strategy and other social policies and the factors needed to ensure adequate performance. Evalu-ation research has suggested that primary care activities are slightly superior as compared to traditional health care units, despite persistent difficulties in access, physical infrastructure, team formation, management, and organization of the network. These difficulties correlate with a low level of public financing, persistent segmen-tation of the system, and weak integration of pri-mary care services with other levels of care. From the technical perspective, a reasonable target is to guarantee the strategy’s continuity with the nec-essary adjustments, conditioned by the dynamics of the health care technical models involved in the dispute.Primary Health Care; Health Services; Family Health
129 citations
TL;DR: Ausencia de uma efetiva Politica Nacional de Saude do Trabalhador (PNSA) is considered to be a contributory factor to a falta de qualificacao das demandas, evidenciando a pouca capacidade de pressao dos movimentos sociais e dos trabalhadores.
Abstract: Como artigo para debate, este texto apresenta tres questoes consideradas cruciais pelos autores: (a) ausencia de uma efetiva Politica Nacional de Saude do Trabalhador que coloque um marco conceitual claro, apresente diretrizes de implementacao e proponha estrategias e planos de acao e de avaliacao para efetiva-la; (b) fragmentacao e dispersao da producao cientifica da area, prejudicando a importante colaboracao que a Academia poderia oferecer para fundamentar as necessidades dos agentes politicos, movimentos sociais, gestores e profissionais de saude; (c) enfraquecimento e pouca capacidade de pressao dos movimentos sociais e dos trabalhadores, evidenciando a falta de qualificacao das demandas, diante dos desafios do momento presente do mundo do trabalho no Brasil. O metodo deste trabalho consistiu na revisao critica de documentos e publicacoes da area a fim de fundamentar o tom do debate e as questoes levantadas. As bases teoricas de toda a argumentacao sao os textos que tratam da reestruturacao produtiva no Brasil, sobretudo os que analisam os efeitos nefastos desse processo e, tambem, os fundamentos do chamado "campo de saude do trabalhador".
122 citations
TL;DR: Uma breve retrospectiva do processo de instituicao das acoes de Saude do Trabalhador no âmbito do SUS, a descricao dos aspectos organizacionais e operacionais da RENAST, nos Estados e municipios e identificados avancos, dificuldades e as perspectivas vislumbradas.
Abstract: A construcao da Rede de Atencao Integral a Saude do Trabalhador (RENAST) no SUS, para implementar as acoes de uma atencao diferenciada para os trabalhadores na rede de servicos de saude e a principal estrategia adotada pela area Tecnica de Saude do Trabalhador do Ministerio da Saude (COSAT), a partir de janeiro de 2003. A RENAST esta organizada como rede nacional de informacao e praticas de saude: acoes assistenciais, de vigilância e promocao da saude, nas linhas de cuidado da atencao basica, da media e alta complexidade ambulatorial, pre-hospitalar e hospitalar, sob o controle social, nos tres niveis de gestao do SUS. Na proposta da RENAST, os Centros de Referencia em Saude do Trabalhador (CRST) deixam de ser porta de entrada e assumem o papel de suporte tecnico, polo irradiador da cultura da centralidade do trabalho e producao social das doencas, e locus de pactuacao das acoes de saude, intra e intersetorialmente, no seu territorio de abrangencia. Neste texto, sao apresentados: uma breve retrospectiva do processo de instituicao das acoes de Saude do Trabalhador no âmbito do SUS, a descricao dos aspectos organizacionais e operacionais da RENAST, nos Estados e municipios e identificados avancos, dificuldades e as perspectivas vislumbradas.
99 citations