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Journal ArticleDOI

Perspectivas da avaliação na Política Nacional de Humanização em Saúde: aspectos conceituais e metodológicos

01 Jul 2007-Ciencia & Saude Coletiva (ABRASCO - Associação Brasileira de Saúde Coletiva)-Vol. 12, Iss: 4, pp 999-1010

TL;DR: Reforcar tais especificidades e perspectivas de aproximacao, buscou-se nao somente registrar a amplitude e complexidade dos dispositivos e acoes propostos no âmbito do HumanizaSUS, como tambem fazer uma breve revisao of conceitos e componentes englobados na area of monitoramento e avaliacao.

AbstractThe purpose of this paper is to prompt discussions of the perspectives of the Evaluation of Brazil's National Health Humanization Policy being implemented by the Ministry of Health (PNH/HumanizaSUS). It strives to systemize some Health Evaluation benchmarks, distinguishing two key aspects of this evaluation: one examines methodologies for the definition of Humanization actions monitoring indicators; the other analyzes evaluatory surveys measuring the impacts of these actions. Both aspects were scored, highlighting specific characteristics that must be recognized in the approach and use of evaluation methodologies under the aegis of this Policy. In order to strengthen such specific characteristics and approach perspectives, it explores the extent and complexity of the tools and actions proposed in the field covered by this Policy, while also offering an brief review of the concepts and components encompassed by the Monitoring and Evaluation area.

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Citations
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Journal ArticleDOI
TL;DR: The scope of this article is to elicit a debate among different stakeholders in the evaluation in the hope that it can contribute to the reflection on the real usefulness of evaluations in which the political component in management has been increasingly prevalent.
Abstract: The management of health services is a complex administrative practice due to the breadth of the field of health and the need to reconcile individual, corporate and collective interests that are not always convergent. In this context, the evaluation needs to have specific characteristics in order to fulfill its role. The scope of this study was to establish the characteristics that the evaluation for the management of health services should have to contribute to decision-making. Usefulness, opportunity, feasibility, reliability, objectivity and directionality represent the set of principles upon which the evaluation should be based. Evaluations should lead to decisions that guarantee not only their efficiency and effectiveness but also their implementation. The evaluation process should ensure that decisions involve all stakeholders in order to render the implementation of decisions feasible, and take into account the health needs of the population and the goals set for the services. The scope of this article is to elicit a debate among different stakeholders in the evaluation in the hope that it can contribute to the reflection on the real usefulness of evaluations in which the political component in management has been increasingly prevalent.

103 citations


Journal ArticleDOI
Abstract: O artigo discute as praticas de assistencia, politicas, estrategias e acoes governamentais formalizadas para a saude do idoso, visto que, embora o tema "humanizacao" se faca presente em varias discussoes e que, inclusive, tornou-se diretriz da tao aclamada Politica Nacional de Humanizacao, esses pacientes enfrentam, ainda, varios obstaculos para assegurar alguma assistencia a saude. A desinformacao e ao desrespeito aos cidadaos da terceira idade somam-se a precariedade de investimentos publicos para atendimento as necessidades especificas dessa populacao, a falta de instalacoes adequadas, a carencia de programas especificos e de recursos humanos. Dessa forma, faremos uma reflexao sobre a humanizacao na assistencia a saude focada nessa populacao, primeiramente fazendo um resgate da humanizacao nos diversos cenarios do setor saude, considerando a valorizacao dos diferentes sujeitos implicados nesse processo, para que o cuidado dessa especial e crescente fatia da populacao seja realizado de forma humanizada, visto ser este um paciente especial que requer um atendimento diferenciado.

37 citations


Journal ArticleDOI
TL;DR: Focusing on universities and organizations, the main five types of minds valued by modern and future societies are discussed, proposing investment in human assets through the use of strategies and technologies to ensure continuing education throughout life.
Abstract: This paper analyzes issues related to education, crises and changes in light of the postmodern order, emphasizing efforts towards human capital as the impetus to promote changes. Focusing on universities and organizations, we discuss the main five types of minds valued by modern and future societies, proposing investment in human assets through the use of strategies and technologies to ensure continuing education throughout life.

35 citations


Cites background from "Perspectivas da avaliação na Políti..."

  • ...From this perspective, health education is an important tool to permanently construct and reconstruct skills and competencies, allowing a broader understanding of health practice, with an increased ability to analyze and intervene in the different processes that result from it, encouraging changes of valorization and humanization in the relationships between the involved subjects(9-11)....

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Journal ArticleDOI
Abstract: In the quest for quality in health services, management control is a critical factor for hospitals to be efficient. In this sense, it is necessary that hospital managers carry out performance evaluation in order to measure the management efficiency. This paper presents a discussion about two models for evaluating the management control function in hospitals: Hospital Certification and Reinforcement and Improvement Program for Quality in Hospitals (Pro-Hosp). The main objective was to analyze if hospitals disclose enough information to allow the evaluation of their management performance. This research was based on case studies carried out in three hospitals located in the State of Minas Gerais/Brazil. The first one is profit oriented, the second is charitable, and the third is a university hospital. The data analysis was performed according to three dimensions, each encompassing several variables as defined by Pro-Hosp (FJP, 2007) and LIMA, BARBOSA, PORTELA et al. (2004). It can be concluded that all studied hospitals are incipient in terms of management control.

29 citations


Journal ArticleDOI
01 Jan 2009
Abstract: Trata-se de estudo descritivo de abordagem qualitativa cujo objetivo foi compreender como os profissionais da enfermagem (enfermeiros e tecnicos) percebem a politica de humanizacao no cenario de uma UTI e sua importância nesse processo. Foi desenvolvido em uma instituicao privada no municipio de Porto Alegre/RS, com 18 participantes. A coleta dos dados ocorreu por meio de entrevista estruturada. Da analise emergiram aspectos referentes a elementos e caracteristicas que definem a humanizacao, bem como questoes facilitadoras e dificultadoras presentes no processo. Conclui-se que a empatia, o respeito e a valorizacao constituem elementos fundamentais e que o profissional de enfermagem acredita fazer a diferenca no processo de humanizar, com vistas a melhorar as praticas de cuidado baseadas na etica, no dialogo e na autonomia do paciente, de sua familia e da propria equipe.

28 citations


References
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Journal ArticleDOI
Abstract: This paper discusses the relationships between quality of life and health by applying the discourses emerging in the health sector to other fields and other disciplines. These relationships constitute social representation based on subjective parameters (well-being, happiness, love, pleasure, personal satisfaction), and on objective ones such as satisfaction of basic needs and of the needs created by the degree of economical and social development of a given society. The text presents the main instruments which have been constructed during the last years for measuring quality of life, as well as the debate they cause. It also debates the semantic field where the representations and actions in favour of quality of life - such as the concept of development, democracy, quality, way and conditions of life - develop. In relation to the field of health, this article discusses the tendency to restrict the concept of quality of life to the biomedical area, associated with an economic assessment. It shows the variety of instruments created for measuring quality of life in accordance with the concept. Health promotion is considered one of the most relevant strategies in this field in order to avoid medical reductionism and to develop an interdisciplinary dialogue. It is argued that this proposal, however, still needs to be refined and tested in sanitary practices.

937 citations


Journal ArticleDOI
TL;DR: It is argued that the answer to this question is essential for choosing an appropriate evaluation design, drawing upon examples from the fields of health and nutrition, and a framework is proposed for deciding upon appropriate evaluation designs.
Abstract: The question of why to evaluate a programme is seldom discussed in the literature. The present paper argues that the answer to this question is essential for choosing an appropriate evaluation design. The discussion is centered on summative evaluations of large-scale programme effectiveness, drawing upon examples from the fields of health and nutrition but the findings may be applicable to other subject areas. The main objective of an evaluation is to influence decisions. How complex and precise the evaluation must be depends on who the decision maker is and on what types of decisions will be taken as a consequence of the findings. Different decision makers demand not only different types of information but also vary in their requirements of how informative and precise the findings must be. Both complex and simple evaluations, however, should be equally rigorous in relating the design to the decisions. Based on the types of decisions that may be taken, a framework is proposed for deciding upon appropriate evaluation designs. Its first axis concerns the indicators of interest, whether these refer to provision or utilization of services, coverage or impact measures. The second axis refers to the type of inference to be made, whether this is a statement of adequacy, plausibility or probability. In addition to the above framework, other factors affect the choice of an evaluation design, including the efficacy of the intervention, the field of knowledge, timing and costs. Regarding the latter, decision makers should be made aware that evaluation costs increase rapidly with complexity so that often a compromise must be reached. Examples are given of how to use the two classification axes, as well as these additional factors, for helping decision makers and evaluators translate the need for evaluation--the why--into the appropriate design--the how.

714 citations


Journal ArticleDOI
Abstract: Este trabalho resume um debate metodologico em processo na Escola Nacional de Saude Publica, Brasil, sobre as duas formas de abordagem mais correntes nas investigacoes da area de saude: o metodo quantitativo e o metodo qualitativo. Os autores - uma antropologa sanitarista e um bioestatistico - demonstram, com argumentacoes teoricas e praticas, que esses metodos sao de natureza diferenciada, mas se complementam na compreensao da realidade social. Num mundo onde o que distingue o ser humano e a linguagem comunicativa, o acento deste debate recai sobre a possibilidade, o significado e os limites da linguagem matematica e da linguagem de uso comum na experiencia cotidiana.

546 citations


Journal ArticleDOI
TL;DR: The incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in Brazil, particularly at the local level, and recent implementation of projects for the reorganization of the health services system raises the need for more appropriate strategies aimed at health care evaluation.
Abstract: This is a literature review of theoretical and methodological issues on health care evaluation of research and technical reports. Conceptual frameworks, approaches, subject matter, strategies, and study designs are identified and analyzed. Evaluative research designs are compared with epidemiological ones. A diverse terminology was encountered, and many methodological problems in the literature were examined. The incorporation of evaluative procedures in health planning or health policy-making and administration is still limited in Brazil, particularly at the local level. Recent implementation of projects for the reorganization of the health services system based on the administrative autonomy of Local Health Units raises the need for more appropriate strategies aimed at health care evaluation. Perspectives for the development of alternative strategies are indicated.

198 citations


Journal ArticleDOI
TL;DR: Nuclear criteria involved in the organization of all evaluation processes are identified, and articulated with the existing institutionalized evaluation practices in developed countries, that is, program evaluation, quality assessment and management and technology assessment.
Abstract: The field of program, services and technology evaluation in general, and in health care in particular, is going through an important growth and conceptual and methodological diversification. It is also the object of an increasing demand for its participation as an effective supportive instrument in the decision-making process, and a constant need in the dynamics of health systems and services. In this paper, based on literature review, nuclear criteria involved in the organization of all evaluation processes are identified, and articulated with the existing institutionalized evaluation practices in developed countries, that is, program evaluation, quality assessment and management and technology assessment. In conclusion, the incipient development of a methodological evaluation output in Brazil is analyzed.

190 citations