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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.
Abstract: The 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: Evaluated the implementation of the National Iron Supplementation Program in Vicosa in the State of Minas Gerais and its impact on 6- to 18-month-old non-anemic infants, children showed low adhesion and the dosage wasn't effective in preventing anemia.
Abstract: The scope of this work was to evaluate the implementation of the National Iron Supplementation Program (NISP) in Vicosa in the State of Minas Gerais and its impact on 6- to 18-month-old non-anemic infants assisted by the Family Health Teams. Interviews were conducted with the professionals and with the children's mothers/guardians. The non-anemic children who didn't receive the earlier supplementation (n=133) were given ferrous sulphate syrup for six months. Hemoglobin dosage, anthropometric evaluation and a socioeconomic survey were conducted before and after the six-month period. Children who ingested 75% or more of the prescribed dosage were classified as high adhesion, while the others were classified as low adhesion, according to the mothers' testimonials. With respect to the implementation in the city, the distribution system was not always available to the priority group and there was a lack of training and motivation on the part of most Community Health Agents. The lack of promotion of NISP among the priority group was detected, apart from a mothers' awareness drive. Regarding diet supplementation, children showed low adhesion and the dosage wasn't effective in preventing anemia. Therefore, important operational barriers to implementation were observed.

17 citations

Journal ArticleDOI
TL;DR: In this paper, a study of the humanización de la asistencia hospitalaria segun la percepcion de los usuarios hospitalizados was presented.
Abstract: La investigacion tuvo por objetivo etno-evaluar la humanizacion de la asistencia hospitalaria segun la percepcion de los usuarios hospitalizados. Los datos fueron recolectados de enero a julio del 2005, en un hospital publico de Fortaleza-CE, a traves de la opinion del paciente. Participaron 13 usuarios hospitalizados. El analisis fue realizado por analisis de categorias: etno-evaluacion de la estructura y dinamica hospitalaria, la imagen hospitalaria y la competencia profesional humana y tecnica. Los usuarios utilizaron varias formas para suavizar sus opiniones, siendo mostrados factores denominados de mediadores de la etno-evaluacion catalogados como: condiciones de la entrevistas, condicion socioeconomica, personalidad y religiosidad del usuario, narracion ironica, diagnostico sombrio y necesidades atendidas y experiencia anterior a la hospitalizacion. Aspectos mencionados por los pacientes son significativos para movilizar profesionales y gestores para cambios que promuevan la humanizacion e incluyan al usuario como etno-evaluador critico social.

16 citations

Dissertation
13 Apr 2009
TL;DR: It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don’t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment.
Abstract: The Specialized Dental Care Centers (CEO) were developed to provide specialized dental care to the population, given the accumulated needs of health since the past. They must operate as units of reference for the Oral Health Team of the Primary Care, complementing the dental procedures performed at this level of attention. This study aims to assess the performance of CEOs of the Grande Natal Health Region as a strategy of Secondary Care consolidation in oral health through users, dentists and managers. For this to try to identify factors about access, hosting and satisfaction with the service, the actions developed in these centers, integration between the CEOs and the Basic Health Units (UBS), considering the reference and counter reference. Data were collected through semi-structured interview, conducted in four CEOs, among 253 users, 31 dentists and 4 managers. It was submitted to descriptive statistical analysis and to content analysis by software ALCESTE 4.5. The results revealed that the specialties of prosthesis, endodontics and surgery were the most sought by 38.2%, 23.7% and 21.7% of respondents, respectively. It was noticed that among users aged 18 to 30 years-old the greatest demand is for the specialty of endodontics (44.4%) and over 50 years for prosthesis (76.4%). There is a weakness in the reference and counter reference between UBS and CEO, because part of users goes directly to the centers without going before to the Primary Care and the majority does not want to return to the dentist of Health Unit. Satisfaction with care was reported by 90.9% of users, because they resolved the problems needed and were welcomed by the team. But the delay in care was the main factor for not satisfaction. For most dentists, some users could solve their problems completely in Primary Care, which shows the existence of unnecessary referrals to the CEOs, however they consider the existence of limiting factors in UBS that compromise the service. Most dentists revealed that some users do not get to CEOs with the basic dental treatment done, and some of them do not counter reference users. It can be concluded that the studied CEOs are being resolutive for those who access them, offering necessary care for the population, and if they don’t account with this service, will encounter obstacles to resolution of problems, ranging seek care service in particular, in another public sector, or even giving up treatment. However, it is perceived the need of professionals training to understand the importance of the reference and counter reference, to that they can better serve and guide users. It is also important that cities offer better conditions to UBS and CEOs, so they can work together, with complementary actions of oral health, seeking full care, aiming for better resolution to the users' health problems.

15 citations

Journal ArticleDOI
01 Jan 2009
TL;DR: Barros, Passos, et al. as mentioned in this paper describe a processo de humanizacao in saude coletiva, in which trabalhadores do Sistema Unico deSaude (SUS) comecavam a protagonizar this process.
Abstract: Esta foi uma dentre muitas das expressoes lancadas para partilhar com outrosnavegantes virtuais as turbulencias vividas por trabalhadores do Sistema Unico deSaude (SUS) que comecavam a protagonizar um processo de formacao. Ela eexpressiva da experiencia de educacao em saude que aqui queremos por emanalise por varios motivos: primeiro, pela peculiaridade do objeto a que se destinaum curso de pos-graduacao para formar apoiadores institucionais da Humanizacaoda Atencao e Gestao do SUS; segundo, pelo carater de curso-intervencao que oestruturou e, ainda, por se tratar de um per-curso cuja intensidade, abrangencia epotencia transformadora so puderam ser atingidas com o suporte dado peloambiente virtual de aprendizagem que conectou trabalhadores das setemacrorregioes do estado do Rio Grande do Sul.O proprio tema da humanizacao da saude ja impoe desafios a seremtrabalhados que, de alguma forma, se exacerbam na aproximacao ao campo daeducacao. Se ja soa paradoxal humanos propondo-se a humanizar outros, quandose fala em formar para esta tarefa, os ruidos podem ser ainda maiores. Tomando-se, entretanto, o conceito de humanizacao nao como um valor abstrato, mascomo producao de mudancas concretas que reafirmem o valor da vida epromovam praticas sociais inclusivas e solidarias (Barros, Passos, 2005), uma novaperspectiva se abre para se pensar um processo de formacao.Isto leva a crer que compartilhar uma experiencia de formacao na area dasaude, que tenha se utilizado do ensino a distância como ferramenta depotencializacao dos principios de humanizacao do SUS, possa trazer umacontribuicao ao debate da educacao em saude coletiva no Brasil.

15 citations

Journal ArticleDOI
TL;DR: The professionals demonstrate understanding of the meaning of humanization and acknowledge the need to cope with difficulties, and propose to educate and qualify professionals, make activities adequate given the professionals' roles and improve the organization of services.
Abstract: This study analyzes the understanding of professionals composing teams of the Family Health Strategy concerning humanization of care. This qualitative survey was carried out in a city in the interior of Sao Paulo through interviews with 20 professionals. The data analysis method used was Interpretation of Meanings based on the hermeneutic-dialectic perspective. The meaning of humanization according to the interviewed professionals includes an enlarged view, respect for ethical principles and facilitated access. The difficulties refer to the lack of prepared professionals, excessive demand and deficiencies in service organization. The professionals propose to educate and qualify professionals, make activities adequate given the professionals' roles and improve the organization of services. The professionals demonstrate understanding of the meaning of humanization and acknowledge the need to cope with difficulties.

14 citations


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

  • ...In terms of care delivery, this policy targets accessibility and integrality of care, bonds between workers and the population as well as the advancement of an “enlarged clinic” dealing with the needs of individuals(3)....

    [...]

References
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Journal ArticleDOI
TL;DR: In this article, the authors discuss the relationship between quality of life and health by applying the discourses emerging in the health sector to other fields and other disciplines, which constitute social representation based on subjective parameters such as satisfaction of basic needs and of the needs created by the degree of economical and social development of a given society.
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.

964 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.

739 citations

Journal ArticleDOI
TL;DR: In this article, a debate metodologico em processo at the Escola Nacional de Saude Publica, Brasil, sobre as duas formas de abordagem mais correntes nas investigacoes da area de saude was conducted.
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.

589 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.

200 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.

192 citations