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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TL;DR: The quality of the current health management model should be continued, however, it should start during gestation, include a higher number of follow up consultations and develop more multidisciplinary work.
Abstract: OBJETIVO: avaliar um programa de acompanhamento do desenvolvimento infantil na atencao basica em saude, desenvolvido pela area da Fonoaudiologia, sob a otica da familia. METODO: utilizou-se pesquisa qualitativa, por meio do grupo focal, com realizacao de dois encontros e participacao de oito sujeitos. Todos os participantes convidados para o grupo haviam comparecido, pelo menos, a duas avaliacoes no programa em questao. A coleta de dados teve a participacao de moderador, relatora e observadora. Os dados foram analisados, unindo-se as categorias mais relevantes e frequentes no discurso dos participantes. A discussao se concentrou nos aspectos: acolhimento, promocao de saude, empoderamento, equipe de saude, trabalho interdisciplinar, integralidade e vinculo. RESULTADOS: os participantes do programa reconheceram que o Fonoaudiologo atua na prevencao e promocao de saude e desenvolve acoes de esclarecimento de duvidas dos cuidadores, empoderando os familiares sobre aspectos do desenvolvimento infantil, estabelecendo o vinculo e a integralidade da atuacao. CONCLUSAO: foi possivel avaliar a qualidade do modelo de gestao em saude vigente, propondo a continuidade deste programa, porem com inicio durante a gestacao, com retornos mais frequentes, enfatizando a importância do trabalho interdisciplinar.
9 citations
TL;DR: In this paper, a qualitative, ethnographic study, conducted with 30 members of sexual minorities in Juazeiro do Norte, Brazil, identified the perception of Gays, Lesbians, Bisexuals and Transgenders in relation to the care received from health professionals, in the light of Cross-Cultural Theory.
Abstract: The provision of care by health professionals seems to be related to cultural patterns in which these workers are inserted. The relationship between culture and care becomes a challenge for the provision of health care to homosexual and bisexual population. Thus, this study aimed to identify the perception of Gays, Lesbians, Bisexuals and Transgenders in relation to the care received from health professionals, in the light of Cross-Cultural Theory. This is a qualitative, ethnographic study, conducted with 30 members of sexual minorities in Juazeiro do Norte, Brazil. The data analysis lead to the elaboration of five categories based on of the Theory of Cultural Care Diversity and Universality. The participants emphasized the constant violation of their rights to universal and equitable access to the National Health System, stating that they have suffered from prejudice and exclusion, as result of a heteronormative culture. They highlighted that homophobia and dehumanization of care have a strong relation to sexual orientation. The transvestites are the most prone to humiliation and pejorative attitudes of professionals and such condition is a barrier to accessing services.
8 citations
01 Jun 2012
TL;DR: In this paper, the authors investigated the adequacies from freirean theory in the building of critical reflexive pedagogic models, with technical and social excellences, but in applied perspective to health process.
Abstract: The Single Health System historical building get to Family Health adoption how central strategy to do minor distance between ideal and real. Professional formation is one challenge in this context. Many initiatives to significant changes were implemented. The assay`s aim is to investigated this context and to show the adequacies from freirean theory in the building of critical reflexive pedagogic models, with technical and social excellences, but in applied perspective to health process.
8 citations
21 Dec 2010
TL;DR: Moreno et al. as discussed by the authors present a modelo-padrao, which compreende tanto financeiros quanto operacionais for calculo da eficiencia dos hospitais da amostra.
Abstract: Apesar de apresentarem predominante importância no sistema de saude no Brasil, poucos estudos nacionais dissertam sobre a avaliacao de hospitais, principalmente sobre a analise financeira de indicadores que possam orientar os formuladores de politicas publicas no pais. Alem disso, poucos estudos internacionais tem como foco analisar organizacoes prestadoras de servicos de saude (LA FORGIA; COUTTOLENC, 2009). De forma geral, alem das dificuldades inerentes as especificidades dessas organizacoes, os estudos tem demonstrado que a ausencia de informacoes confiaveis sobre qualidade, eficiencia e custos da atencao hospitalar e um dos principais problemas dos hospitais e dificulta os esforcos para melhorar a eficacia na prestacao de servicos. Dado esse contexto, o presente estudo tem como foco a gestao financeira de hospitais, o qual pode ser traduzido em duas perguntas de pesquisa, a saber: (i) que fatores determinam a eficiencia de hospitais? (ii) como os indices de eficiencia variam entre hospitais de tipos e tamanhos diferentes? Para tanto, o objetivo do presente estudo foi analisar a eficiencia de hospitais a partir de indicadores financeiros e nao financeiros, a fim de evidenciar a (in) eficiencia da gestao financeira das organizacoes hospitalares publicas e privadas (com e sem fins lucrativos). Dentre os resultados apresentados, destaca-se a proposta de uma estrutura de avaliacao de eficiencia da gestao financeira de hospitais. Composta de treze Modelos que utilizam o metodo da Analise Envoltoria de Dados (Data Envelopment Analysis DEA), a proposta compreende tanto indicadores financeiros quanto operacionais para calculo da eficiencia dos hospitais da amostra. Por meio dos indicadores selecionados a partir dos ultimos seis desses Modelos, propoe-se um Modelo-padrao, composto pelas variaveis de maior peso e que, portanto, podem determinar a eficiencia dos hospitais analisados. Salienta-se que de um total de 72 hospitais prestadores de servicos conveniados ao Sistema Unico de Saude (SUS), foram selecionadas 26 organizacoes para analise, devido principalmente a disponibilidade de acesso as demonstracoes financeiras que deveriam ser publicamente divulgadas e, em especial, via Internet e aos dados do Sistema de Informacoes Hospitalares do SUS (SIH-SUS) e do Sistema de Informacoes Ambulatoriais do SUS (SIA-SUS). Os indicadores considerados nas formulacoes dos Modelos foram (i) financeiros PCT, LC, PMP, GA, MO, ROA e End; (ii) operacionais TO, TMP, LO, FTE/LO. As relacoes estabelecidas entre esses indicadores basearam-se nos autores: (i) Schuhmann (2008) e McCue e Nayar (2009); (ii) Barnum e Kutzin (1993); (iii) Younis, Younies e Okojie (2006); (iv) Marinho, Moreno e Cavalini (2001); (v) Ersoy et al. (1997). A partir dos resultados, pode-se observar que os indicadores financeiros considerados no estudo PCT, LC, PMP, End de forma geral, apresentaram, para os Modelos com resultados referentes a esses inputs, relevância para a determinacao da eficiencia dos hospitais. A excecao foi para o input PMP, que nao apresentou peso medio relevante nos Modelos calculados. Para os indicadores operacionais TMP, TO, LO e FTE/LO, obtiveram-se resultados relevantes para o indicadores TMP, TO e FTE/LO em alguns dos Modelos que consideraram esses indicadores como inputs. De forma geral, concluiu-se que o presente trabalho pode contribuir para a analise do desempenho da gestao financeira de hospitais. Em primeiro lugar, porque se apresenta a relacao de indicadores financeiros e operacionais que podem ser utilizados para analise da eficiencia dessas organizacoes. Em segundo, porque se apresentam valores desses indicadores que podem ser utilizados como padrao para analise das organizacoes do setor de saude.
8 citations
TL;DR: The actions within the preventive and new health promotion models that were identified reveal characteristics that are grounded in the ethics of oppression/subordination of users and cooperation/acceptance of users as free and responsible for their choices and consequences.
Abstract: OBJECTIVE: To analyze the model for actions by health promotion group coordinators, in primary healthcare units with links to professional training. METHODOLOGICAL PROCEDURES: A qualitative study was carried out in the municipality of Florianopolis, Southern Brazil, in 2001. Four groups were evaluated, over a total of 24 sessions at primary healthcare units. Participant observation was performed to start the fieldwork. The reports were analyzed by means of the technique of enunciative-pragmatic discourse analysis. ANALYSIS OF RESULTS: The types of action among the coordinators that were congruent with the preventive model were: oppression, bench teaching, biologism and higienism, prescription of approaches, blame apportionment, infantilization, reduction of collective problems, denigration of group settings and use of monologue. The types of action consonant with the new promotion model were: facilitation of free expression and autonomy, empathetic communication, constructivism, receptiveness, active listening and promotion of overcoming of violence and alienation. CONCLUSIONS: The coordinators acted primarily by means of the preventive model, without using technical and theoretical resources that allude to group methodology in the field of healthcare. The actions within the preventive and new health promotion models that were identified reveal characteristics that are grounded in, respectively, the ethics of oppression/subordination of users and cooperation/acceptance of users as free and responsible for their choices and consequences.
8 citations
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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.
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200 citations
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.
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192 citations