Processo de revisão da Política Nacional de Promoção da Saúde: múltiplos movimentos simultâneos
01 Nov 2014-Ciencia & Saude Coletiva (ABRASCO - Associação Brasileira de Saúde Coletiva)-Vol. 19, Iss: 11, pp 4313-4322
TL;DR: In this paper, a review of the 2006 National Health Promotion Policy (PNPS) is described, and the results are systematically ordered with the aid of an analytical matrix organized by objectives, principles, guidelines, themes and actions, resulting in a new PNPSP.
Abstract: Public policy can be understood as the translation of government proposals and the aspirations of society. Driven by the advances and challenges of social transformation, the need for the coordination of agendas and limited social participation in the drafting of the 2006 National Health Promotion Policy (PNPS), the Ministry of Health and the Thematic Group on Health Promotion/Abrasco proposed the PNPS review. This article describes the steps in that process. It involves policy analysis conducted by literature review and document analysis from the "internal triangulation" standpoint. The revision process adopted multiple approaches on data gathering (Regional Workshops and Health Councils, Intra/Intersectorial Delphi and Electronic Questionnaire). It also used heterogeneous sources of information, different local contexts (five regions of Brazil) and peer validation. The results were systematically ordered with the aid of an analytical matrix organized by objectives, principles, guidelines, themes and actions, resulting in a draft of the new PNPS. Lastly, a national seminar was organized in which the results of the process and a synthesis of the revised text were presented, making it possible to identify process gains and the next steps for the actors involved with the new PNPS.
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TL;DR: The National Health Promotion Policy (PNPS) as discussed by the authors has a history of its development and its adoption as a National Policy and the possibilities that were produced therein to amplify the completeness of healthcare.
Abstract: Health is a fundamental human right, according to the global commitment to the Universal Declaration of Human Rights. Health is a public good socially produced by and within social networks and disputes among subjects that seek to place certain interests and needs on the agenda of public policies. Health Promotion, as a set of strategies and forms of producing health, both individual and collective, aiming to meet the social needs of health and to assure better quality of life of the population, emerges intrinsically marked by tensions inherent to the defense of the right to health. The present article intends to detail a certain pathway of Health Promotion at SUS, telling the history of its affirmation as a National Policy and the possibilities that were produced therein to amplify the completeness of healthcare. The authors, totally involved in the preparation, implementation, and revision of the National Health Promotion Policy (PNPS), classified the journey into three chapters: (1) 1998/2004 – Embryo of a PNPS; (2) 2005/2013 – Birth, growth, and development of a PNPS; (3) 2013-2015 – Revision, expansion and dissemination of the PNPS. In addition to the narrative of a history, the cycle analysis of a policy, or balance of advancements, there is an attempt to restore contexts, texts, speeches, and tensions in the PNPS trajectory. The next chapters are still ongoing, and announce paths and possibilities on how to ensure that a Policy is kept alive.
72 citations
TL;DR: In this article, a revisao narrativa analyzes the avancos e desafios da implementacao da Politica Nacional de Promocao da Saude (PNPS) quanto as suas agendas prioritarias and aponta aspectos criticos for sua sustentabilidade in tempos de crises.
Abstract: Resumo O estudo analisa os avancos e desafios da implementacao da Politica Nacional de Promocao da Saude (PNPS) quanto as suas agendas prioritarias e aponta aspectos criticos para sua sustentabilidade em tempos de crises. Estudo de revisao narrativa, abrangendo estudos publicados e documentacao institucional. A PNPS foi aprovada em 2006 e revisada em 2014 e destaca a importância dos condicionantes e determinantes sociais da saude no processo saude-doenca e tem como pressupostos a intersetorialidade e a criacao de redes de corresponsabilidade que buscam a melhoria da qualidade de vida. Foram descritos avancos nas prioridades destacadas na PNPS, em programas e acoes de enfrentamento ao uso do tabaco e seus derivados; alimentacao adequada e saudavel; praticas corporais e atividades fisicas; promocao do desenvolvimento sustentavel; o enfrentamento do uso abusivo de alcool e outras drogas; a promocao da mobilidade segura e sustentavel; e a promocao da cultura da paz e de direitos humanos. Entretanto, os avancos da PNPS apresentados podem estar seriamente ameacados frente a grave crise politica, economica e institucional que abateu o pais, em especial os cortes orcamentarios para os proximos 20 anos, com a Emenda Constitucional 95, desenhando um cenario futuro de muitas incertezas.
66 citations
TL;DR: The results show the potential of the Health Academy Program as a strategy to promote healthcare in the community nationwide in Brazil as well as the characteristics of its operation.
Abstract: The National Health Promotion Policy reasserted the Brazilian Ministry of Health's commitment to bolster the promotion of health in the Unified Health System. In this context, the Health Academy Program constitutes a new tool of the health network for the enhancement of individual and collective primary healthcare. The scope of this study is to present the program implementation scenario, describing characteristics of its operation in the country. Data were collected through an electronic form sent to all Municipal Health Departments that received federal resources to implement the program. The response rate was 85%, corresponding to 2,418 municipalities. A total of 856 centers were found to be in operation, primarily promoting physical exercise, healthy eating and health education. The main participants were adults and the elderly. Difficulties reported by the administrators involve the inclusion of children and adolescents and the hiring of professionals. Over 90% of the program centers do not depend exclusively on federal funding for operation and receive municipal support to conduct their activities. The results show the potential of the program as a strategy to promote healthcare in the community nationwide in Brazil.
60 citations
TL;DR: In this article, a revisiting historicamente, de forma sucinta, o processo de conformacao e desenvolvimento da Promocao da Saude no SUS de modo a, na sequencia, apresentar alguns dados sobre as praticas corporais and atividades fisicas nesta realidade.
Abstract: Resumo O presente artigo busca refletir criticamente sobre o processo de institucionalizacao e fortalecimento das praticas corporais e atividades fisicas como acoes de Promocao da Saude na Atencao Basica do Sistema Unico de Saude (SUS). Para examinar a configuracao dessa forma de cuidado e eixo de acao que emerge e vem se consolidando na saude publica brasileira, optamos por revisitar historicamente, de forma sucinta, o processo de conformacao e desenvolvimento da Promocao da Saude no SUS de modo a, na sequencia, apresentar alguns dados sobre as praticas corporais e atividades fisicas nesta realidade. Por fim, ha a analise critica das interacoes, interfaces e distanciamentos que se processam entre as praticas corporais e atividades fisicas e os referenciais teoricos da Promocao da Saude, em sua vertente critica. Argumenta-se que parte do problema reside na producao de saberes que desconsideram os aspectos epistemologicos da relacao entre praticas corporais e atividades fisicas. Conclui-se que apesar do exponencial crescimento da oferta dessas acoes, ainda nao e possivel afirmar que esta forma de cuidado possa ser caracterizada como Promocao da Saude ja que seria necessario observar alguns principios para isso, tais como empoderamento, participacao social, autonomia, equidade, integralidade, entre outros.
33 citations
TL;DR: The authors examine distanciamentos e interfaces entre os campos da Educacao Fisica (EF) and da Saude Coletiva (SC) no contexto brasileiro.
Abstract: Resumo O artigo examina distanciamentos e interfaces entre os campos da Educacao Fisica (EF) e da Saude Coletiva (SC) no contexto brasileiro, explicitando tensionamentos na luta pela autoridade e competencia cientificas, consoante os conceitos de “campo cientifico” e “nucleos de saberes”. Compreendendo a SC como campo institucionalizado, legitimado e cientificamente consolidado com tres nucleos fundamentais: Epidemiologia; Ciencias Sociais e Humanas; e Politicas, Planejamento e Gestao; evidenciamos sua aproximacao com o campo da EF, resultando em saberes e praticas especificas da EF em SC. Ao naturalizar a linguagem do risco do sedentarismo, a Epidemiologia foi o primeiro nucleo de vinculacao desse novo campo. Nao obstante, reflexoes vindas das Ciencias Sociais ampliam a visao dos objetos de estudo da EFSC ao reconhecer a natureza multidimensional da cultura corporal vinculada a saude. Ja o nucleo Politicas so adquire contornos recentemente, quando a atividade fisica se torna prioridade no conjunto de politicas e programas de combate as doencas cronicas e de promocao da saude. Tensoes entre os paradigmas biologico e social marcam a conformacao dos campos e representam um desafio a ser vencido pela EFSC, mas o referencial critico em saude oferece um caminho promissor para esta superacao.
30 citations
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01 Apr 2007
TL;DR: In this article, an artigo busca analisar as relacoes entre saude and seus determinantes sociais de saude, apresentando inicialmente o conceito de determinantes Sociais of saude (DSS) and uma breve evolucao history of the processo saude/doenca no âmbito das sociedades, desde meados do seculo XIX.
Abstract: RESUMO Este artigo busca analisar as relacoes entre saude e seus determinantes sociais, apresentando inicialmente o conceito de determinantes sociais de saude (DSS) e uma breve evolucao historica dos diversos paradigmas explicativos do processo saude/doenca no âmbito das sociedades, desde meados do seculo XIX. Em seguida sao discutidos os principais avancos e desafios no estudo dos DSS, com enfase em novos enfoques e marcos de referencia explicativos das relacoes ente os diversos niveis de DSS e a situacao de saude. Com base nesses estudos e marcos explicativos, discutese, em seguida, uma serie de possibilidades de intervencoes de politicas e programas voltados para o combate as iniquidades de saude geradas pelos DSS. Finalmente, sao apresentados os objetivos, linhas de atuacao e principais atividades da Comissao Nacional sobre Determinantes Sociais da Saude, criada em marco de 2006, com o objetivo de promover estudos sobre os DSS, recomendar politicas para a promocao da equidade em saude e mobilizar setores da sociedade para o debate e posicionamento em torno dos DSS e do enfrentamento das iniquidades de saude.
615 citations
TL;DR: In this paper, an analysis of qualitative research, based on benchmark authors and the author's own experience, is presented, with the hypothesis that in order for an analysis to be considered reliable, it needs to be based on structuring terms of qualitative analysis, namely the verbs "comprehend" and "interpret", and nouns "experience", "common sense" and social action.
Abstract: This essay seeks to conduct in-depth analysis of qualitative research, based on benchmark authors and the author's own experience. The hypothesis is that in order for an analysis to be considered reliable, it needs to be based on structuring terms of qualitative research, namely the verbs 'comprehend' and 'interpret', and the nouns 'experience', 'common sense' and 'social action'. The 10 steps begin with the construction of the scientific object by its inclusion on the national and international agenda; the development of tools that make the theoretical concepts tangible; conducting field work that involves the researcher empathetically with the participants in the use of various techniques and approaches, making it possible to build relationships, observations and a narrative with perspective. Finally, the author deals with the analysis proper, showing how the object, which has already been studied in all the previous steps, should become a second-order construct, in which the logic of the actors in their diversity and not merely their speech predominates. The final report must be a theoretic, contextual, concise and clear narrative.
527 citations
TL;DR: The artigo discute a promocao da saude como uma estrategia importante for o enfrentamento dos problemas sanitarios no contemporâneo e a melhoria da qualidade de vida da populacao em sua relacao indiscutivel com os compromissos eticos da politica and do sistema de saude brasileiros as mentioned in this paper.
Abstract: O artigo discute a promocao da saude como uma estrategia importante para o enfrentamento dos problemas sanitarios no contemporâneo e a melhoria da qualidade de vida da populacao em sua relacao indiscutivel com os compromissos eticos da politica e do sistema de saude brasileiros. Nele tambem sao apresentadas as bases da Politica Nacional de Promocao da Saude que o Ministerio da Saude vem construindo.
154 citations
TL;DR: Uma analise longitudinal da experiencia brasileira com o Programa Saude da Familia (PSF), ao longo dos doze anos da sua implantacao e implementacao, contextualizando a luz da experiencecia que e unica e peculiar ao Sistema Unico de Saude.
Abstract: The present article is a longitudinal analysis of the Brazilian experience with the Family Health Program (PSF) throughout its 12 years of implementation. The article starts with the fundamental purpose of such strategy which is the reorganization of Basic Health Care, contextualizing in the light of this unique and peculiar experience to the Brazilian Unified Health System (SUS). It highlights the progresses and challenges of the PSF, indicating urgent needs regarding technological incorporation, formation of labor force, establishment of new mechanisms as well as agreements on basic care funds and the direction of new strategies and technologies in the process of monitoring and evaluation. To conclude, the article shows the elements to foster a debate about such questions, which must be permanent and lucid in the perspective of building the Brazilian Unified Health System and the right to health.
140 citations
Journal Article•
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