| |  | Miranda, J. J. | ¿Políticas de salud y salud politizada? Un análisis de las políticas de salud sexual y reproductiva en Perú desde la perspectiva de la ética médica, calidad de atención y derechos humanos read moreAbstract: Health professionals view medical ethics as a discipline that provides the basis for more adequate patient care. In recent years the concepts of quality of care and human rights - with their attending discourses - have joined the concept of medical ethics among the paradigms to consider in care for humans both at the individual and health policy levels. The current study seeks to analyze such paradigms, based on a case study of sexual and reproductive health policies in Peru in the last 10 years. | 2008 |
| | | Bosi, Maria L. | Avaliação da qualidade ou avaliação qualitativa do cuidado em saúde? read moreAbstract: The paper presents a theoretical exercise regarding health care evaluation in an effort to define several concepts. The multi-dimensional aspects of quality in health are emphasized in addition to the differences between quality evaluation and qualitative evaluation. The implications of not distinguishing between these two concepts are also discussed. Health care is analyzed as a material expression of interpersonal relations in this field and as an object of evaluation, highlighting its intricate relation with integrality and humanization. It is affirmed that quality evaluation and qualitative evaluation are not interchangeable labels, but rather political choices connected to health policies that can not be juxtaposed. Therefore, understanding this distinction is necessary for constructing evaluation proposals that surpass traditional and exclusionary perspectives. | 2007 |
| | | Macinko, James | La renovación de la atención primaria de salud en las Américas read moreAbstract: At the 2003 meeting of the Directing Council of the Pan American Health Organization (PAHO), the PAHO Member States issued a mandate to strengthen primary health care (Resolution CD44.R6). The mandate led in 2005 to the document "Renewing Primary Health Care in the Americas. A Position Paper of the Pan American Health Organization/WHO [World Health Organization]," and it culminated in the Declaration of Montevideo, an agreement among the governments of the Region of the Americas to renew their commitment to primary health care (PHC). Scientific data have shown that PHC, regarded as the basis of all the health systems in the Region, is a key component of effective health systems and can be adapted to the range of diverse social, cultural, and economic conditions that exist. The new, global health paradigm has given rise to changes in the population's health care needs. Health services and systems must adapt to address these changes. Building on the legacy of the International Conference on Primary Health Care, held in 1978 in Alma-Ata (Kazakhstan, Union of Soviet Socialist Republics), PAHO proposes a group of strategies critical to adopting PHC-based health care systems based on the principles of equity, solidarity, and the right to the highest possible standard of health. The main objective of the strategies is to develop and/or strengthen PHC-based health systems in the entire Region of the Americas. A substantial effort will be required on the part of health professionals, citizens, governments, associations, and agencies. This document explains the strategies that must be employed at the national, subregional, Regional, and global levels. | 2007 |
| | | Gil, Célia R. | Atenção primária, atenção básica e saúde da família: sinergias e singularidades do contexto brasileiro read moreAbstract: This article analyzes the concepts of primary health care, basic health care, and family health care as used in official documents by the Brazilian Ministry of Health, final reports of the National Conferences on Health and Human Resources, the Basic Operational Ruling on Human Resources, and texts accessed on-line by BIREME. The data analysis, through double-entry matrices, showed a lack of these references in Brazilian health policy formulation and implementation. Basic Operational Ruling 96 (NOB/96) plays a distinct role in this regard; the national conference reports show an important gap in this debate, and most of the published articles present the concepts of primary care and basic care with the meaning of health unit or local service. Articles on the Family Health Program refer to it more as a program than a strategy, and the articles analyzing such concepts show the influence of rationalities underlying the different strategies for organization of health services in the Brazilian scenario, namely Health Surveillance and Programmatic Actions in Health and in Defense of Life. | 2006 |
| | | Souza, Luis E. | O uso de pesquisas na formulação de políticas de saúde: obstáculos e estratégias read moreAbstract: Management of a health system requires knowledge of the health situation and administration, among other factors. The use of scientific knowledge by health policy-makers is thus recommendable. However, policy-making processes and scientific practices themselves often appear to pose obstacles to the actual utilization of research results. Many such obstacles result from reifying views of the decision-making process and objectivist conceptions of science. We propose a re-conceptualization of health policy-making and scientific practices based on the language game notion. The use of research results would thus become an exchange of significant metaphors between policy-makers and scientists. Adoption of pluralistic research systems and intensification of interfaces between researchers and policy-makers in a context of knowledge-sharing would be the main strategies to improve this exchange. Such strategies would be efficient to the extent that they succeeded in drawing science and common sense closer together, thereby transforming both. | 2004 |
| | | Carneiro Jr., Nivaldo | Organização das práticas de atenção primária em saúde no contexto dos processos de exclusão/inclusão social read moreAbstract: This article reports on a primary health care and training center in São Paulo, Brazil, and the organization of its activities based on equity and positive discrimination. Operating in the city center of São Paulo, the policy aims to provide health services access to certain target groups (homeless, sex workers, and slum-dwellers). It also raises discussion on the various forms of social life found in downtown areas, mainly those of vulnerable groups lacking access to public goods and services. The experience demonstrates the feasibility of implementing health policies based on universal access. | 2003 |
| | | Pierantoni, Celia R. | As reformas do Estado, da saúde e recursos humanos: limites e possibilidades read moreAbstract: As transformações observadas a partir da implementação da reforma do Estado brasileiro destacam antigos problemas e introduzem outros novos para a área de recursos humanos em saúde. Este trabalho examina o desenvolvimento da área de recursos humanos (RH) nas políticas públicas, tendo como referencial as reformas da política nacional de saúde na década de 1990 no Brasil. Aponta para a necessidade de ampliação e aprofundamento do conhecimento sobre o trabalho desenvolvido na área de saúde que envolve a abordagem da administração geral, da sociologia do trabalho e das profissões e especialidades, do desenvolvimento tecnológico, das análises econômicas, dos processos de aprendizagem, entre outras. Identifica dimensões críticas para a abordagem de recursos humanos em saúde que necessitam ser analisadas e acompanhadas de mecanismos de intervenção específica e não excludentes: a dimensão gerencial, a dimensão estrutural e a dimensão regulatória. Destaca a necessidade de intervenções que reintroduzam os profissionais de saúde na centralidade do debate como participantes da implementação das políticas em seus aspectos político, administrativo, técnico e social. | 2001 |
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