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Ciência & Saúde Coletiva

Paulo Amarante, Mônica de Oliveira Nunes
T This article presents a historical and epistemological study of the construction of public policies about mental health and psychosocial care in Brazil´s Unified Health System, the SUS. To that end, it proposes an approach that identifies actions and strategies related to social participation in the construction of policies, one of the founding principles of SUS, seeking to delineate its importance in the specific trajectory of the psychiatric reform process. Subsequently, it highlights the originality and importance of actions that used culture as a means and as an end, in the sense of not restricting psychiatric reform to a transformation limited to public services or health in the strict sense of the term, emphasizing the principle of construction of a new locus in society for madness...
June 2018: Ciência & Saúde Coletiva
José Gomes Temporão
In this interview, the former Minister of Health, José Gomes Temporão, professor and retired tenured researcher from Fiocruz in Rio de Janeiro, outlines the trajectory and the challenges facing management in the Ministry of Health in the period from 2007 to 2010 when he held the post.
June 2018: Ciência & Saúde Coletiva
José Carvalho de Noronha, Gustavo Souto de Noronha, Telma Ruth Pereira, Ana Maria Costa
This article reflects on the future of the Brazilian Unified Health System (SUS, acronym in Portuguese), based on the foresight exercises conducted by the Brasil Saúde Amanhã initiative of the Oswaldo Cruz Foundation. The text briefly reviews some paths followed by the SUS as referred to in the Federal Constitution of 1988. It highlights the movement towards the decentralization of care and the constraint of health financial resources that reduced policies of increasing public expenditures. It examines the public and private arrangements for financing and provision of services that have resulted in sectoral privatization, mainly from economic policies articulated with concession of fiscal benefits...
June 2018: Ciência & Saúde Coletiva
Lenir Santos
This article takes stock of the implementation of Brazil's public health system in the period since the promulgation of the 1988 Constitution, which enshrines the right to health. It analyzes issues affecting the organizational effectiveness of health service provision such as funding and relations between different spheres of government. It focuses on the role of local government, the centralization of legislative powers, which has been shown to weaken the member states, and the financial dependence of local and state governments on federal government and how this has affected policy implementation...
June 2018: Ciência & Saúde Coletiva
Carlos Octávio Ocké-Reis
Using official data from Brazil's Internal Revenue Service, this article estimates health-related federal tax expenditures between 2003 and 2015. The Ministry of Health will thus be able to assess the relevance of these subsidies within a context of gross underfunding of Brazil's public health system. The analysis was built around concepts and theories developed in the fields of political economy and public finance, focusing on policies directed at public funding of the health sector. The results show that tax expenditures associated with health insurance plans was R$12...
June 2018: Ciência & Saúde Coletiva
José Antonio de Freitas Sestelo
This article gives, first, a historical account of the action of capital in healthcare in contemporary Brazil and then introduces a debate on the dominance of finance ('financial dominance') in healthcare based on one case to examine: the hypertrophy of the structure for intermediation in private healthcare existing in Brazil, using the theses of José Carlos de Souza Braga as its principal reference. The article highlights the nebulous nature of what happens at the interface between the public and private elements of the Brazilian health system, and the limits inherent to the use of reductionary, or dichotomic, models to explain details and factors in this interaction...
June 2018: Ciência & Saúde Coletiva
Hillegonda Maria Dutilh Novaes, Guilherme Loureiro Werneck, Eduarda Angela Pessoa Cesse, Moises Goldbaum, Maria Cecília de Souza Minayo
This article deals with a public policy in education, Post Graduation in Collective Health, to identify forms of dialogue of this policy, with the public health policy, the SUS, starting in 1990. The main product of PGSC policy is the training of masters and doctors, essential for teaching and research in the field. Bibliographic review and analysis of CAPES documents and databases based the analysis. Education policy was consistent over time and core to social development, alongside health policy, without presenting formal points of intercession, and its impacts occur mainly through the formation of good and committed professionals, teachers and researchers...
June 2018: Ciência & Saúde Coletiva
Maria Cecilia de Souza Minayo, Edinilsa Ramos de Souza, Marta Maria Alves da Silva, Simone Gonçalves de Assis
This article reflects on the evolution of the theme of violence within the field of public health. It provides an overview of the strategies and actions developed within Brazil's Unified Health System developed in response to the country's main guiding policy on violence, the National Policy for the Reduction of Morbidity and Mortality due to Accidents and Violence, drawing on baseline documents, national and international research, data from the country's main violence information systems, and the firsthand experiences of the authors from their participation in the abovementioned actions...
June 2018: Ciência & Saúde Coletiva
Romeu Gomes, Daniela Murta, Regina Facchini, Stela Nazareth Meneghel
This article is an objective examination of aspects of gender and sexual rights, and their implications in the field of health field, using the methodology of an essay. The first part discusses femicide, highlighting that there are deaths of women due to the fact of being women, which constitute what could be described as the crimes of lèse-humanité or 'femi-genocide'. The second part discusses sexual and gender diversity, with an emphasis on the fragility of the 'right to have rights' expressed in the deterioration in health conditions of the population that is LGBTI (Lesbians, Gays, Bisexuals, Transvestites, Transsexuals and Intersex)...
June 2018: Ciência & Saúde Coletiva
Carlos Machado de Freitas, Vânia Rocha, Eliane Lima E Silva, Taís de Moura Ariza Alpino, Mariano Andrade da Silva, Maíra Lopes Mazoto
The 1988 Constitution represents an important achievement in terms of rights and an important pact sealed around a long-term strategy for the nation's future based on a social development model oriented towards reducing the risk of disease and injuries and an ecologically balanced environment. These achievements manifested themselves in policies, institutionalization and the creation of spaces for public participation. The article outlines the main achievements, limits and obstacles that have affected the environmental and health agendas in the last 30 years since the creation of the Unified Health System ...
June 2018: Ciência & Saúde Coletiva
Maria Helena Machado, Francisco Rosemiro Guimarães Ximenes Neto
This article presents a historical analysis of work management and education in the healthcare field over the three decades since the creation of Brazil's Unified Health System (SUS, acronym in Portuguese). Using the sociology of professions as a frame of reference, it addresses the following topics: the health labor market; trends in healthcare employment; the healthcare workforce; and the regulation and dynamics of undergraduate programs in the health field. It analyzes each of the moments that characterize the area, from the pre-SUS period to the present day...
June 2018: Ciência & Saúde Coletiva
Carlos Minayo Gomez, Luiz Carlos Fadel de Vasconcellos, Jorge Mesquita Huet Machado
This article draws on current understandings of workers' health in Brazil that emerged concomitantly with advances in the field of public health. It describes the institutional trajectory of the field of workers' health within the Unified Health System (SUS), emphasizing the challenges faced in developing actions in the sphere of workers' health surveillance. It synthesizes the often tortuous path taken over the last 30 years between multiprofessional training processes, coordination between different levels of the SUS, interinstitutional support, especially from public universities, and interaction with participatory processes...
June 2018: Ciência & Saúde Coletiva
José Agenor Alvares da Silva, Ediná Alves Costa, Geraldo Lucchese
This article presents an overview of the nature, functions and history of health surveillance in the structure of the Brazilian Unified Health System (SUS). Bibliographical sources and official documents were used, with references from the careers of the authors, who have worked in health surveillance. Extremely serious adverse events in the mid-1990s gave political visibility to the fragility of Brazilian health surveillance, and were reflected in serious problems for the SUS. The creation of Anvisa and the SNVS surveillance system, and the support for bodies in individual states and municipalities, resulted in improvement in the structure and functioning of health surveillance, and improved recognition of the area as an emerging theme in research and education in public health...
June 2018: Ciência & Saúde Coletiva
Jorge Antonio Zepeda Bermudez, Angela Esher, Claudia Garcia Serpa Osorio-de-Castro, Daniela Moulin Maciel de Vasconcelos, Gabriela Costa Chaves, Maria Auxiliadora Oliveira, Rondineli Mendes da Silva, Vera Lucia Luiza
This article examines pharmaceutical services and access to essential medicines in Brazil during the 30 years since the advent of Brazil's Unified Health System from a comprehensiveness perspective. The following topics are addressed: the "realignment" of pharmaceutical services; human resources in pharmaceutical services; the essential medicines concept; the rational use of medicines; technological advances and drug manufacturing; and ethical regulation. With a strong regulatory focus and a structural framework centered on the National Medicines Policy, the past three decades represent a mixture of progress and setbacks, considering the national complexities of the healthcare system and the political, economic and social changes that have influenced policy and access to medicines, which is a key concern even in the world's richest countries, as the forums of discussion on global health have demonstrated...
June 2018: Ciência & Saúde Coletiva
Renato Peixoto Veras, Martha Oliveira
The article discusses the development of a health care model for the elderly, seeking to add to the discussion about the aging of the population in the context of a new epidemiological and demographic scenario. Considering that the aging process in Brazil is relatively recent, more relevant social movements have been described in the construction of health policies directed towards the elderly. After an initial description of the main milestones, we present the model of care considered most appropriate for the best care of the elderly...
June 2018: Ciência & Saúde Coletiva
Maria do Carmo Leal, Celia Landmann Szwarcwald, Paulo Vicente Bonilha Almeida, Estela Maria Leão Aquino, Mauricio Lima Barreto, Fernando Barros, Cesar Victora
This study presents an overview of public sector interventions and progress made on the women's and child health front in Brazil between 1990 and 2015. We analyzed indicators of antenatal and labor and delivery care and maternal and infant health status using data from the Live Birth Information System and Mortality Information System, national surveys, published articles, and other sources. We also outline the main women's and child health policies and intersectoral poverty reduction programs. There was a sharp fall in fertility rates; the country achieved universal access to antenatal and labor and delivery care services; access to contraception and breastfeeding improved significantly; there was a reduction in hospital admissions due to abortion and in malnutrition...
June 2018: Ciência & Saúde Coletiva
Luiz Felipe Pinto, Ligia Giovanella
Since its creation in 1994, the Family Health Program has become the main strategy for changing care models and increasing access to the first contact service of the Unified Health System (SUS). A little more than ten years later, in 2006 the program was transformed into the Family Health Strategy (FHS) within the National Policy on Primary Care (PNAB). This article evaluates the effects of the implementation of the FHS over the last two decades in Brazil, demonstrating the access provided and the trends in ambulatory care sensitive conditions (ACSC)...
June 2018: Ciência & Saúde Coletiva
Carlos Augusto Grabois Gadelha, José Gomes Temporão
The concept and approach of the Health Economic-Industrial Complex (HEIC) were present in the advancement of the Unified Health System (SUS) in the last decades, contributing to the incorporation of an agenda related to the national pattern of development. The paper reconstructs this approach to capture its dynamics and demarcate the vision developed in this paradigm. It reveals the thinking matrices of the field of political economy that provide the analytical substrate for its development, allowing us to confront the reductionist use of the concept...
June 2018: Ciência & Saúde Coletiva
Paulo Marchiori Buss
This paper addresses the role of health in Brazil's health diplomacy and international cooperation since the emergence of the Brazilian Unified Health System (SUS), focusing in particular on South-South cooperation, in line with the priorities of the country's international technical cooperation since its creation. It highlights the relationship with the Latin American and Caribbean Countries (LAC) and the Community of Portuguese Speaking Countries (CPLP), more specifically, with the Portuguese Speaking African Countries (PALOP) and East Timor...
June 2018: Ciência & Saúde Coletiva
Janine Miranda Cardoso, Rogério Lannes Rocha
This article aims to reflect on communication and health projects and strategies involved in the struggle for the right to health, construction and defense of the Unified Health System. Drawing on studies, debates and deliberations that have been ongoing since the 8th National Health Conference and based on contemporary communication configurations, it problematizes tensions, challenges and opportunities related to digital culture, journalistic coverage and public communication in health institutions in Brazil...
June 2018: Ciência & Saúde Coletiva
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