Viva Mulher: constructing a cervical cancer control program in Brazil

ABSTRACT

Through a number of isolated initiatives that began in the 1960s, Brazil accumulatedknowledge and experience that in the late 1990s culminated in the implementation of the firstnationwide public health action meant to coordinate health bodies and personnel from thefederal, state, and municipal administrative levels to address a chronic degenerative disease.The main goal of this article is to analyze the process of construction of this public policy forcancer control in Brazil —more specifically, organized screening for the control of cervicalcancer in the form of the Viva Mulher program. Our analytical approach relies on elementsfrom the history of public policy and from the history of institutions, combining the use ofdocumental sources, scientific literature, and interviews with managers involved in the processunder study. Our analysis endeavors to show how and to what extent this national processincorporated the experiences of local projects and responded both to pressure from the socialmovement and to the country’s political environment. It further shows how the new context,shaped by changes in the organization of the Brazilian health system, influenced this process. (AU)