[Getting to know former students of PROFAE nursing courses]. / Conhecendo egressos do curso técnico de Enfermagem do PROFAE.

The PROFAE (Professionalization Project in Nursing) was a relevant initiative for professional education. The objectives were to describe the profile of the former students of the technical nursing course of the São Paulo Health Department training centers so as to evaluate the effects of the course for the mobility and professional performance in the working market. Data collection was performed using a questionnaire answered by 216 former students and four focal groups with former students and nurse supervisors. Most respondents were women, with an average age of 42.2. The course received a positive evaluation, and two aspects were pointed out as motivating for searching for it: institutional support and COREN's resolutions. The former students perceive they had more initiative and theoretical preparation after the course. Nursing aide remains as the most common position in the area, thus causing dissatisfaction, because, especially in public services, technician positions are not available.

Attitudes, knowledge and skills of nurses in the Xingu Indigenous Park.

OBJECTIVE: to analyze the attitudes, knowledge and skills that make up the professional competencies of nurses working in indigenous territories. METHOD: this is an exploratory-descriptive study with a qualitative approach, conducted with nurses working in the Xingu Indigenous Park in 2016. Data were obtained in semi-structured interviews and treated according to the thematic-categorical analysis method. RESULTS: the nurse's performance in the Xingu Indigenous Park has a multifaceted character, being defined by the territory's interculturality and specificities and by how the service is organized. Technical skills, concepts from anthropology and attitudes that facilitate a respectful dialogue with cultural difference are required for a professional to act in this context. FINAL CONSIDERATIONS: the performance of health professionals in indigenous territories requires specificities associated with the acquisition of new knowledge, attitudes and skills geared to the intercultural dimension of the work developed.

[Leprosy in Espírito Santo State, Brazil: a growing endemic?]. / Hanseníase no Estado do Espírito Santo, Brasil: uma endemia em ascensão?

This study provides a trend analysis of leprosy among patients in the State of Espírito Santo, Brazil, from 1980 to 2003. Using temporal series statistical models, an upward trend was identified throughout the period in the overall detection rate (p<0.05), with an apparent stabilization at the end of the period. We also observed an upward trend for the following periods: (i) 1980-1987 in the <15 and >or=50-year age groups and for paucibacillary forms; (ii) 1988-1995 for the 15-19, 20-29, and >or=50-year groups and for multibacillary forms; and (iii) 1996-2003 in the 20-29-year group and paucibacillary forms. The indicators for evaluation of the endemic indicate: stable levels in grade 2 disability (mean of 6%); a proportion of less than 10% of cases in individuals<15 years of age; and a treatment dropout rate of approximately 6%. Prevalence showed a sharp decline. The upward trend can be explained partially by greater surveillance sensitivity, but the high proportion of individuals<15 highlights the need for studies aimed at better knowledge of residual sources of infection, especially in the household.

[The basic health and assistance to Hansen's Disease in health care services of a municipality of São Paulo State]. / Atenção básica de saúde e a assistência em Hanseníase em serviços de saúde de um município do Estado de São Paulo.

UNLABELLED: This descriptive study was carried out in a municipality of Sao Paulo State. The objective was to identify and to characterize the Leprosy Control Program in primary care in the city of research. METHODOLOGY: the interviews were conducted with professionals responsable for care in Hansen's Disease and with manager of public health policies. RESULTS: the public health policies prioritize the development of primary care and emphasis on the public health. The control actions are held by trained and experient professionals. It emphasizes absence of active search for cases which undermines the real epidemiological situation, and the important health education to the reduction of stigma and bring the subject of adjustments necessary in new situation of life and overcome limitations.

[Health services organization on the elimination of Leprosy in municipalities of São Paulo State]. / Organização de serviços de saúde na eliminação da Hanseníase em municípios do Estado de São Paulo.

The present study aims to analyze actions to control Hansen's disease developed in nine municipalities of the State of São Paulo and one of the health authorities of the city of São Paulo, selected based on their population, geographic location and prevalence coefficients. The study was approved by the Ethics Committee n masculine 514/05 and instruments were administered by means of interviews to 59 professionals, 17 interlocutors and 9 managers. Data were analyzed using the program SPSS (Statistical Package for Social Scientists). It was verified that prevalence is on the decline and detection remains stable. The physical incapacity prevention actions, health education and active search have not been satisfactorily developed. The most qualified professionals are in the reference units and teamwork is fragile.

Crises contemporâneas: retrocessos sociais, políticas de saúde e desafios democráticos / Contemporary crisis: social regressions, health policies, and democratic challenges

Resumo No contexto da globalização, é recorrente a menção às crises contemporâneas da democracia, da ciência, econômico-sociais, sanitárias e ambientais. No Brasil, essas crises se agravam em função da estrutura histórico-social que carrega profundos problemas não resolvidos, bem como em função de governos que têm desgastado as instituições nacionais que foram arduamente reconstruídas no processo de redemocratização do país. Neste editorial, refletimos sobre o contexto de crise nacional experimentado no Brasil nos últimos anos, situando retrocessos sociais resultantes de políticas neoliberais e conservadoras levadas à cabo pelos últimos dois mandatários do governo federal, e posicionando alguns desafios a serem enfrentados pelo país, a partir de um movimento de retomada da democracia.

Abstract In the context of globalization, mentioning contemporary democracy, science, social-economic, sanitary, and environmental crises is recurrent. In Brazil, these crises have worsened due to historical-cultural structures that carry deep unresolved problems and due to governments that have worn down the national institutions that were reconstructed with hard work during its re-democratization process. In this editorial, we reflect on the national crisis context experienced in Brazil in the last years, situating social regressions resulting from neoliberal and conservative policies carried out by the last two heads of the federal government and placing some challenges to be faced by the country beginning by a movement to retrieve democracy.

Primary health care and the coordination of care in health regions: managers' and users' perspective. / Atenção primária à saúde e coordenação do cuidado nas regiões de saúde: perspectiva de gestores e usuários.

This paper aims to analyze the healthcare coordination by Primary Health Care (PHC), with the backdrop of building a Health Care Network (RAS) in a region in the state of São Paulo, Brazil. We conducted a case study with qualitative and quantitative approaches, proceeding to the triangulation of data between the perception of managers and experience of users. We drew analysis realms and variables from the three pillars of healthcare coordination - informational, clinical and administrative/organizational. Stroke was the tracer event chosen and therapeutic itineraries were conducted with users and questionnaires applied to the managers. The central feature of the construction of the Health Care Network in the studied area is the prominence of a philanthropic organization. The results suggest fragility of PHC in healthcare coordination in all analyzed realms. Furthermore, we identified a public-private mix, in addition to services contracted from the Unified Health System (SUS), with out-of-pocket payments for specialist consultation, tests and rehabilitation. Much in the same way that there is no RAS without a robust PHC capable of coordinating care, PHC is unable to play its role without a solid regional arrangement and a virtuous articulation between the three federative levels.

[Ostomized person's experience with cancer: an analysis based on the chronic disease model according to Morse and Johnson]. / A experiência da pessoa estomizada com câncer: uma análise segundo o Modelo de Trajetória da Doença Crônica proposto por Morse e Johnson.

The study aimed at understanding the meaning of the disease experience for the ostomized people with cancer and the changes on their identity. With a qualitative approach based on the methodological referential of the oral history of life, we have accompanied the subjects during one year, from the moment of hospitalization. During that period, a series of five interviews were performed with each subject. The description and analysis of the evolution were based on the Model of Constellation of the Disease proposed by Morse and Johnson. The analysis showed that, after the deep impact caused by the disease and the permanent ostomy, the subjects begin a new process of realizing their identities, which includes a rediscovery of their place in life.

[Interprofessional collaboration in the Family Health Strategy: implications for the provision of care and work management]. / Colaboração interprofissional na Estratégia Saúde da Família: implicações para a produção do cuidado e a gestão do trabalho.

Interprofessional collaboration is seen as a resource for tackling model of care and workforce problems. The scope of this study was to understand the perception about the shared work and interprofessional collaboration of professionals who work in primary health care. A qualitative study was conducted in São Paulo city. In-depth interviews were performed with professionals from distinct categories who worked in the Family Health Strategy and Support Center for Family Health. The results highlighted the empirical 'professional interaction' and 'production goals' categories. The forms of interaction, the role of specialized matrix support and the perspective in which production goals are perceived by the professionals pointed to tensions between traditional professional logic and collaboration logic. It also revealed the tensions between a model based on specialized procedures and a more collaborative model centered on health needs of families and of the community. The sharing of responsibilities and practices, changes in the logic of patient referral to specialized services and inadequate organizational arrangements remain major challenges to the integration of interprofessional collaboration for the development of new care practices.

Saúde e Sociedade Journal: partnership and openness to new approaches.

The text traces the trajectory of the Saúde e Sociedade scientific journal, published by the School of Public Health, University of São Paulo in partnership with the Associação Paulista de Saúde Pública since 1992. It presents the context of the era in which the journal was created and its mission of divulging the contributions of Human and Social Sciences to Health Care, the challenges it has faced over the length of its history until today, its goals and strategies for improving scientific quality, the journal's visibility, becoming indexed in various national and international bibliographic databases and about its internationalization and sustainability, reaffirming its founding principles.

Attitudes, knowledge and skills of nurses in the Xingu Indigenous Park / Actitudes, conocimientos y habilidades en el trabajo del enfermero en el Parque Indígena de Xingu / Atitudes, conhecimentos e habilidades para o trabalho do enfermeiro no Parque Indígena do Xingu

ABSTRACT Objective: to analyze the attitudes, knowledge and skills that make up the professional competencies of nurses working in indigenous territories. Method: this is an exploratory-descriptive study with a qualitative approach, conducted with nurses working in the Xingu Indigenous Park in 2016. Data were obtained in semi-structured interviews and treated according to the thematic-categorical analysis method. Results: the nurse's performance in the Xingu Indigenous Park has a multifaceted character, being defined by the territory's interculturality and specificities and by how the service is organized. Technical skills, concepts from anthropology and attitudes that facilitate a respectful dialogue with cultural difference are required for a professional to act in this context. Final considerations: the performance of health professionals in indigenous territories requires specificities associated with the acquisition of new knowledge, attitudes and skills geared to the intercultural dimension of the work developed.

RESUMEN Objetivo: analizar las actitudes, conocimientos y habilidades que conforman la competencia profesional de los enfermeros para trabajar en territorios indígenas. Método: estudio exploratorio descriptivo con enfoque cualitativo, en el cual participaron enfermeros que trabajaban en el Parque Indígena de Xingú en 2016. Los datos se obtuvieron mediante entrevistas semiestructuradas y se sometieron al análisis temático categórico. Resultados: la actuación del enfermero en el Parque Indígena de Xingú se caracteriza por la interculturalidad y las especificidades del territorio y de la organización de servicio. El trabajo tiene un carácter de múltiples facetas. Las habilidades técnicas, los conocimientos en antropología y las actitudes que facilitan una interlocución respetuosa con la diferencia cultural constituyen la competencia profesional para actuar en este contexto. Consideraciones finales: el trabajo con la salud en los territorios indígenas presenta especificidades y exige de los enfermeros una práctica profesional única marcada por la adquisición de nuevos conocimientos, actitudes y desarrollo de habilidades orientadas a la dimensión intercultural del trabajo en salud.

RESUMO Objetivo: analisar as atitudes, conhecimentos e habilidades que compõem a competência profissional dos enfermeiros para o trabalho nos territórios indígenas. Método: estudo exploratório-descritivo com abordagem qualitativa realizado com enfermeiros atuantes no Parque Indígena do Xingu em 2016. Os dados foram obtidos por meio de entrevistas semiestruturadas e tratados conforme método da análise temático-categorial. Resultados: a atuação do enfermeiro no Parque Indígena do Xingu é definida pela interculturalidade e pelas especificidades do território e da organização do serviço. O trabalho tem caráter multifacetado. Habilidades técnicas, conhecimentos da antropologia e atitudes facilitadoras de uma interlocução respeitosa com a diferença cultural compõem a competência profissional para atuação neste contexto. Considerações finais: o trabalho da saúde nos territórios indígenas abriga especificidades e demanda dos enfermeiros uma prática profissional singular marcada pela aquisição de novos conhecimentos, atitudes e desenvolvimento de habilidades orientadas para a dimensão intercultural do trabalho em saúde.

[Professionalization of nursing aides at the State of Sao Paulo: a study of supply/demand regarding training]. / Profissionalização de atendentes de enfermagem no Estado de Säo Paulo: um estudo sobre a oferta e demanda de formaçäo.

The purpose of this exploratory study was to verify the problem of nursing aides professionalization and to analyze the offer of courses and demand regarding technical level capacitation at the state of São Paulo, Brazil. Data were obtained through the analysis of documents on professional capacitation in the area in the 1990s. Authors identified a scenario of conceptual and political changes regarding the professionalization and the existence of a great number of aides being professionalized. They also verified a tendency to increase the offer of courses and the demand regarding the capacitation and specialization at the technical level.

[Nursing scientific production presented at the annual meetings of the Brazilian Society for the Development of Science]. / A PRODUÇÃO CIENTÍFICA DOS ENFERMEIROS NAS REUNIÕES DA SOCIEDADE BRASILEIRA PARA O PROGRESSO DA CIÊNCIA.

The authors have analized the scientific production presented by nurses and other professionals associated with the teaching of Nursing, published in the ANNALS of the Yearly Meetings of the Brazilian Society for Science Development (SBPC) from 1949 to 1983. Data showed a prevalence of papers prepared by faculty members over those prepared by Nursing Service Staff, as well a tendency for a quantitative decrease in the scientific production in the last five years.

Oral health technicians in Brazilian primary health care: potentials and constraints.

Different perspectives on the role of mid-level workers in health care might represent a constraint to health policies. This study aimed to investigate how different agents view the participation of oral health technicians in direct activities of oral healthcare with the goal of understanding the related symbolic dispositions. Theoretical assumptions related to inter-professional collaboration and conflicts in the field of healthcare were used for this analysis. A researcher conducted 24 in-depth interviews with general dental practitioners, oral health technicians and local managers. The concepts of Pierre Bourdieu supported the data interpretation. The results indicated inter-professional relations marked by collaboration and conflict that reflect an action space related to different perspectives of primary care delivery. They also unveiled the symbolic devices related to the participation of oral health technicians that represent a constraint to the implementation of oral health policy, thus reducing the potential of primary health care in Brazil.

A atenção primária em regiões de saúde: política, estrutura e organização / Primary care in health regions: policy, structure, and organization / La atención primaria en regiones de salud: política, estructura y organización

Resumo: A atenção primária à saúde (APS) concebida como coordenadora do cuidado e ordenadora da rede regionalizada de atenção à saúde (RAS) é um dos condicionantes da dinâmica regional da saúde. O objetivo do artigo é identificar as dimensões política, de estrutura e de organização da APS em diferentes regiões do Brasil; assume-se que estas dimensões podem explicar, se não o todo, pelo menos parte importante do funcionamento da APS em cenário regional. Foram realizadas 84 entrevistas com atores-chave em cinco regiões de saúde. Essas regiões foram selecionadas com base na diversidade de situações socioeconômicas, territoriais e de organização do sistema de saúde. Apesar da heterogeneidade das RAS, notam-se traços comuns. Na dimensão da política, observou-se fragilidade na cooperação intergovernamental e no protagonismo da esfera estadual, além da incapacidade da Comissão Intergestores Bipartite em se configurar como espaço de planejamento e pactuação. Na dimensão estrutura ficou clara a insuficiência de condições que assegurem minimamente a execução de funções essenciais da APS. Pontos críticos são escassez, má distribuição e problemas de qualificação de recursos humanos, além do subfinanciamento das ações. Na dimensão organização são visíveis as dificuldades para se romper a fragmentação dos serviços. A APS não consegue assumir seu papel de coordenadora do cuidado, e observa-se a ausência de um modus operandi capaz de atender às necessidades dos usuários considerando as especificidades de cada região. A superação dos constrangimentos identificados é central para o fortalecimento do próprio SUS como sistema público, universal, equânime e integral.

Abstract: Primary health care (PHC), conceived as the coordinator of care and the backbone of the regionalized health care network, is one of the conditioning factors in health. The article aims to identify the political, structural, and organizational dimensions of PHC in different regions of Brazil and assumes that these dimensions can at least partially explain the functioning of PHC in the regional scenario. A total of 84 interviews were held with key actors in five health regions. The regions were selected on the basis of the diversity of socioeconomic, territorial, and organizational situations in the health system. Despite the heterogeneity in the regionalized health care networks, some common traits were seen. The political dimension revealed fragilities in intergovernmental cooperation and state-level leadership, in addition to the inability of the Bipartite Inter-Managers Commission to serve as a space for planning and negotiated agreements. The structural dimension showed a clear insufficiency of conditions to minimally ensure the execution of essential functions in PHC. Critical points are the shortage, poor distribution, and deficient qualifications of human resources and underfunding of activities. The organizational dimension reveals difficulties in breaking with the fragmentation of services. PHC is unable to fulfill its role as coordinator of care, and there is lack of a modus operandi capable of meeting users' needs, considering each region's specificities. Overcoming the above-mentioned constraints is essential for strengthening the Brazilian Unified National Health System as a public, universal, equitable, and comprehensive system.

Resumen: La atención primaria de salud (APS), concebida como coordinadora del cuidado y organizadora de la red regionalizada de atención de salud (RAS), es uno de los condicionantes de la dinámica regional de salud. El objetivo del artículo es identificar las dimensiones: política, de estructura y de organización de la APS en diferentes regiones de Brasil; se asume que estas dimensiones pueden explicar, si no todo, por lo menos una parte importante del funcionamiento de la APS en el escenario regional. Se realizaron 84 entrevistas con actores clave en cinco regiones de salud. Las regiones se seleccionaron basándose en la diversidad de situaciones socioeconómicas, territoriales y de organización del sistema de salud. A pesar de la heterogeneidad de las RAS se notan rasgos comunes. En la dimensión política se advirtió la fragilidad en la cooperación intergubernamental y en el protagonismo de la esfera estatal, además de la incapacidad de la Comisión Intergestores Bipartita para convertirse en un espacio de planificación y pactos. En la dimensión estructura quedó patente la insuficiencia de las condiciones que aseguren mínimamente la ejecución de las funciones esenciales de la APS. Puntos críticos son la escasez, mala distribución y problemas de cualificación de recursos humanos, además de la escasa financiación de las acciones. En la dimensión organización son visibles las dificultades para romper la fragmentación de los servicios. La APS no consigue asumir su papel de coordinadora del cuidado, y se observa la ausencia de un modus operandi capaz de atender a las necesidades de los usuarios, considerando las especificidades de cada región. La superación de los obstáculos identificados es primordial para el fortalecimiento del propio Sistema Único de Salud como sistema público, universal, ecuánime e integral.

Gestão do trabalho em saúde: sentidos e usos da expressão no contexto histórico brasileiro / Work management in healthcare: meaning and use of expression in the brazilian historical context / Gestión del trabajo en salud: sentidos y uso de la expresión en el contexto histórico brasileño

Resumo No Brasil, a expressão 'gestão do trabalho' passou a ser utilizada após a 12a Conferência Nacional de Saúde em substituição a 'recursos humanos'. O objetivo foi analisar, com base no contexto histórico brasileiro, os sentidos atribuídos à expressão 'gestão do trabalho em saúde' na literatura científica brasileira, por meio de scoping review na base Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), entre 1990 e 2010. De 436 estudos identificados, 34 foram incluídos. Houve crescimento absoluto das publicações após a 3a Conferência Nacional de Gestão do Trabalho e Educação em Saúde, 2006. O conteúdo foi sintetizado em cinco unidades temáticas: conceitos de gestão do trabalho em saúde, formulação de políticas, participação dos trabalhadores nos processos de trabalho, precarização do trabalho e novos desafios. Observou-se consenso sobre a complexidade da expressão e os aspectos distintos foram explorados dependendo das características políticas, sociais e econômicas no momento da construção do pensamento. As discussões teóricas deveriam estimular mudanças nas práticas de gestão e cultura dos modelos de produção, porém as mudanças são escassas, restando um questionamento não desvelado: gestão do trabalho em saúde, uma mudança terminológica ou de paradigma?

Abstract The expression 'work management in healthcare' began to be used in Brazil after the 12a National Conference of Health, replacing 'human resource'. The aim was analyze the meanings attributed to the use of the term 'work management in healthcare' based on the Brazilian historical context. This research developed a scoping review in the Lilacs database, between 1990 and 2010. Among 436 eligible studies, 34 were included. These publications presented numerical growth especially after the 3rd National Conference of Work Management and Education in Healthcare at 2006. The content was synthetized in five main topics: conceptualizing of work management in healthcare, policy formulation, and participation of workers in the work process, labor precarization and new challenges. Despite the consensus about the complexity of the expression, distinct aspects are explored by the authors depending of political, social and economic contexts during the construction of thought. The theoretical discussions should support changes on practices of management and on culture of production modeling, but practical changes are scarce, generating a question that was not completely answered: does work management in healthcare represent a simple terminology exchange or paradigm shift?

Resumen En Brasil, el término 'gestión del trabajo' pasó a ser utilizado después de la 12a Conferencia Nacional de Salud en sustitución a los 'recursos humanos'. El objetivo fue analizar, con base en el contexto histórico brasileño, los sentidos atribuidos a la expresión 'gestión del trabajo en salud' en la literatura científica brasileña. Esta encuesta ha desarrollado un scoping review en la base Lilacs, entre 1990 y 2010. De 436 estudios identificados, 34 fueron incluidos. Hubo crecimiento absoluto de las publicaciones después de la 3a Conferencia Nacional de Gestión del Trabajo y Educación en Salud, 2006. El contenido fue sintetizado en cinco unidades temáticas: conceptos de gestión del trabajo en salud, formulación de políticas, participación de los trabajadores en los procesos de trabajo, precariedad del trabajo y nuevos desafíos. Se observó consenso sobre la complejidad de la expresión y se exploraran aspectos distintos dependiendo de las características políticas, sociales y económicas al momento de la construcción del pensamiento. Las discusiones teóricas deberían estimular cambios en las prácticas de gestión y en la cultura de los modelos de producción, sin embargo los cambios son escasos, restando un cuestionamiento no dado a conocer: gestión del trabajo en salud, un cambio terminológica o de paradigma?

Atenção primária à saúde e coordenação do cuidado nas regiões de saúde: perspectiva de gestores e usuários / Primary health care and the coordination of care in health regions: managers' and users' perspective

Resumo O objetivo deste artigo é analisar a coordenação do cuidado pela Atenção Primária à Saúde (APS), tendo como pano de fundo o processo de construção da Rede de Atenção à Saúde (RAS) em região do estado de São Paulo. Foi realizado estudo de caso com abordagens quantitativa e qualitativa, procedendo-se à triangulação dos dados, entre a percepção dos gestores e as experiências dos usuários. As dimensões e as variáveis de análise partiram dos três pilares da coordenação do cuidado - informacional, clínico, administrativo/organizacional. Tendo como evento traçador o Acidente Vascular Encefálico, itinerários terapêuticos foram conduzidos com usuários e questionários aplicados a gestores. A construção da Rede de Atenção à Saúde na região estudada tem como traço central o protagonismo de entidade filantrópica. Os resultados sugerem fragilidades da APS em assumir papel de coordenação do cuidado em todas as dimensões analisadas. Ademais, foi identificado mix público-privado para além dos serviços contratados pelo SUS, com desembolso direto para consultas especializadas, exames e reabilitação. Da mesma forma que não existe RAS sem APS robusta capaz de coordenar o cuidado, a APS não consegue exercer seu papel sem um sólido arranjo regional e uma articulação virtuosa entre os três entes federados.

Abstract This paper aims to analyze the healthcare coordination by Primary Health Care (PHC), with the backdrop of building a Health Care Network (RAS) in a region in the state of São Paulo, Brazil. We conducted a case study with qualitative and quantitative approaches, proceeding to the triangulation of data between the perception of managers and experience of users. We drew analysis realms and variables from the three pillars of healthcare coordination - informational, clinical and administrative/organizational. Stroke was the tracer event chosen and therapeutic itineraries were conducted with users and questionnaires applied to the managers. The central feature of the construction of the Health Care Network in the studied area is the prominence of a philanthropic organization. The results suggest fragility of PHC in healthcare coordination in all analyzed realms. Furthermore, we identified a public-private mix, in addition to services contracted from the Unified Health System (SUS), with out-of-pocket payments for specialist consultation, tests and rehabilitation. Much in the same way that there is no RAS without a robust PHC capable of coordinating care, PHC is unable to play its role without a solid regional arrangement and a virtuous articulation between the three federative levels.

Entraves à participação social dos representantes dos trabalhadores no conselho municipal de saúde / Barriers to social participation of workers' representatives in the municipal council of health

Resumo O Conselho Municipal de Saúde é uma instância colegiada de participação social no campo das políticas públicas em saúde. De caráter representativo e deliberativo, o conselho é formado por usuários, trabalhadores e gestores do setor da saúde em esfera municipal. Este artigo busca descrever a participação do segmento desses trabalhadores no Conselho Municipal de um município de grande porte da região metropolitana de São Paulo, identificando os fatores que podem se constituir em entraves à efetiva participação dos representantes deste segmento. A abordagem foi qualitativa e a coleta de dados feita por meio de análise documental, da observação de reuniões do Conselho e de entrevistas semiestruturadas. Como resultado, verificou-se que os conselheiros não identificam com clareza os representantes do segmento dos trabalhadores no conselho, desconhecem o papel deste segmento e apresentam uma expectativa sobre o papel técnico-científico a ser desempenhado por eles. No município de Guarulhos, de forma peculiar, denomina-se "promotores da saúde" o conjunto desses trabalhadores e gestores. Observou-se que isso contribuiu para a diluição de seu papel, acentuando os entraves e obstáculos à efetiva participação da sociedade civil nas decisões relativas às políticas de saúde locais.

Abstract The Municipal Council of Health is a collegiate body of social participation in the field of public health policies. Representative and deliberative council is made up of users, workers and managers in the health sector at the municipal level. This article aims to describe and analyze the participation of health workers segment in the Municipal Health Council of Guarulhos, São Paulo, Brazil. The approach was qualitative and the data were collected through documentary analysis observation of Council meetings and semi-structured interviews. As a result, it was found that members of the city council do not identify clearly the representatives of the segment of workers and unaware of the role of this segment and have an expectation of the scientific-technical role to be played by them. In the municipality of Guarulhos, the worker segment makes up with the segment managers a group called "health promoters". It was observed that this contributed to the dilution of its role, highlighting the barriers and obstacles to the effective participation of civil society in decisions relating to local health policies. Distortions in representation of the segments that compose the council contribute to accentuate the barriers and obstacles to the effective participation of civil society in decisions about local health policies.

O trabalho do fonoaudiólogo no Núcleo de Apoio à Saúde da Família (NASF) - especificidades do trabalho em equipe na atenção básica / The work of speech therapists under Support Centers for Family Health (NASF) - specificities of primary care

Resumo:OBJETIVO:compreender o trabalho do fonoaudiólogo no Núcleo de Apoio à Saúde da Família, identificando tecnologias incorporadas ao processo de trabalho tradicional desse profissional.MÉTODOS:os sujeitos são fonoaudiólogos das equipes de São Paulo/SP do Núcleo de Apoio à Saúde da Família. Por meio de questionário on-line, foram levantadas informações acerca da formação e dos processos de trabalho do fonoaudiólogo como apoiador nessas equipes. Os dados quantitativos foram analisados por meio da Estatística Descritiva e os qualitativos de acordo com os preceitos da Análise Categorial Temática, sob o referencial teórico do Trabalho em Saúde.RESULTADOS:o processo de trabalho foi caracterizado a partir dos elementos que o compõem, sendo que o objeto do trabalho consiste nas equipes de Saúde da Família e na população adscrita, o meio é o Apoio e os instrumentos consistem nas ferramentas tecnológicas preconizadas pelo Ministério da Saúde. A conformação das equipes é variada e a organização do trabalho parte das reuniões de matriciamento. Suas práticas envolvem ações de apoio à assistência, ações de apoio técnico-pedagógico, ações de articulação de Rede e ações de gestão do trabalho e os fonoaudiólogos se apropriam de novos conhecimentos e estratégias por meio do trabalho compartilhado.CONCLUSÃO:na Atenção Básica, as possibilidades de atuação podem ser específicas ou compartilhadas, do núcleo de conhecimento ou de âmbito geral, e o enfoque dependerá das características do território e da disponibilidade dos profissionais. A formação não garante as competências necessárias, havendo a incorporação de novas práticas a partir das vivências experimentadas em serviço.

Abstract:PURPOSE:to understand the work of the speech therapist in the Support Center for Family Health, identifying incorporated technologies to the traditional professional work process.METHODS:these people are speech therapist of São Paulo / SP Support Center for Family Health team. Through online questionnaire, were raised information about the training and work processes of speech therapist as a supporter in these teams. The quantitative data were analyzed using a Descriptive Statistics and qualitative according to the precepts of Thematic Category Analysis, under the theoretical reference Health Work.RESULTS:the work process was characterized from the elements that compose it, and the object of work consists on the Family Health team and the population described, with support and instruments consist on technological tools recommended by the Health Ministry. The conformation team is varied and work organization start on matricial meetings. Their practices involve actions to support assistance, technical and pedagogical actions support, articulations actions of Network and work management actions and the speech therapists have a new knowledge and strategies through the shared work.CONCLUSION:on the Primary Care, the performance possibilities can be specific or shared, the knowledge core or in general , the focus depends on the characteristics of territory and availability. The training does not guarantee the necessary skills, with incorporation of new practices from the experiences in service.

Saúde de sociedade: parceria e abertura para novas abordagens / Saúde e Sociedade Journal: partnership and openness to new approaches

O texto relata a trajetória do periódico científico Saúde e Sociedade, editado desde 1992 pela Faculdade de Saúde Pública da Universidade de São Paulo em parceria com a Associação Paulista de Saúde Pública. Apresenta o contexto da época de criação do periódico, sua missão, voltada à divulgação da contribuição das Ciências Humanas e Sociais à Saúde, os principais desafios enfrentados ao longo de sua história até os dias de hoje, as metas e as estratégias para melhoria da qualidade científica, da visibilidade da revista, da indexação em diferentes bases bibliográficas nacionais e internacionais, da internacionalização e da sustentabilidade, com reafirmação de seus princípios fundantes