Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
1.
Rev. NUFEN ; 12(3): 116-138, set.-dez. 2020. tab
Artículo en Portugués | LILACS-Express | Index Psicología - Revistas técnico-científicas, LILACS | ID: biblio-1136670

RESUMEN

Descrever as características socioeconômicas e da exposição à violência de mulheres acompanhadas em um Centro de Atenção Psicossocial II (CAPS), e analisar a compreensão dos profissionais acerca dessa realidade. Estudo quali-quantitativo que contemplou o inventário sociodemográfico e o histórico da violência de 33 mulheres, e a análise das narrativas de seis profissionais de saúde. A violência doméstica contra a mulher atravessa mais de uma etapa de vida das entrevistadas. As principais formas são a violência sexual e física, principalmente por (ex) parceiros íntimos. As profissionais de saúde compreendem a violência em aspectos individuais e sociais permeadas pelas relações de gênero e poder. Não há consenso sobre algumas ações, como a intersetorialidade com as áreas jurídicas e de proteção a mulher, questão da notificação da violência e o fluxo de atendimento das mulheres. A violência doméstica é um fenômeno expressivo e os CAPS apresentam forte potencial para o empoderamento feminino.


Describe the socioeconomic characteristics and the exposure to violence of women monitored in a Psychosocial Care Center II (CAPS), and analyze the professionals' understanding of this reality. Quali-quantitative study that included the sociodemographic inventory and the history of violence of 33 women, and the analysis of the narratives of six health professionals. Domestic violence against women goes through more than one stage of the interviewees' lives. The main forms are sexual and physical violence, mainly by (ex) intimate partners. Health professionals understand violence in individual and social aspects permeated by gender and power relations. There is no consensus on some actions, such as intersectorality with the legal and women's protection areas, the issue of notification of violence and the flow of care for women. Domestic violence is an expressive phenomenon and CAPS have a strong potential for female empowermentment


Describir las características socioeconómicas y la exposición a la violencia de las mujeres monitoreadas en un Centro de Atención Psicosocial II (CAPS), y analizar la comprensión de los profesionales sobre esta realidad. Estudio cuali-cuantitativo que incluyó el inventario sociodemográfico y la historia de violencia de 33 mujeres, y el análisis de las narrativas de seis profesionales de la salud. La violencia doméstica contra las mujeres atraviesa más de una etapa de la vida de las entrevistadas. Las principales formas son la violencia sexual y física, principalmente por parte de (ex) parejas íntimas. Los profesionales de la salud entienden la violencia en aspectos individuales y sociales permeados por las relaciones de género y poder. No existe consenso en algunas acciones, como la intersectorialidad con las áreas legal y de protección de la mujer, el tema de la notificación de violencia y el flujo de atención a la mujer. La violencia doméstica es un fenómeno expresivo y los CAPS tienen un gran potencial para el empoderamiento femenino.

2.
Arch Environ Occup Health ; : 1-8, 2020 Jun 30.
Artículo en Inglés | MEDLINE | ID: mdl-32602785

RESUMEN

Worldwide, waste pickers are exposed to adverse health effects resulting from hazards at work. This study aimed to identify possible gender disparities among waste pickers. A quantitative cross-sectional epidemiological study, using semi-structured data was conducted in Estrutural's dumpsite, Brasília, Brazil. It included 1,025 waste pickers, with 67% being female. Most of them lived without partners (73.7%), have 3 to 4 children (47.8%), and have a lower monthly income (62.6%

3.
Saúde debate ; 43(spe2): 63-74, nov. 2019. tab
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1059042

RESUMEN

RESUMO Mensurar o impacto do investimento em pesquisas contribui para a compreensão do alcance dos resultados nos sistemas de saúde e para o direcionamento de recursos para áreas prioritárias. Este estudo avaliou o impacto na dimensão 'avanços no conhecimento' produzido pelas pesquisas em saúde financiadas pelo Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS), no período de 2009 a 2014, no Brasil. Trata-se de pesquisa avaliativa, que utilizou o modelo adaptado de avaliação de pesquisas em saúde da Canadian Academy of Health Sciences (CAHS), a partir de análise documental dos registros de acompanhamento de projetos e relatórios de prestação de contas apresentados pelas instituições executoras das pesquisas. Foram investidos R$ 66,49 milhões em 46 pesquisas, em 12 áreas temáticas, distribuídas em cinco tipos de estudos, principalmente em cardiologia. Foram identificados produtos de 28 projetos (60,8%). Observou-se potencial avanço do conhecimento no campo das doenças crônicas. A transferência dos conhecimentos gerados por essas pesquisas e o impacto do investimento nas categorias tomada de decisão informada e benefícios ao setor saúde não foram mensurados e permanecem como desafios para a efetiva avaliação do programa. Estudos que avaliem a aplicação das evidências produzidas na prática clínica e na gestão podem contribuir para a compreensão da medida do impacto das pesquisas financiadas pelo Proadi-SUS em outras dimensões.


ABSTRACT Measuring the impact of investment in research can contribute to a better understanding of the achievement of results in health systems and to guide the management of resources for priority areas. This study sought to evaluate the impact of 'advances in knowledge' produced by research on health funded by the Support Program for the Institutional Development of the Unified Health System (Proadi-SUS) between 2009 and 2014 in Brazil. It is an evaluative investigation based on the institutional records of project monitoring and accountability reports presented by the research institutions. The impact analysis used some of the indicators proposed by the adapted health research evaluation model of the Canadian Academy of Health Sciences (CAHS). The global investments were of R$ 66.49 million in 46 investigations and identified 12 subject areas, distributed in five types of studies. The main area was cardiology. The impact analysis identified the results of 28 projects (60.8%). It was possible to observe potential advances in knowledge in the field of chronic non-infectious diseases. The transfer of knowledge generated by these surveys and the impact of investing on informed decision-making and health sector benefits have not been measured and remain challenges for an effective evaluation of the program. Studies that evaluate the use of evidence produced in clinical practice and management can help understand the impact of research funded by the Proadi-SUS in other dimensions.

4.
BMC Public Health ; 19(1): 581, 2019 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-31096940

RESUMEN

BACKGROUND: The inadequate management of solid waste impacts populations' health and quality of life, and disproportionately affects developing countries. This study aims to describe a protocol for epidemiological diagnosis, the purpose being to estimate the prevalence of chronic and communicable and non communicable diseases in waste pickers, and the occupational and environmental risk factors to which these are exposed. METHODS: This is a cross-sectional study, based on survey design in an area of extreme social vulnerability - the largest garbage dump in Latin America. Using a multidimensional research protocol, divided in three stages: 1- The identification of the subjects, and the scheduling of tests; 2- Situational diagnosis through interviews, anthropometric evaluation, measuring blood pressure, collecting hair and nail samples to detect exposure to heavy metals and undertaking laboratory tests; 3- The return of the waste pickers to receive the test results, followed by referral to the health team and to report occupational accidents. RESULTS: One thousand twenty-five waste pickers undertook tests and interviews. The majority were women (67.0%), with 36-45 years old (45.7%), and 96.0% had children. In total, 27.3% of the participants did not attend to any school and 47.7% were educated only up to primary level. The majority of waste pickers (68.70%) reported accidents and most of them (89.69%) were related to sharp objects. The mean time working in this open dump was 15 years. According the anthropometric measure, 32.6% were overweight and 21.1% were obese. The most common reported diseases were: osteomuscular disorders (78.7%); arboviruses (28.6%); episodic diarrhea (24.9%); hypertension (24.2%); bronchitis (14.3%); intestinal worms (12.6%) and diabetes (10.1%). According to the blood tests, the values outside the reference limits were: Uric acid (23.89%); creatinine (54.06%); GGT range (16.04%); SGOT - Serum Glutamic Oxaloacetic Transaminase (5.29%); SGPT - serum Glutamic-Pyruvic Transaminase (35.52%). CONCLUSIONS: This study is the first to evaluate multiple risks and diseases in the majority of waste pickers working in the largest garbage dump of a continent. These findings highlight the importance to address urgently the environmental, social and health impacts related to the management of solid waste in developmental countries to protect these workers and their families.


Asunto(s)
Accidentes de Trabajo/estadística & datos numéricos , Residuos de Alimentos , Enfermedades Profesionales/epidemiología , Residuos Sólidos , Adulto , Preescolar , Estudios Transversales , Países en Desarrollo , Diseño de Investigaciones Epidemiológicas , Femenino , Humanos , América Latina/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/etiología , Calidad de Vida , Medición de Riesgo
5.
Physis (Rio J.) ; 29(2): e290215, 2019. tab, graf
Artículo en Portugués | LILACS | ID: biblio-1040763

RESUMEN

Resumo Os estudos de avaliabilidade permitem determinar os propósitos e o foco avaliativo de políticas, auxiliando o entendimento aprofundado e a apreciação prévia das possibilidades de avaliação. Assim, este artigo busca definir em que medida a Política Nacional de Regulação está em condições de ser avaliada a partir da descrição, elaboração dos modelos lógico e teórico de avaliação, de acordo com o sistema dos sete elementos de Thurston e Ramaliu. Trata-se de estudo de abordagem exploratória e qualitativa, desenvolvido de janeiro a maio de 2018. Os resultados contribuíram para a melhor compreensão da estrutura e operacionalização desta política. Essa Política, entretanto, conforme apresentada e discutida, possui numerosos componentes e atividades, sendo difícil a elaboração de indicadores e de matriz de avaliação. Sugere-se um recorte da política por dimensão ou em menor escala para o possível processo avaliativo. Cabe pontuar que após dez anos de existência, a Política Nacional de Regulação não recebeu proposições de avaliação. Sabe-se que a regulação no setor saúde apresenta diversos desafios, sendo necessária uma proposta para além das dimensões de eficiência e equidade, considerando a formação e as atividades dos profissionais, a acessibilidade aos serviços e as tecnologias em saúde.


Abstract Evaluability studies allow determining the purposes of the policy and the evaluation focus, assisting a thorough understanding and prior appreciation of the possibilities of policy evaluation. Thus, this article analyzes the evaluability of the Brazilian Regulatory Policy, from January to May of 2018, with an exploratory and qualitative approach, in order to define how this policy can be evaluated and the elaboration of the logical and theoretical models of evaluation, according to the seven-element system by Thurston and Ramaliu. The results contributed to a better understanding of the structure and operationalization of the policy to reach their results and impacts on health. However, the Policy has many components and activities, so it is difficult to elaborate indicators and a global policy assessment matrix. It is suggested a cut of the policy for an evaluation process. The Brazilian Regulatory Policy was published 10 years ago but any proposal to evaluate it has been submitted. It is known that regulation in the health sector brings numerous challenges, and it requires a proposal of evaluation that goes beyond the dimensions of efficiency and equity, including the training and activities of health professionals, accessibility to health services and health technology assessment.


Asunto(s)
Humanos , Evaluación en Salud , Brasil , Sistemas de Salud , Regulación y Fiscalización en Salud , Política de Salud
6.
Ciênc. Saúde Colet ; 23(1): 7-15, Jan. 2018.
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-890470

RESUMEN

Resumo As políticas informadas por evidências podem produzir impactos sociais e econômicos e benefícios na equidade e na saúde. A interação dos pesquisadores na política depende de interesses dos atores sociais e de ambientes políticos favoráveis. Este artigo busca compreender os significados e as perspectivas de pesquisadores sobre os processos de interação entre cientistas e tomadores de decisão que influenciam o impacto da pesquisa na política de saúde. Trata-se de estudo qualitativo, realizado em 2014, de análise de conteúdo para identificar os núcleos de sentido e as relações entre a pesquisa e a política. Baseou-se na abordagem do programa RAPID da Overseas Development Institute. Foram entrevistados 14 pesquisadores de projetos sobre morbimortalidade materna e neonatal financiados pelo Ministério da Saúde. Os pesquisadores orientaram-se para a produção de conhecimentos, o fortalecimento de capacidades de pesquisa e a divulgação dos resultados. Participaram, em algumas ocasiões, da definição de políticas de cuidado clínico e desempenho dos serviços de saúde. Apontaram barreiras para interatuar e produzir impactos na política devido às tensões do contexto político, econômico e social, às mudanças institucionais e organizacionais no setor saúde, e ao sistema de avaliação acadêmica.


Abstract Evidence-informed policies can produce social and economic impacts and equity and health benefits. Interaction between researchers in politics depends on the interests of social stakeholders and favorable political environments. This paper seeks to understand the meanings and researchers' perspectives of interaction processes between scientists and decision-makers that would influence the research impact on the health policy. This is a qualitative content analysis study conducted in 2014 to identify the core meanings and relationships between research and politics. The paper builds on the RAPID program approach of the Overseas Development Institute. Fourteen researchers who conducted maternal and neonatal morbidity and mortality studies sponsored by the Health Ministry were interviewed. Researchers focused on the production of knowledge, strengthening of research capacities and dissemination of results. On some occasions, researchers also participated in the definition of clinical care policies and performance of health services. They pointed to barriers to interact and produce an impact on politics due to tensions in the political, economic and social context, as well as to institutional and organizational changes in the health sector and to the academic evaluation system.

7.
Cien Saude Colet ; 23(1): 7-15, 2018 Jan.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-29267807

RESUMEN

Evidence-informed policies can produce social and economic impacts and equity and health benefits. Interaction between researchers in politics depends on the interests of social stakeholders and favorable political environments. This paper seeks to understand the meanings and researchers' perspectives of interaction processes between scientists and decision-makers that would influence the research impact on the health policy. This is a qualitative content analysis study conducted in 2014 to identify the core meanings and relationships between research and politics. The paper builds on the RAPID program approach of the Overseas Development Institute. Fourteen researchers who conducted maternal and neonatal morbidity and mortality studies sponsored by the Health Ministry were interviewed. Researchers focused on the production of knowledge, strengthening of research capacities and dissemination of results. On some occasions, researchers also participated in the definition of clinical care policies and performance of health services. They pointed to barriers to interact and produce an impact on politics due to tensions in the political, economic and social context, as well as to institutional and organizational changes in the health sector and to the academic evaluation system.


Asunto(s)
Política de Salud , Investigación sobre Servicios de Salud/organización & administración , Política , Investigadores/organización & administración , Brasil , Femenino , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Entrevistas como Asunto , Mortalidad Materna , Formulación de Políticas , Embarazo
8.
Sao Paulo Med J ; 134(2): 153-62, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27224280

RESUMEN

CONTEXT AND OBJECTIVE: National health research systems aim to generate high-quality knowledge so as to maintain and promote the population's health. This study aimed to analyze the impact of maternal mortality/morbidity research funded by the Brazilian Ministry of Health and institutional partners, on the dimensions: advancing in knowledge, research capacity-building and informing decision-making, within the framework of the Canadian Academy of Health Sciences. DESIGN AND SETTING: Descriptive study based on secondary data, conducted at a public university. METHODS: The advancing in knowledge dimension was estimated from the principal investigators' publication counts and h-index. Data on research capacity-building were obtained from the Ministry of Health's information system. The informing decision-making dimension was analyzed from citations in Stork Network (Rede Cegonha) documents. RESULTS: Between 2002 and 2010, R$ 21.6 million were invested in 128 maternal mortality/morbidity projects. Over this period, the principal investigators published 174 articles, resulting in an h-index of 35, thus showing progress in the advancing in knowledge dimension. Within the research capacity-building dimension, training of 71 students (undergraduate/postgraduate) was observed. Progress in the informing decision-making dimension was modest: 73.5% of the 117 citations in the Stork Network documents were institutional documents and norms. One of the projects funded, the 2006/7 National Demography and Health Survey, was cited in program documents. CONCLUSION: Impacts were shown in the advancing in knowledge and research capacity-building dimensions. The health research system needs to incorporate research for evidence-informed policies.


Asunto(s)
Investigación Biomédica/estadística & datos numéricos , Prestación de Atención de Salud/organización & administración , Política de Salud , Investigación sobre Servicios de Salud/estadística & datos numéricos , Mortalidad Materna , Calidad de la Atención de Salud/organización & administración , Investigación Biomédica/organización & administración , Brasil/epidemiología , Toma de Decisiones , Medicina Basada en la Evidencia , Femenino , Agencias Gubernamentales , Humanos , Morbilidad , Programas Nacionales de Salud/estadística & datos numéricos
9.
Säo Paulo med. j ; 134(2): 153-162, Mar.-Apr. 2016. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: lil-782931

RESUMEN

ABSTRACT: CONTEXT AND OBJECTIVE: National health research systems aim to generate high-quality knowledge so as to maintain and promote the population's health. This study aimed to analyze the impact of maternal mortality/morbidity research funded by the Brazilian Ministry of Health and institutional partners, on the dimensions: advancing in knowledge, research capacity-building and informing decision-making, within the framework of the Canadian Academy of Health Sciences. DESIGN AND SETTING: Descriptive study based on secondary data, conducted at a public university. METHODS: The advancing in knowledge dimension was estimated from the principal investigators' publication counts and h-index. Data on research capacity-building were obtained from the Ministry of Health's information system. The informing decision-making dimension was analyzed from citations in Stork Network (Rede Cegonha) documents. RESULTS: Between 2002 and 2010, R$ 21.6 million were invested in 128 maternal mortality/morbidity projects. Over this period, the principal investigators published 174 articles, resulting in an h-index of 35, thus showing progress in the advancing in knowledge dimension. Within the research capacity-building dimension, training of 71 students (undergraduate/postgraduate) was observed. Progress in the informing decision-making dimension was modest: 73.5% of the 117 citations in the Stork Network documents were institutional documents and norms. One of the projects funded, the 2006/7 National Demography and Health Survey, was cited in program documents. CONCLUSION: Impacts were shown in the advancing in knowledge and research capacity-building dimensions. The health research system needs to incorporate research for evidence-informed policies.


RESUMO: CONTEXTO E OBJETIVO: Sistemas nacionais de pesquisa em saúde buscam gerar conhecimentos de qualidade para manter e promover a saúde da população. Este estudo visou analisar o impacto das pesquisas sobre morbimortalidade materna financiadas pelo Ministério de Saúde do Brasil e instituições parceiras, nas dimensões: avanços no conhecimento, construção de capacidade de pesquisa e tomada de decisão informada, da matriz da Canadian Academy of Health Sciences. DESENHO DO ESTUDO E LOCAL: Estudo descritivo baseado em dados secundários, realizado em universidade pública. MÉTODOS: A dimensão avanços no conhecimento foi estimada pelas publicações dos coordenadores de pesquisa e índice h. Dados sobre a capacidade de pesquisa foram obtidos no sistema de informação do Ministério da Saúde. A dimensão tomada de decisão informada foi analisada pelas citações nos documentos da Rede Cegonha. RESULTADOS: Foram investidos R$ 21,6 milhões de reais em 128 pesquisas sobre morbimortalidade materna entre 2002 e 2010. Nesse período, os coordenadores das pesquisas publicaram 174 artigos, resultando no índice h de 35, mostrando progressos na dimensão avanços no conhecimento. Na dimensão capacidade de pesquisa, foi constatado o treinamento de 71 estudantes (graduação e pós-graduação). Na dimensão tomada de decisão informada, o progresso foi modesto: 73,5% das 117 citações nos documentos da Rede Cegonha eram documentos institucionais e normas. Um dos projetos financiados, Pesquisa Nacional de Demografia e Saúde 2006/7, foi citado em documentos programáticos. CONCLUSÃO: Impactos foram demonstrados nas dimensões avanços no conhecimento e capacidade de pesquisa. O sistema de pesquisa em saúde necessita da incorporação de pesquisas para políticas informadas por evidências.

10.
Cad Saude Publica ; 30 Suppl 1: S1-15, 2014 Aug.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-25167175

RESUMEN

The objective is to identify factors associated with women's satisfaction towards the care provided by the health professionals during hospital assisted delivery and identify how those factors influence their general levels of satisfaction. The cohort hospital based study was carried out in connection with the Birth in Brazil research. 15,688 women were included, interviewed at home, through the phone, from March 2011 to February 2012. All the variables that compose the professional/pregnant woman relationship (waiting time, respect, privacy, clarity of explanations, possibility of asking questions and participating in the decisions) and schooling remained independently associated with general satisfaction towards delivery care, in the adjusted model. The white women assisted in the southeastern and southern regions of the country, by the private sector and with a companion present gave a better evaluation of the care provided. Women value the way in which they are assisted by the health professionals, and there are inequalities in the way they are treated based on skin color, geographic region and financial situation.


Asunto(s)
Parto , Satisfacción Personal , Relaciones Profesional-Paciente , Calidad de la Atención de Salud , Adulto , Brasil , Estudios de Cohortes , Evaluación del Rendimiento de Empleados , Femenino , Encuestas Epidemiológicas , Humanos , Satisfacción del Paciente , Embarazo , Factores Socioeconómicos
11.
Cad. saúde pública ; 30(supl.1): S154-S168, 08/2014. tab, graf
Artículo en Portugués | LILACS | ID: lil-720537

RESUMEN

O objetivo foi identificar fatores associados à avaliação das mulheres quanto à relação profissionais de saúde/parturiente e como esses fatores influenciam a satisfação com o atendimento ao parto. Estudo de coorte de base hospitalar, realizado com base na pesquisa Nascer no Brasil. Foram incluídas 15.688 mulheres entrevistadas no pós-parto, por telefone, de março de 2011 a fevereiro de 2013. Todas as variáveis componentes da relação profissional/parturiente (tempo de espera, respeito, privacidade, clareza nas explicações, possibilidade de fazer perguntas e participação nas decisões) e escolaridade mantiveram-se associadas de forma independente à satisfação geral com o atendimento ao parto, no modelo ajustado. As mulheres atendidas na Região Sudeste e na Sul, no setor privado e com acompanhante avaliaram melhor a relação com os profissionais de saúde, o oposto ocorreu com as pardas e que tiveram trabalho de parto. As mulheres valorizam a forma como são atendidas pelos profissionais e existem desigualdades de cor, região geográfica e fonte de pagamento do parto nessas relações.


El objetivo es identificar los factores asociados con la evaluación de las mujeres sobre la relación entre profesionales de salud y parturientas y cómo estos factores influyen en la satisfacción con la atención al parto. Se trata de un estudio de cohorte hospitalaria, realizado a partir de la investigación Nacer en Brasil. Fueron entrevistadas 15.688 mujeres en el puerperio, por teléfono, de marzo de 2011 a febrero de 2013. Todas las variables evaluadas sobre la relación entre el profesional de salud y parturienta (tiempo de espera, respeto, privacidad, explicaciones claras, posibilidad de hacer preguntas y participación en las decisiones), así como la escolaridad estuvieron asociadas de forma independiente con la satisfacción en la atención al parto, dentro del modelo ajustado. Las mujeres atendidas en las regiones sudeste y sur, en el sector privado y con acompañante, evaluaron mejor la relación con los profesionales de salud. Las mujeres valoran la forma en que son atendidas y se encontraron desigualdades relacionadas con el color, la región geográfica y la financiación de los servicios de atención al parto en estas relaciones.


The objective is to identify factors associated with women’s satisfaction towards the care provided by the health professionals during hospital assisted delivery and identify how those factors influence their general levels of satisfaction. The cohort hospital based study was carried out in connection with the Birth in Brazil research. 15,688 women were included, interviewed at home, through the phone, from March 2011 to February 2012. All the variables that compose the professional/pregnant woman relationship (waiting time, respect, privacy, clarity of explanations, possibility of asking questions and participating in the decisions) and schooling remained independently associated with general satisfaction towards delivery care, in the adjusted model. The white women assisted in the southeastern and southern regions of the country, by the private sector and with a companion present gave a better evaluation of the care provided. Women value the way in which they are assisted by the health professionals, and there are inequalities in the way they are treated based on skin color, geographic region and financial situation.


Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Parto , Satisfacción Personal , Relaciones Profesional-Paciente , Calidad de la Atención de Salud , Brasil , Estudios de Cohortes , Evaluación del Rendimiento de Empleados , Encuestas Epidemiológicas , Satisfacción del Paciente , Factores Socioeconómicos
12.
Health Res Policy Syst ; 9: 35, 2011 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-21884575

RESUMEN

This commentary describes how the Brazilian Ministry of Health's (MoH) research support policy fulfilled the National Agenda of Priorities in Health Research (NAPHR). In 2003, the MoH started a democratic process in order to establish a priority agenda in health research involving investigators, health managers and community leaders. The Agenda was launched in 2004 and is guiding budget allocations in an attempt to reduce the gap between scientific knowledge and health practice and activities, aiming to contribute to improving Brazilian quality of life. Many strategies were developed, for instance: Cooperation Agreements between the Ministry of Health and the Ministry of Science and Technology; the decentralization of research support at state levels with the participation of local Health Secretariats and Science and Technology Institutions; Health Technology Assessment; innovation in neglected diseases; research networks and multicenter studies in adult, women's and children's health; cardiovascular risk in adolescents; clinical research and stem cell therapy. The budget allocated by the Ministry of Health and partners was expressive: US$419 million to support almost 3,600 projects. The three sub-agenda with the higher proportion of resources were "industrial health complex", "clinical research" and "communicable diseases", which are considered strategic for innovation and national development. The Southeast region conducted 40.5% of all projects and detained 59.7% of the resources, attributable to the concentration of the most traditional health research institutes and universities in the states of São Paulo and Rio de Janeiro. The second most granted region was the Northeast, which reflects the result of a governmental policy to integrate and modernize this densely populated area and the poorest region in the country. Although Brazil began the design and implementation of the NAPHR in 2003, it has done so in accordance with the 'good practice principles' recently published: inclusive process, information gathering, careful planning and funding policy, transparency and internal evaluation (an external independent evaluation is underway). The effort in guiding the health research policy has achieved and legitimated an unprecedented developmental spurt to support strategic health research. We believe this experience is valuable and applicable to other countries, but different settings and local political circumstances will determine the best course of action to follow.

13.
Cad Saude Publica ; 25(11): 2480-8, 2009 Nov.
Artículo en Portugués | MEDLINE | ID: mdl-19936485

RESUMEN

This study analyzes the different representations and experiences of women from different social classes, including issues related to their relations with hospital staff in different institutional settings. This qualitative study focused on women who had experienced both types of delivery, in three maternity hospitals in Rio de Janeiro, Brazil (one public, one fully private, and another private under an outsourcing agreement with the public health system). The study showed that variations in public and private service models result in different types of delivery care and different relations with staff, and are reflected in different birthing experiences for the women. However, a critical gender perspective shows that in both cases, the service models reproduce the medicalization of childbirth and women's submission as objects in the birthing process. Although this is manifested in different ways in the three groups, the end result is to reduce the range of care and the possibility of women's empowerment during childbirth.


Asunto(s)
Parto Obstétrico/métodos , Dolor de Parto/psicología , Servicios de Salud Materna , Relaciones Profesional-Familia , Adulto , Brasil , Cesárea/psicología , Parto Obstétrico/psicología , Femenino , Maternidades , Hospitales Privados , Hospitales Públicos , Humanos , Recién Nacido , Embarazo , Factores Socioeconómicos , Adulto Joven
14.
Cad. saúde pública ; 25(11): 2480-2488, nov. 2009.
Artículo en Portugués | LILACS | ID: lil-531165

RESUMEN

Este estudo analisa as diferentes representações e experiências quanto ao parto vaginal e cesárea de mulheres de diferentes estratos sócio-econômicos, bem como a natureza das relações profissionais de saúde/usuárias no contexto institucional em que estão inseridas. A pesquisa de natureza qualitativa foi desenvolvida em três maternidades do Município do Rio de Janeiro, Brasil, sendo uma pública, uma conveniada com o SUS e uma particular, com mulheres que tiveram os dois tipos de parto. Os resultados revelam que o modelo de organização dos serviços público e privado apresentam variações que produzem diferentes tipos de assistência e de relação entre os profissionais de saúde e as usuárias, dando forma a experiências distintas entre as mulheres pesquisadas. Todavia, ao empreendermos uma crítica assentada nas relações de gênero, podemos verificar que o modelo de assistência ao parto permanece submetendo quem deve ser sujeito e reproduzindo o projeto da medicalização - mesmo que este processo se manifeste de formas diferenciadas entre os grupos estudados -, o que reduz o campo da assistência e inviabiliza um lugar de poder diferenciado das usuárias.


This study analyzes the different representations and experiences of women from different social classes, including issues related to their relations with hospital staff in different institutional settings. This qualitative study focused on women who had experienced both types of delivery, in three maternity hospitals in Rio de Janeiro, Brazil (one public, one fully private, and another private under an outsourcing agreement with the public health system). The study showed that variations in public and private service models result in different types of delivery care and different relations with staff, and are reflected in different birthing experiences for the women. However, a critical gender perspective shows that in both cases, the service models reproduce the medicalization of childbirth and women's submission as objects in the birthing process. Although this is manifested in different ways in the three groups, the end result is to reduce the range of care and the possibility of women's empowerment during childbirth.


Asunto(s)
Adulto , Femenino , Humanos , Recién Nacido , Embarazo , Adulto Joven , Parto Obstétrico/métodos , Dolor de Parto/psicología , Servicios de Salud Materna , Relaciones Profesional-Familia , Brasil , Cesárea/psicología , Parto Obstétrico/psicología , Maternidades , Hospitales Privados , Hospitales Públicos , Factores Socioeconómicos , Adulto Joven
15.
Cad. saúde pública ; 22(10): 2067-2078, out. 2006. ilus
Artículo en Inglés | LILACS | ID: lil-434024

RESUMEN

O Brasil apresenta uma das maiores proporções de cesáreas do mundo. Fatores contribuintes para este fenômeno incluem organização da prática obstétrica, atitudes dos obstetras, preferências e decisões das mulheres. Com o objetivo de identificar fatores associados à realização de cesáreas, foi realizado estudo de caso-controle em uma maternidade pública do Município do Rio de Janeiro. Incluíram-se 231 partos por cesárea (casos) e 230 partos vaginais (controles). Utilizou-se análise multivariada com regressão logística, as variáveis foram incluídas no modelo obedecendo à ordem hierárquica definida em modelo conceitual. Fatores associados à maior chance de cesárea: primiparidade; idade 20-34 anos; último parto por cesárea; dilatação cervical < 3cm na admissão; preferência da mulher por cesárea; horário diurno; parto realizado por obstetra do sexo masculino; obstetra que trabalha mais de 24 horas semanais de plantão; obstetra com consultório particular; hipertensão; apresentação fetal não-cefálica; e idade gestacional > 41 semanas. Fatores associados à menor chance de cesárea: prematuridade; sinais de trabalho de parto ao sair de casa; uso de ocitocina e amniotomia. Propostas de modificação nos fatores estudados podem contribuir para redução da proporção de cesáreas.


Asunto(s)
Humanos , Femenino , Embarazo , Cesárea/estadística & datos numéricos , Maternidades , Hospitales Públicos , Estudios de Casos y Controles , Modelos Logísticos
16.
Cad Saude Publica ; 22(10): 2067-78, 2006 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16951878

RESUMEN

Brazil has one of the world's highest cesarean section rates. Contributing factors include the organization of obstetric practice, physicians' attitudes, and women's preferences and decisions. This study aimed to identify factors associated with cesarean sections in a public maternity hospital in Rio de Janeiro. A case-control study was conducted with 231 cesarean sections (cases) and 230 vaginal deliveries (controls). Hierarchical logistic regression analysis was performed, based on a conceptual model. Factors associated with increased odds of cesarean section were: primiparity; mother's age 20-34; last birth by cesarean; cervical dilatation < 3cm at admission; patient request; daytime birth; male attending obstetrician; obstetrician on duty for more than 24 hours a week; obstetrician with private practice; gestational hypertension; non-cephalic presentation; and gestational age > 41 weeks. Factors associated with lower odds of cesarean were: gestational age < 37 weeks; leaving home with signs of labor, use of oxytocin; and amniotomy. In this hospital, interventions aimed to modify the above-mentioned factors can help lower the cesarean rate.


Asunto(s)
Cesárea/estadística & datos numéricos , Brasil , Estudios de Casos y Controles , Cesárea/psicología , Femenino , Maternidades/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Humanos , Análisis Multivariante , Embarazo , Análisis de Regresión
17.
Cad. saúde pública ; 22(9): 1775-1785, set. 2006. tab, graf
Artículo en Inglés | LILACS | ID: lil-433330

RESUMEN

A necessidade de estabelecer uma política de ciência e tecnologia em saúde e prioridades de pesquisa em saúde foi destacada no cenário internacional. No Brasil, estes processos iniciaram em 2003, quando um grupo designado pelo Conselho Nacional de Saúde propôs 20 subagendas para abarcar as especificidades da pesquisa em saúde. O segundo passo foi identificar prioridades em cada subagenda, durante seminários nacionais envolvendo 510 cientistas e gestores. A 2ª Conferência Nacional de Ciência, Tecnologia e Inovação em Saúde ocorreu em julho de 2004. Durante a fase preparatória 307 municípios e 24 Estados organizaram conferências locais, envolvendo 15 mil pessoas. Do setor saúde foram indicados 360 delegados nas conferências locais, além dos indicados pelos setores de educação e ciência e tecnologia. Durante a conferência, a política nacional foi aprovada e três novas subagendas foram introduzidas e aprovadas. Atualmente, a política nacional e a agenda de prioridades estão guiando os investimentos de recursos para pesquisa e desenvolvimento do Ministério da Saúde e, de certa forma, do Ministério da Ciência e Tecnologia. Entre 2003 e 2005, 24 editais de pesquisa foram lançados, nos quais foram recebidas 3.962 propostas de pesquisa e aprovadas 1.300.


Asunto(s)
Difusión de Innovaciones , Política Nacional de Ciencia, Tecnología e Innovación , Investigación
18.
Cad Saude Publica ; 22(9): 1775-85; discussion 1786-94, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16917568

RESUMEN

The need for clearly-defined health research policies and priorities has been emphasized in the international scenario. In Brazil, this process began in 2003, when a group appointed by the National Health Council proposed 20 sub-agendas to account for the various health research specificities. The second step was to identify research priorities for each sub-agenda during national seminars involving 510 researchers and policymakers. The 2nd National Conference on Science, Technology, and Innovation in Health was held in July 2004. During the preparatory phase, 307 cities and 24 States organized local conferences, involving 15,000 participants. Some 360 health sector delegates were appointed during the local conferences, in addition to those from the education and science and technology sectors. During the Conference, the national policy was approved and 3 other sub-agendas were introduced and approved. The national policy and the priority agenda are currently guiding investments by the Ministry of Health for research and development, and to a certain extent those from the Ministry of Science and Technology as well. From 2003 to 2005, 24 calls for proposals were launched; as a result, 3,962 research projects were submitted and 1,300 financed.


Asunto(s)
Investigación Biomédica/economía , Tecnología Biomédica/economía , Difusión de Innovaciones , Organización de la Financiación/organización & administración , Política de Salud , Brasil , Organizaciones de Planificación en Salud , Prioridades en Salud , Promoción de la Salud , Humanos
19.
Rev Saude Publica ; 39(4): 645-54, 2005 Aug.
Artículo en Portugués | MEDLINE | ID: mdl-16113917

RESUMEN

OBJECTIVE: To evaluate the quality of birth care based on the World Health Organization guidelines. METHODS: A case-control study was carried out in a public and a private maternity hospitals contracted by the Brazilian Health System in the city of Rio de Janeiro, Brazil, from October 1998 to March 1999. The sample comprised 461 women in the public maternity hospital (230 vaginal deliveries and 231 Cesarean sections) and 448 women in the private one (224 vaginal deliveries and 224 Cesarean sections). Data was collected through interviews with puerperal women and review of medical records. A summarization score of quality of delivery care was constructed. RESULTS: There was low frequency of practices that should be encouraged, such as having an accompanying person (1% in the private hospital for both vaginal delivery and C-sections), freedom of movements throughout labor (9.6% of C-sections in the public hospital and 9.9% of vaginal deliveries in the private hospital) and breastfeeding in the delivery room (6.9% of C-sections in the public hospital and 8.0% of C-sections in the private hospital). There was a high frequency of known harmful practices such as enema administration (38.4%); routine pubic shaving; routine intravenous infusion (88.8%); routine use of oxytocin (64.4%), strict bed rest throughout labor (90.1%) and routine supine position in labor (98.7%) in vaginal deliveries. The best summarizing scores were seen in the public maternity hospital. CONCLUSIONS: The two maternity hospitals have a high frequency of interventions during birth care. In spite of providing care to higher risk pregnant women, the public maternity hospital has a less interventionist profile than the private one. Procedures carried out on a routine basis should be pondered based on evidence of their benefits.


Asunto(s)
Parto Obstétrico/normas , Maternidades/normas , Hospitales Privados/normas , Hospitales Públicos/normas , Brasil , Estudios de Casos y Controles , Cesárea , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Salas de Parto , Parto Obstétrico/estadística & datos numéricos , Femenino , Maternidades/estadística & datos numéricos , Hospitales Privados/estadística & datos numéricos , Hospitales Públicos/estadística & datos numéricos , Humanos , Recién Nacido , Trabajo de Parto , Bienestar Materno , Servicio de Ginecología y Obstetricia en Hospital/normas , Servicio de Ginecología y Obstetricia en Hospital/estadística & datos numéricos , Embarazo , Embarazo de Alto Riesgo
20.
Rev. saúde pública ; 39(4): 646-654, ago. 2005.
Artículo en Portugués | LILACS | ID: lil-412665

RESUMEN

OBJETIVO: Avaliar a qualidade da atenção durante o processo de trabalho de parto de acordo com normas da Organização Mundial de Saúde. MÉTODOS: Trata-se de estudo do tipo caso-controle, realizado em duas maternidades: pública e conveniada com o Sistema Unico de Saúde, no Município do Rio de Janeiro. A amostra foi composta por 461 mulheres na maternidade pública (230 partos vaginais e 231 cesáreas) e por 448 mulheres na maternidade conveniada (224 partos vaginais e 224 cesáreas). De outubro de 1998 a março de 1999, foram realizadas entrevistas com puérperas e revisão de prontuários. Foi construído escore sumarizador da qualidade do atendimento. RESULTADOS: Observou-se baixa freqüência de algumas práticas que devem ser encorajadas, como presença de acompanhante (1 por cento na maternidade conveniada, em ambos os tipos de parto), deambulação durante o trabalho de parto (9,6 por cento das cesáreas na maternidade pública e 9,9 por cento dos partos vaginais na conveniada) e aleitamento na sala de parto (6,9 por cento das cesáreas na maternidade pública e 8,0 por cento das cesáreas na conveniada). Práticas comprovadamente danosas e que devem ser eliminadas como uso de enema (38,4 por cento), tricotomia, hidratação venosa de rotina (88,8 por cento), uso rotineiro de ocitocina (64,4 por cento), restrição ao leito durante o trabalho de parto (90,1 por cento) e posição de litotomia (98,7 por cento) para parto vaginal apresentaram alta freqüência. Os melhores resultados do escore sumarizador foram obtidos na maternidade pública. CONCLUSÕES: As duas maternidades apresentam freqüência elevada de intervenções durante a assistência ao parto. A maternidade pública, apesar de atender clientela com maior risco gestacional, apresenta perfil menos intervencionista que maternidade conveniada. Procedimentos realizados de maneira rotineira merecem ser discutidos à luz de evidências de seus benefícios.


Asunto(s)
Humanos , Femenino , Parto Obstétrico , Investigación sobre Servicios de Salud , Salud Materno-Infantil , Parto Normal , Parto , Calidad de la Atención de Salud
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...