Qualitative study with the purpose of analyzing intersectorial actions for health promotion in the context of the Family Health Strategy, identifying experiences, facilitating and restricting factors to the process of building partnerships. Subjects were health managers and informers from social equipment in the territory covered by a local health service in Belo Horizonte/Minas Gerais, Brazil. The results indicate the existence of a wide social network. However, intersectorial health promoting actions are still incipient. Intersectorial actions are faced with the challenge of creating communication spaces that allow the resolution of complex problems. It is concluded that intersectorial actions constitute an innovative strategy which is still under construction, and the paths of which are still being unraveled.
The study seeks to analyze intersectoriality from the socio-environmental perspective on health promotion. Qualitative research was conducted in six municipalities in Belo Horizonte, Minas Gerais, Brazil. The data were obtained from the mapping of health promotion experiences considered successful by municipal managers, interviews with coordinators, professionals and participants and observations of participants of the practices. The data were subjected to thematic content analysis. Intersectoriality was revealed as a premise for the political definition of the majority of the practices. At the normative program level, the social assistance sector has shown greater potential to develop intersectorial practices and centrality in the implementation grid due to its involvement with the social and environmental determinants. The results indicate that there is a gap between the intention to practice intersectoriality, witnessed by the political decisions in the municipalities, and effective intersectorial action in everyday life. The conclusion reached is that there is potential for intersectorial interventions on the social and environmental determinants in favor of health promotion, but the lack of consistency between what occurs in practice and the political aspects reveal a challenge to be overcome.
ResumoO objetivo do estudo foi analisar programas de atenção domiciliar na saúde suplementar do ponto de vista do direito à saúde, a partir de estudo de casos, de natureza qualitativa, desenvolvido em quatro operadoras de saúde no município de Belo Horizonte, Minas Gerais. Os dados empíricos foram obtidos de entrevistas com gestores de operadoras e prestadoras que ofertam programas de atenção domiciliar. Os resultados são discutidos a partir de três eixos analíticos: a oferta da atenção domiciliar e os desafios da universalização do direito à saúde; a relação da saúde suplementar com o sistema público de saúde e com as famílias; e a judicialização como caminho para se garantir o direito à saúde no campo da atenção domiciliar na saúde suplementar. A desregulamentação da atenção domiciliar na saúde suplementar foi revelada como um desafio para a garantia do direito à saúde, prevalecendo a oferta segundo os interesses das operadoras que adotam estratégias para evitar a judicialização, como, por exemplo, não divulgar o benefício. A suspensão da assistência por decisão unilateral da operadora e a transferência de responsabilidades para o sistema público de saúde e para as famílias afrontam o direito dos usuários de receber serviços na modalidade que melhor responda a determinadas situações de saúde. Conclui-se que a atenção domiciliar na saúde suplementar é permeada por tensões que evidenciam a urgência de maior regulamentação no campo. Palavras-chave: Cuidados domiciliares de saúde; Regulamentação governamental; Planos de pré--pagamento em saúde. Kênia Lara Silva AbstractThis study analyzes home care in supplementary health programs from the right-to-health perspective. A qualitative case study was conducted in four health operationsoperators in the municipality of Belo Horizonte, Minas Gerais State. Empirical data was collected via interviews with health operators and health providers offering home care services. The results were discussed according to three analytical criteria: provision of home care and challenges to the universal right to health; supplementary health relationship with the public health system and with families; and judicialization as a way of protecting the right to home care in supplementary health programs. Home care deregulation in supplementary health programs was exposed as a challenge to the right to health because this service provision is underhealth operators' control. These operators develop ways to avoid judicialization, such as providing home care services as an undisclosed benefit. The service disruption caused by the private operators' unilateral decisions and the transfer of responsibility to the public health system and families affronts the user's right to care that addresses specific health conditions. In conclusion, home care in supplementary health programs is permeated by tensions that highlight the need for urgent regulation.
OBJECTIVETo examine successful practices of health promotion in health, education, culture, welfare and sport, leisure, identifying the elements of success and challenges in the field.METHODSA qualitative study with data obtained from in-depth analysis that included participant observation, interviews with managers, coordinators, professionals and participants from 29 practices reported as successful for promoting health in six municipalities of the metropolitan region of Belo Horizonte, MG, Southeastern Brazil, in 2011. The variables of the study were concept, dimension, dissemination and ease of access, identified in practices guided by content analysis.RESULTSThe results indicate a conceptual and methodological uncertainty about health promotion as evidenced by conflicting objects and contradictory purposes. The practices differ in size, coverage and ease of access, determined by inter-sector coordination and political and financial investment.CONCLUSIONSWe identified challenges to health promotion focusing on vulnerable populations, limits to financing and intersectoral partnerships.
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