One of the challenges with respect to public health and the abuse of alcohol and other drugs is to implement policies in support of greater co-ordination among various levels of government. In Brazil, policies are formulated by the Secretaria Nacional de Políticas sobre Drogas (SENAD - State Department for Policies on Drugs) and the Ministério da Saúde (MS - Ministry of Health). This study aims to compare implementation of policies adopted by SENAD and MS at the municipal level. Three municipalities were intentionally selected: Juiz de Fora having a larger network of treatment services for alcohol and drug users; Lima Duarte, a small municipality, which promotes the political participation of local actors (COMAD - Municipal Council on Alcohol and Drugs); and São João Nepomuceno, also a small municipality, chosen because it has neither public services specialised to assist alcohol and other drugs users, nor COMAD. Data collection was conducted through interviews with key informants (n = 19) and a review of key documents concerned with municipal policies. Data analysis was performed using content analysis. In Juiz de Fora, there are obstacles regarding the integration of the service network for alcohol and other drug users and also the articulation of local actors, who are predominant in the mental health sector. In Lima Duarte, while there is a link between local actors through COMAD, their actions within the local service network have not been effective. In São João Nepomuceno, there were no public actions in the area of alcohol and drugs, and consequently insufficient local debate. However, some voluntary, non-governmental work has been undertaken. There were weaknesses in the implementation of national-level policies by SENAD and the MS, due to the limited supply of available treatment, assistance and the lack of integration among local actors.
RESUMOEste estudo buscou traçar o perfil epidemiológico de usuários de um Centro de Atenção Psicossocial da Infância e Juventude (CAPSij) vítimas de violência. Trata-se de um estudo transversal, documental e quantitativo, realizado com dados obtidos por meio de prontuários do serviço referentes aos usuários acolhidos nos anos de 2018 e 2019. Foram investigados um total de 471 prontuários. Os dados foram expressos em porcentagem e comparados pelo teste de qui-quadrado. Foi encontrado que 112 (23,77%) crianças e adolescentes apresentaram registro de algum tipo de violência. O tipo de violência mais registrado foram os maus-tratos (37,5%). Os agressores do sexo masculino predominaram na amostra (52,5%), assim como agressores familiares às vítimas (54,2%). A residência das vítimas foi o local que apresentou maior registro de violências (36,6%). A maior fonte de encaminhamentos foram as Unidades Básicas de Saúde (48,2%). A agressividade foi a queixa principal mais relatada (53,5%), ademais, o grupo dos transtornos do comportamento e transtornos emocionais foram os mais prevalentes (23,1%). Foram evidenciados aspectos da violência contra crianças, da complexidade do contexto nos quais ela ocorre, da qualidade das informações coletadas bem como os aspectos clínicos das vítimas.
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