Currently, many countries throughout the world are reforming their health services. Even though these reforms differ according to the country's characteristics, they share many policies, one of which is the promotion of social participation in health-related matters. This policy, however, is not new in the field of health service organization. Throughout the last century, individual or collective collaboration between the population and health services has been promoted by several philosophies and concepts with different aims: from the search for collaboration with the general public to broaden public health system coverage to the promotion of the creation of mechanisms that would allow society to exercise control over these services' performance. Nevertheless, for the public to be involved with these services, several factors concerning both the services themselves and the population, need to converge. Although the theoretical frameworks that have encouraged social participation throughout the history of the development of health systems differ considerably, their practical implementation shares many common elements in all periods, from participation as a means of obtaining certain objectives to being an end in itself, as a democratic process. This can also be applied to the current promotion of social participation policies in the context of health care reforms, which are analyzed using Colombia and Brazil as examples.

Introduction: this study was motivated from the reflection and identification in the assistance practice, the difficulty of access and adherence of pregnant and dependent on drugs women to ambulatory care services. We intended to answer the following question: how are pregnant and dependent on alcohol, tobacco and illicit drugs women being cared in outpatient health services? Goals: to characterize the selected studies with the focus on the intervention modality and the strategies of care adopted to the pregnant women; to conceptualize the production of care for pregnant and dependent on drugs women, based on the emerging concepts of the selected work. Methodology: this is a review study of the type Scoping Review. The results were obtained from the LILACS, MEDLINE, BEDENF, PUBMED, WEB OF SCIENCE and CINAHL databases, in Portuguese, English and Spanish, from the following controlled descriptors: pregnant, street drugs, standard of care, substance abuse treatment centers, susbtance-related disorders, mental health, women's health services, ambulatory care. Results: 939 related studies were identified. After the application of inclusion criteria, exclusion and evaluation of articles by judges, nine studies of the PUBMED database, published in the United States of America, were selected. All of the studies involved a randomized clinical trial type design. The period of publication was from 2007 to 2015. The pregnant women were mostly single, low income and aged between 18 and 50 years old. The production of knowledge was led by Medicine (66.6%), participation of Nursing (22.2%) and Nutrition (11.1%). The main intervention modalities were made in groups, randomized clinical trial and individual monitoring. The main tools used to follow up these groups were: improved motivational interview, brief intervention, therapeutic work place and contingency incentives.The following elements emerged from the selected works that allowed the formulation of the concept of care production: relational care, bonding, listening sensitivity to socio-historical-cultural approach, gender and time. Conclusion: from the present study it was possible to analyze the emergent elements and formulate a concept of care production for pregnant women.

Introdução: este trabalho buscou responder à seguinte pergunta de pesquisa: como cuidar da dependência, de drogas lícitas e ilícitas, de gestantes em contexto de serviço ambulatorial de saúde? Objetivo: identificar na literatura as estratégias interventivas de cuidados às gestantes afetadas pelo consumo de drogas lícitas e ilícitas. Metodologia: trata-se de um estudo de revisão do tipo Scoping Review de acordo com o Instituto Joanna Briggs. Bases de dados pesquisadas: LILACS, MedLine, BDENF, PubMed, Web of Science e CINHAL. Os principais descritores foram: gestantes, drogas ilícitas, padrão de cuidado e assistência ambulatorial. Resultados: foram identificados 939 artigos sendo selecionados nove estudos da base de dados PubMed, publicados nos Estados Unidos, com desenho do tipo ensaio clínico randomizado, no período de 2007- 2015. As gestantes apresentavam perfis de baixa renda e de vulnerabilidade social. As estratégias de intervenção de cuidados foram de entrevista motivacional aprimorada, intervenção breve e, especialmente, de um projeto de intervenção terapêutica pelo trabalho, cuja finalidade era o estímulo à abstinência associado ao apoio financeiro para melhora da qualidade de vida. Conclusão: a produção do cuidado às gestantes envolveu trabalho relacional como acolhimento, vínculo, escuta e sensibilidade para abordagem sócio-histórico-cultural, associados às especificidades de gênero e tempo.

A gravidez na adolescência é considerada um determinante social e um grave problema de saúde pública, devido a sua magnitude e amplitude e não é apenas fruto, mas também é um determinante da disfuncionalidade familiar. A violência doméstica também constitui um grave problema de saúde pública, uma vez que afeta profundamente a integridade física e psicológica das vítimas. Este estudo tem como objetivo apresentar uma proposta de jogo que atenda as necessidades em saúde das adolescentes grávidas que frequentam um Hospital Universitário na cidade de São Paulo...Palavras chave: Violência doméstica; Adolescentes Grávidas; Profissionais de Saúde; Gênero; Jogo.

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