RESUMO Este ensaio teve como objetivo discutir o financiamento federal da Atenção Básica no SUS, buscando ressaltar a persistência histórica da fragilidade desse financiamento em termos do modelo de transferências e de uma visão limitada do conceito de Atenção Básica. O estudo está estruturado em três partes. A primeira delas discute a trajetória histórica do conceito de Atenção Básica, desde sua radicalidade inicial nos anos 1960 até o 'apequenamento' trazido pela nova Política Nacional de Atenção Básica (PNAB) de 2017. A segunda aborda, em uma perspectiva histórica, os repasses do financiamento federal do SUS, com destaque à Atenção Básica e aos critérios de rateio utilizados. A terceira parte trata do financiamento da Atenção Básica, com destaque para os recursos do Ministério da Saúde para esse nível de atenção, com foco para a nova PNAB 2017 e, particularmente, para aos transferidos mediante o Piso da Atenção Básica (PAB) Variável.

This cross-sectional population-based study in 2007 focused on prevalence of food insecurity and associated factors in households with adolescents in four towns in the Legal Amazonia located along highway BR-163, from Cuiabá, Mato Grosso State, to Santarém, Pará State, Brazil. The study applied the Brazilian Food Insecurity Scale to a sample of 363 households. Anthropometric assessment was performed on 534 adolescents from 10 to 19 years of age. A Poisson model was used in the multiple regression analysis. The results showed 23.1% prevalence of moderate to severe food insecurity, suggesting association with the following: low income, poor sanitation, head of household born in Mato Grosso State, and the adolescent's race (black). The results emphasize the need for improved access to basic sanitation, training of human resources to generate employment/income, and educational activities to improve understanding of food insecurity and its determinants.

Information on prevalence and type of problems of psychomotor development (PPD) is necessary for implementation of specific care programmes at field level. With the purpose of obtaining this information, a screening test, the Prueba Nacional de Pesquisa (PRUNAPE) for PPD was implemented in three health centres in San Isidro, a city near Buenos Aires, attended by different socio-economic groups: centres A and B were located in the inner city, and C in a middle-class area. The test was administered by three previously trained paediatricians to 839 apparently healthy children aged 0-5 years. The failure rates were 24%, 19% and 16% in centres A, B and C respectively (20% in total). Out of the 170 children failing the test and referred to hospital for diagnosis and treatment, only 96 complied and went through a series of studies carried out by a previously prepared multidisciplinary team. With the exception of children who failed the Battelle test [classified as Global Developmental Delay (GDD)], final diagnoses were classified according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition: GDD (60 children), pervasive developmental disorders (11), communication disorders (10), motor disorders (6, of whom 2 were with cerebral palsy), attention deficit disorders (5), attachment disorders (2), normal children (3). Co-morbidity was present in 22 affected children. Forty-three per cent of children failing the test did not attend hospital or did not complete studies because of major social and family problems, the family not living in the area, or the parents preferring to consult their own paediatrician. Health centres and children not selected in a randomised way, and a significant proportion of them not complying with the indication of hospital referral were major sources of bias, so that PPD prevalences, positive and negative predictive values should be interpreted with great caution. Further studies accounting for these sources of bias are needed to confirm the observed prevalence of PPD. Training of health personnel, at hospital and health centre level, priority settings, and operational research to evaluate effectiveness of treatments and care delivery systems at field level are necessary in Argentina for optimal use of limited healthcare resources.

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Resumo As situações de insegurança alimentar e nutricional (IAN) são impeditivos para a concretização do direito humano à alimentação adequada (DHAA) e podem estar ligadas à disponibilidade, ao acesso, ao consumo, à produção, à utilização biológica dos alimentos e às questões sociais, políticas e econômicas, que expressam os problemas alimentares atuais existentes entre os países. O objetivo é revisar como a alimentação é compreendida enquanto um direito humano na produção científica da área da saúde, em artigos que se dedicaram à análise empírica da SAN em diferentes cenários urbanos com crianças e adolescentes. Realizou-se uma revisão integrativa da literatura, com 80 artigos científicos disponíveis na base de dados PubMed, publicados no período de 2007 a 2016. Foram extraídas dos estudos informações a respeito dos cenários de investigação, abordagens metodológicas, aspectos relacionados à IAN, conclusões e recomendações. Esta revisão mostrou a diversidade dos focos temáticos para a compreensão da alimentação como um direito humano e as estratégias de ação tiveram como foco os cuidados primários em saúde. A alimentação, tanto nos países desenvolvidos quanto nos que estão em desenvolvimento, é um direito humano em disputa que necessita efetivação, visando à justiça social para todas as pessoas.

: The study analyzed the social representations of primary health care professionals on evaluative processes of groups that work with food and nutrition, and described the educational strategies used in this care. This was a qualitative study from 2012 to 2014 in the city of São Paulo, Brazil, in which 48 interviews were analyzed. In the analysis of the interviews, for classification of the educational strategies in learning categories and contents, Bogdan & Biklen and Zabala were used, respectively. The evaluative processes used the collective subject discourse technique, based on Jodelet's social representations. Three learning contents were found in the educational strategies and four social representations of the evaluative processes which combined to reveal the presence of a conflict by a practice directed by the work process to quantitative and individual evaluative criteria and a health-promoting practice that used inclusive approaches and participant evaluation. In this practice, the study implicitly identified the presence of autonomy in health. The study revealed the need to acknowledge and systematize group planning as an educational tool that qualifies and empowers comprehensive care.

Resumo A insegurança alimentar e nutricional permanece no cenário brasileiro como um desafio para a realização do direito à alimentação adequada. O objetivo do estudo foi analisar a situação de insegurança alimentar e nutricional de adolescentes no âmbito domiciliar e individual. Estudo transversal de base populacional realizado com 363 domicílios e 95 adolescentes, na área urbana de municípios da Amazônia Brasileira. A insegurança alimentar e nutricional foi avaliada através da Escala Brasileira de Medida de Insegurança Alimentar. Regressão linear foi utilizada na análise do efeito bruto e ajustado da insegurança alimentar e nutricional sobre a disponibilidade e o consumo. Houve prevalência de 51,8% de insegurança alimentar e nutricional nos domicílios, maior disponibilidade e consumo de alimentos fontes de energia e baixo consumo de hortaliças, frutas e leguminosas. A análise de variância do modelo linear mostrou dependência entre a insegurança alimentar e o efeito da frequência de disponibilidade dos alimentos e o consumo alimentar. Os resultados apontam para o desafio da implementação de políticas públicas, tendo em vista o consumo alimentar não saudável como um aspecto de comprometimento nutricional, corporal e emocional permanente na idade adulta.

This article aims to discuss the meaning of the coronavirus crisis as an integral part of the totality of the capitalist crisis and its implication in the health area of Brazilian capitalism, in which the rise of ultraliberal and neofascist policies is witnessed by the Bolsonaro government. To this end, we opted for a historical-dialectical materialist analysis of the situation experienced between the global beginning of the pandemic until the month of May 2020 in Brazil. The article is structured in 2 parts: The first discusses the problem of agrifood systems in the context of capitalism in crisis and its effects on the spread of diseases such as the coronavirus, and the second discusses the neglect of the Bolsonaro government in facing the COVID-19 pandemic and the Brazilian universal health system. Evidence shows that the Bolsonaro government has led to more deaths and more of the barbarism of capitalism. The scenario after the pandemic will be one of a country with a more or less intense capitalist crisis depending on the resistance of workers in the defense of public health and lives.