Pensamento clássico da saúde pública paulista na era dos centros de saúde e educação sanitária

Abstract

The article reviews the ideas and concepts of health service organization that followed the introduction of the Health Center model by the Health Service reform in 1925. It discusses the thinking of Geraldo de Paula Souza, Rodolfo Mascarenhas and Reinaldo Ramos, distinguished representatives of "classical thought" of public health in São Paulo, Southeastern Brazil. DESCRIPTORS:Public Health, history. Health Care Reform. Social Medicine. Primary Health Care. INTRODUÇÃOReferring to the history of discourse (contextualism history/ideas), in this article I review the modern approach to public health education that developed from the ideals of neighborhood health centers (HC), exported worldwide by the Rockefeller Foundation in the 1920s. Its reading will be mediated by the political-public health line of thought established in São Paulo in the Pan American atmosphere of the end of the First Republic, which met its symbolic, rather than semantic, demise in the 1970s a under the pressure of new ideals, particularly associated with the "system" technology and the concepts gestated by the Alma-Ata Declaration, and by the radical changes in the public health discourse at that time. Instigated by Brandão, 1 I aim at identifying, in that new lexicon, some ideas that are perpetuated as "analytical a prioris" in the perception of reality.The brevity of this historical time will be illustrated by a concise intellectual sketch of three of its central characters. A lineage unveiled in the literature by the profi cuous interconnected production that was continued and enriched along time by an intense personal, professional, intellectual and even familial relationship at the head of the Hygiene Institute and School of Public Health of Universidade de São Paulo (FSP/USP). These intellectual fi gures were, according to Brandão, responsible for "ideas that affected men of a certain historical time". b With arms open and connecting generations is the eminent public health specialist Rodolfo Mascarenhas (1909Mascarenhas ( -1979, associated with Geraldo de Paula Souza (1889-1951), whom he calls "master", 2 and succeeded by his disciple Reinaldo Ramos (1920Ramos ( -1990.

João de Barros Barreto: um construtor do debate organizacional em saúde no Brasil

“…Esses diferentes estudos têm revelado certo protagonismo do recém-criado Ministério da Educação e Saúde Pública (1930), sobretudo sob a liderança de seu mais importante e longevo ministro, o mineiro Gustavo Capanema , tanto na formulação quanto na implementação de políticas de saúde de caráter nacional. Outrora identificado como um ministro e uma pasta consagrada pelas realizações no campo educacional 1,2 , hoje, graças a uma renovada historiografia [3][4][5][6] , as realizações no campo da saúde do período Vargas também ganham o seu lugar na história da saúde pública brasileira.…”

“…Ao formular e conduzir a reforma na saúde, o chefe do DNS produziu uma centralização normativa em torno do executivo federal e a criação de serviços verticais centrados em doenças especificas 3,6 . Adicionalmente, o mesmo conjunto de reformas administrativas permitiu a criação de uma estrutura organizacional do tipo distrital como uma forma de melhor oferecer a prestação da saúde pública no país 5,7 . Ambos os movimentos representaram, sem dúvida, uma maior presença do governo federal no território nacional.…”