Atendimento à saúde de crianças e adolescentes em situação de violência sexual, em quatro capitais brasileiras

Abstract

O artigo analisa a atenção à saúde de crianças e adolescentes em situação de violência sexual (VS) na rede pública municipal de saúde de quatro capitais brasileiras – Porto Alegre (RS), Belém (PA), Fortaleza (CE) e Campo Grande (MS) –, enfocando a disponibilidade de serviços e a oferta de atendimentos, tais como a anticoncepção de emergência hormonal (AEH), profilaxias para doenças sexualmente transmissíveis (DSTs) e interrupção legal da gravidez (ILG). O método de estudo de casos foi conduzido por entrevistas semiestruturadas, com vinte gestores e técnicos do nível central, representantes das secretarias municipais de saúde, e de análise documental. A atenção é desigual entre as capitais. Considerando-se a alta demanda, há baixa oferta de serviços em três delas. Os atendimentos especializados, como AEH e ILG, encontram resistências dos profissionais e setores religiosos. Destacam-se inovações de dois Centros Integrados de Atenção e de um Centro de Atenção Psicossocial Pós-Trauma.

Revisão integrativa sobre redes de cuidados aos adolescentes em situação de violência sexual

“…This category highlights the services identified by the articles as being components of care networks. Eight of the 11 articles analyzed by this study [1][2][3]8,19,26,27,29 presented the component services of networks, highlighting that services linked to education, health, social welfare 1,3,26 , and the defense of human rights, such as Child Protective Services 1,3,8,19,26,29 were partners. Other services mentioned in the articles include the District Attorney's Office 2,3 , local child and adolescent bureaus 2,8,19 , juvenile courts 3,19 , Public Defender's Office , and the Municipal Council for Child and Adolescent Rights 1 .…”

“…This category encompasses the different understandings of networks expressed in the articles. Five studies failed to provide a definition for the term network or its derivatives ("service network", "care network", "protection network", among others), basically using the composition of the network to describe it 8,15,[26][27][28] . For example, Deslandes et al 8 state that the municipality provides assistance to children and adolescents via a network system across different levels of the justice, health, education, and social development sectors.…”

“…Within this context, this study focuses on sexual violence against adolescents in view of the specific issues related to this type of violence in young victims -such as the risk of pregnancy, abortion, and the right to emergency contraception -and the notorious lack of research focusing on this group. In this regard, according to Deslandes et al 8 , a search of the SciELO database conducted in January 2015 using sexual violence as the topic and including the descriptor 'care' yielded 13 articles, only three of which focused on adolescents.…”

Fatores que interferem no enfrentamento da violência infantil por conselheiros tutelares

“…It is emphasized that, in order to face child violence, it is necessary to overcome the weaknesses of the network and promote integrated and effective actions among the various services and social actors 10,20-23 . To overcome these conditions, intense and continuous movement, articulation of wills, permanent dialogue among the actors, search for partners and permanent training for collective and intersectorial work are required 15,29,30 .…”

Surviving Sexual Abuse in Everyday Life: Forms of Resistance Used by Children and Adolescents

“…3 The higher prevalence of female sexual abuse is rooted in patriarchy, which throughout history incorporates male-dominated social relationships that determine unequal social roles and opportunities between men and women. [4][5] As we can see, male dominance accentuates the submission and perpetuation of violence against women which, in relation to girls and adolescents, the abusive situation occurs in a game of seduction, threat, blackmail and pacts that the abuser uses repeatedly, to exercise control over the victim. [6][7] This dynamic leads to a confusion of the roles of victim and abuser: in an imaginary of fear, a sexu-ally abused girl cannot react or contest the authority exercised by her abuser, and although she does not agree, she feels unable to prevent new episodes from happening.…”