Intersetorialidade, determinantes socioambientais e promoção da saúde

Abstract

The study seeks to analyze intersectoriality from the socio-environmental perspective on health promotion. Qualitative research was conducted in six municipalities in Belo Horizonte, Minas Gerais, Brazil. The data were obtained from the mapping of health promotion experiences considered successful by municipal managers, interviews with coordinators, professionals and participants and observations of participants of the practices. The data were subjected to thematic content analysis. Intersectoriality was revealed as a premise for the political definition of the majority of the practices. At the normative program level, the social assistance sector has shown greater potential to develop intersectorial practices and centrality in the implementation grid due to its involvement with the social and environmental determinants. The results indicate that there is a gap between the intention to practice intersectoriality, witnessed by the political decisions in the municipalities, and effective intersectorial action in everyday life. The conclusion reached is that there is potential for intersectorial interventions on the social and environmental determinants in favor of health promotion, but the lack of consistency between what occurs in practice and the political aspects reveal a challenge to be overcome.

Health promotion in the territory: strengths and challenges of local projects

“…The School Health Program presents important limitations to address the complex problems of health of students, with their sporadic actions that prioritize only prevention and risk, to the detriment of the determinants of the health-disease process. Breaking with this paradigm is still a challenge in many aspects, from the pedagogical to the insertion of active methodologies that allow the problematization of social determinants through criticism and reflection [20][21] . Dialectically, it also includes the ideological challenge, based on the construction of discourses that value autonomy, participation, co-responsibility, as well as the understanding of health as a right to be assured by the State, according to PNPS principles, values and guidelines.…”

Concepções de programas de prevenção à violência e promoção da cultura de paz

“…A intersetorialidade presente em três programas (P1, P4, P6) sinaliza um consenso discursivo sobre a potencialidade da articulação como dispositivo de construção compartilhada de diferentes setores com vistas a intervenções estratégicas, para superar as hierarquias institucionais e as relações de poder entre setores, políticas e segmentos sociais 23 . Quanto às concepções de cultura de paz, os discursos revelam elementos que se aproximam da perspectiva defendida pela ONU (Quadro 2) com expressão dos princípios de: promoção da prática à não violência; promoção dos direitos humanos e das liberdades fundamentais; e promoção do fim da exclusão, injustiça e opressão político-econômica.…”

O fazer coletivo nas políticas de saúde da FÓ/Brasilândia (SP): fóruns, redes, grupalidades

“…A tomada coletiva de decisões, da mesma forma, amplia o compromisso dos profissionais com as intervenções, fortalecendo a corresponsabilidade em torno das prioridades eleitas para o trabalho. Tais práticas necessitam, no entanto, de permanente reflexão e abertura para se rever e transformar 26 . Ainda que a força coletiva das ações da rede de saúde da FÓ/Brasilândia se expresse na sua história e na sua prática atual, observamos que a constituição de espaços coletivos e de diálogo não é um movimento contínuo, nem tampouco estanque.…”