An analysis of actions to promote health in underprivileged urban areas: a case in Brazil
An analysis of actions to promote health in underprivileged urban areas: a case in Brazil
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DOI：
10.1186/1471-2296-14-80
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发表时间：
2013-06-13
影响因子：
2.9
通讯作者：
O'Dwyer, Gisele
中科院分区：
文献类型：
--
作者：
dos Reis Moreira, Erika Cardoso;O'Dwyer, Gisele
背景资料：在2000年代，两项政策脱颖而出，旨在改变在巴西通过的护理模式：国家初级卫生保健政策，基于家庭卫生保健模式，和国家健康促进政策。本研究的目的是分析在贝尔福德罗克索市的家庭卫生保健团队开发的健康促进行动。这个镇被选中凭借其“低于平均水平”的初级卫生保健服务提供的有关其他城市在里约热内卢state.Methods：以下方法策略被采用：卫生系统分析，文件分析（2010年年度健康计划和2010年年度管理报告），参与者观察和采访了研究地区的9名卫生保健专业人员，即：地区卫生综合诊所的经理（负责该地区的卫生保健行动）和属于八个家庭保健小组的护士。Giddens' Theory of Structuration was used for analysis of the results.Results：不同层次的医疗保健活动被发现，表明管理者已经无法或缺乏承诺，以执行拟议的行动。从结构上看，87.5%的团队是不完整的。还特别值得注意的是，医疗队中没有医生，尽管这造成了不利影响，但受访者认为这是“自然的”，该地区强大的政党影响阻碍了医疗队与当地居民之间的关系。健康教育，特别是通过讲座是主要的健康促进活动拿起在这项研究中。没有确定跨部门或公众参与的行动。结论：除了政治因素外，还存在诸如人力资源不足等结构性限制，使各小组的日常活动负担过重。从这个角度来看，政治环境和缺乏专业人员是促进健康的限制因素。Belford Roxo不一定代表巴西的其他经验。然而，诸如赞助、政治操纵、贫困和刚开始的跨部门行动等问题是巴西其他城镇的共同问题。
Background: Two policies stood out in the 2000s geared towards changing the care model adopted in Brazil: The National Policy on Primary Health Care, based on a family health care model, and the National Policy on Health Promotion.The aim of this study was to analyze health promotion actions developed by family health care teams in the municipality of Belford Roxo. This town was chosen by virtue of its "below average" level of primary health care services offered in relation to other municipalities in Rio de Janeiro state.Methods: The following methodological strategies were employed: analysis of health systems, document analysis (2010 Annual Health Schedule and 2010 Annual Management Report), participant observation and interviews with nine health care professionals in the region of study, namely: the manager of the Regional Health Polyclinic (responsible for health care actions in the region), and nurses belonging to the eight family health teams. Giddens' Theory of Structuration was used for analysis of the results.Results: Varying levels of health care activity were found, indicating that the managers have been either unable or lacked the commitment to perform the proposed actions. From a structural point of view, 87.5% of the teams were incomplete. Also of particular note was the lack of any physicians in the teams, which, despite its detrimental effect, was regarded by the interviewees as "natural".Strong political party influence in the area hindered relations between the team and the local population. Health education, especially through lectures was the main health promotion activity picked up in this study. No cross-sectorial or public participation actions were identified. Connections between the teams for sharing responsibilities were found to be very weak.Conclusion: In addition to political factors, there are also structural limitations such as a lack of human resources that overburdens the teams' daily activities. From this point of view, the political context and lack of professionals were restrictive factors for health promotion. Belford Roxo is not necessarily representative of other experiences in Brazil. However, problems such as patronage, political manipulation, poverty and incipient cross-sectorial actions are common to other Brazilian towns and cities.