O Programa Saúde da Família:: um estudo sobre a formação pedagógica do egresso do V e VI Curso de Especialização em PSF da Universidade do Estado do Pará

This study aims identificaras pedagogical contributions, Specialization in Family Health Program (PSF) of the University of Pará (UEPA), in order to plan educational activities in health education and evaluate the pedagogical guidelines of the mentioned course. Specifically studied classes V and VI Course, for the period from 2005 to 2007. Proposed to investigate and analyze which major procedures, concerns and difficulties of graduates to plan an activity for health education. In this sense, was carried literature and field research with his former students. Concluding, as a suggestion, that the institution UEPA must reorganize and reshape the mentioned course, to foster and encourage students with a quality educational practice, allowing thus the development of skills, abilities and competencies required to develop d student for professional practice, for their critical and creative participation to real and effective professional practice humane and committed to the collective and ethics in public health.  Este estudo tem por objetivo identificaras contribuições pedagógicas do Curso de Especialização em Programa Saúde da Família (PSF) da Universidade do Estado do Pará (UEPA), visando o planejamento pedagógico de atividades de educação em saúde e avaliar as diretrizes pedagógicas do referido Curso. Estudou especificamente as turmas do V e do VI Curso, referentes ao período de 2005 e 2007. Propôs-se a Investigar e analisar quais os principais procedimentos, preocupações e dificuldades dos egressos para planejar uma atividade de educação em saúde. Nesse sentido, foi efetivada pesquisa bibliográfica e pesquisa de campo com seus alunos egressos. Concluindo-se, a título de sugestão, que a Instituição UEPA deve reorganizar e reformular o referido Curso, para que fomente e favoreça aos alunos uma prática pedagógica de qualidade, permitindo, dessa forma, o desenvolvimento de capacidades, habilidades e competências necessárias ao desenvolvimento d aluno para uma prática profissional, visando sua participação crítica e criativa para o real e efetivo exercício profissional humanizado e comprometido com o coletivo e com a ética na área da saúde pública

Reforma sanitária no Ceará: o processo de descentralização nos anos 90

The objective of this article is to offer an overview of the health reform in Ceará focusing on the decentralisation process in the 1990s. The driving factor behind the Brazilian health reform movement was the necessity to reorganise the national health system and overcome inequalities. For the reformists, decentralisation, and together with it the idea of popular participation, is seen as essential to guarantee the fulfilment of the people's needs and to incorporate their voice in the decision-making processes of the health system. In the state of Ceará, after the 1986 elections, health reform movement members took control over the management of the state Health Secretariat. This is the main cause of the acceleration of the decentralisation process with the transference of responsibility over the  management of health care delivery to municipalities.O objetivo deste artigo é oferecer uma visão geral da reforma da saúde no Ceará, com foco no processo de descentralização nos anos 90. O fator de condução por trás do movimento brasileiro de reforma da saúde foi a necessidade de reorganizar a sistema nacional de saúde e superar as desigualdades. Para os reformistas, descentralização e, juntamente com ela, a idéia de participação popular, é vista como essencial para garantir o atendimento das necessidades das pessoas e incorporar suas voz nos processos de tomada de decisão do sistema de saúde. No estado do Ceará, após as eleições de 1986, os membros do movimento de reforma da saúde assumiram o controle sobre o gestão da Secretaria Estadual de Saúde. Esta é a principal causa da aceleração processo de descentralização com a transferência de responsabilidade sobre o gestão da prestação de cuidados de saúde aos municípios

Going down to the local: incorporating social organisation and political culture into assessments of decentralised health care

The social organisation and political culture of the society in which an organisation is embedded can have major effects on the way in which organisational policy is implemented and on how that organisation functions. Research on health sector reforms has paid scant attention to this aspect. If the claims made for decentralised management in the health sector are to be evaluated seriously, it is critical to develop concepts and methods to evaluate not only the formal organisation and the outputs of the health system, but also the aspects of local social organisation and political culture within which that local health system is embedded that may mediate their relationship. The paper explores three cases of district health systems in Northeast Brazil in order to identify aspects of local social organisation and political culture that appear to influence the implementation of the reforms and thereby potentially impact upon the quality of the care provided. The results of the study indicate the importance that aspects of local social organisation and political culture may exert on the operations of a decentralised health system. Key aspects identified are: the space for autonomy; the space for local voice in political life; personalised and institutionalised influences on autonomy and local voice; differences of involvement of health staff with the district; different spaces of acceptable practice and accountability. These factors are seen to moderate the intent of the health reforms at all stages in their implementation. Three possibilities are discussed for the nature of the interaction in terms of cause and effect between the formal organisation of the health system and its local context. Seeing this relationship as one of a dialogue offers some cautious optimism for the potential of the reform agenda. The paper closes with suggestions on how to take this line of research forward.Health reforms Social organisation Political culture Decentralisation Brazil