Ecosaúde:: experiências de pesquisa e práticas inovadoras para compreender os vínculos entre a saúde, os ecossistemas e a sociedade

Dominique F. Charron (editor). Ecohealth Research in Practice ”“ Innovative Applications of an Ecosystem Approach to Health. Ottawa, ON, Canadá, International Development Research Centre (IDRC) & Springer, 2012. 282 páginas. ISBN: 978-1-4614-0516-0. $179,00 (Hardcover).Fotografias, figuras, gráficos, índice remissivo, lista de colaboradores, mapas, referências bibliográficas, tabelas

Práticas sustentáveis em agricultura, meio ambiente e saúde : a técnica de irrigação com secas intermitentes na costa Norte do Peru

Tese (doutorado)—Universidade de Brasília, Centro de Desenvolvimento Sustentável, Programa de Pós-Graduação em Desenvolvimento Sustentável, 2020.Desde a década de 1970, sistemas de irrigação em larga escala na costa norte do Peru permitiram a expansão do monocultivo de arroz, embora tenham trazido também problemas ambientais, socioeconômicos e de saúde para a região. O projeto de pesquisa e intervenção “Técnica de Irrigação com Secas Intermitentes (TISI) para o cultivo de arroz no Vale do Jequetepeque”, coordenado pelo Ministério da Saúde (MINSA) do Peru, buscou implementar uma prática inovadora de manejo da água para irrigação. A TISI é uma técnica de plantio de arroz baseada na implementação de períodos de secas como alternativa à irrigação permanente, que é o modelo de cultivo usual na região. Entre 2014 a 2017, o projeto executou atividades em diferentes componentes: agronômico, social e de saúde. Esta Tese se insere no componente social do projeto e tem como objetivo compreender os fatores que podem favorecer ou dificultar a implementação da TISI para a população de agricultores do Vale do Jequetepeque e o papel do projeto do MINSA na difusão dessa prática ao longo do tempo. Entrevistas semiestruturadas foram realizadas em dois momentos, no início e no final do projeto, sendo estudadas dois grupos de agricultores: (i) uma linha de base com 319 agricultores, distribuídos por todo o Vale do Jequetepeque; e (ii) um grupo de agricultores selecionados que participaram diretamente das atividades de aprendizagem e implementação da TISI, durante os quatro anos do projeto. Os dados incluíram as características sociodemográficas dos agricultores, o contexto econômico da produção do arroz e os canais de comunicação formais (mídias de massa) e informais (relações interpessoais) utilizados como fontes de informação sobre agricultura e na saúde. As percepções sobre os benefícios ou prejuízos da TISI foram analisadas com base nas características intrínsecas da inovação. Os resultados mostraram que a TISI é reconhecida como uma prática agrícola com múltiplos benefícios e alguns poucos prejuízos pela maioria dos agricultores do estudo. Alguns fatores estiveram associados à percepção de benefícios da TISI, entre eles, os anos de experiência na agricultura, os investimentos na produção agrícola e as relações interpessoais. Espera-se que futuras atividades de intervenção na região possam fazer uso desses resultados para favorecer de forma mais efetiva a adoção e difusão da TISI em todo o vale.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).Since the 1970s, large-scale irrigation systems on the northern coast of Peru have supported the expansion of rice monoculture, although they have also brought environmental, socioeconomic and health problems to the region. The research and intervention project “Intermittent Rice Irrigation Technique (IRIT) in the Jequetepeque Valley”, coordinated by the Ministry of Health (MINSA) of Peru, sought to implement an innovative water management practice for irrigation. The IRIT is a rice cultivation technique based on the implementation of drought periods as an alternative to permanent irrigation, which is the usual production model in the region. Between 2014 and 2017, the project carried out activities in three different components: agronomic, social and health. This Thesis is part of the social component of the project and aims to understand the factors that may favor or hinder the implementation of the IRIT by the population of farmers of the Jequetepeque Valley and the role of the MINSA project in diffusing this practice over time. Semi-structured interviews were conducted at the beginning and at the end of the project, with two groups of farmers: (i) a baseline sample of 319 farmers, distributed throughout the Jequetepeque Valley; and (ii) a group of selected farmers who participated directly in the IRIT learning and implementation activities during the four years of the project. We collected data on the sociodemographic characteristics of farmers, the economic context of rice production and the formal (mass media) and informal (interpersonal relationships) communication channels used as information sources on agriculture and health. The perceptions about the benefits or disadvantages of the IRIT were analyzed based on the intrinsic characteristics of the innovation. The results showed that the IRIT is recognized as an agricultural practice with multiple benefits and a few disadvantages by most of the farmers. Some factors, such as years of experience in agriculture, investments in agricultural production and interpersonal relationships, were associated with the perceived benefits of the IRIT. We hope that future intervention activities in the region will build upon these results to promote the adoption and diffusion of the IRIT across the valley

Participação e transdisciplinaridade em Ecosaúde: a perspectiva da análise de redes sociais

A Ecosaúde usa abordagens participativas e transdisciplinares com o intuito de compreender as inter-relações entre os componentes dos sistemas socioecológicos e como estas interações influenciam a saúde das populações humanas. O objetivo do artigo é usar a Análise de Redes Sociais (ARS) para entender o papel das relações de colaboração entre os diversos atores envolvidos nos processos participativos e transdisciplinares em projetos de Ecosaúde. Apresentamos um conjunto de indicadores de ARS para caracterizar a evolução e a equidade de participação e diferenciar a inter e a transdisciplinaridade. A análise foi feita com base na rede de colaboração entre os atores da Iniciativa de Liderança em Ecosaúde para as Enfermidades Transmitidas por Vetores (ETV) na América Latina e Caribe. O processo participativo ficou mais intenso ao longo do projeto, com mais sujeitos envolvidos e um número crescente de colaborações. A cooperação entre os atores das ciências sociais, ambientais e da saúde é pouco equitativa; assim, predominam as ciências da saúde. Os poucos cientistas ambientais presentes estão, porém, ativamente envolvidos em colaborações interdisciplinares. A abordagem tem aplicação ampla para estudar a participação e a transdisciplinaridade em projetos sobre saúde e meio ambiente.Ecohealth uses participatory and transdisciplinary approaches to understand the relationships between the components of socio-ecological systems and how these interactions influence the health of human populations. The article aims to use Social Network Analysis (SNA) to understand the role of collaborative relationships between the various actors involved in participatory and transdisciplinary processes in Ecohealth projects. We present a set of SNA indicators to characterize the evolution and equity of participation and to differentiate the inter and the transdisciplinarity. The analysis was based on the collaboration network among the members of the Ecohealth Field Building Leadership Initiative for Vector-Borne Diseases (VBD) in Latin America and Caribbean. The participatory process intensified throughout the project, with more subjects involved and a growing number of collaborations. Cooperation between members from the social, environmental, and health sciences is unbalanced; thus, health scientists predominate. The few environmental scientists are, however, actively involved in interdisciplinary collaborations. The proposed approach has wide application to study participation and transdisciplinarity in projects about health and environment

Social networks, social capital and environmental governance in the Amazonian Gateway Territory

O artigo trata de um estudo empírico em que a análise de redes sociais é utilizada para mapear o capital social de atores envolvidos em processos de governança ambiental na Amazônia brasileira. Por meio de entrevistas, foi mapeada a rede de relações de diálogo sobre questões socioambientais de um conjunto de 505 atores no Território Portal da Amazônia. Foram identificadas 3384 relações de diálogo, com uma média de 6,7 parceiros de diálogo por ator. A análise dos aspectos estruturais da rede de diálogo foi utilizada para construir indicadores de capital social de ligação, com mapeamento da organização interna dos atores de um mesmo município, e de conexão, com a caracterização das relações entre atores de municípios diferentes. Em nível municipal, a distribuição das duas formas de capital social permitiu caracterizar os grupos de atores de acordo com as suas atuações diferenciadas na governança ambiental do Território. Em nível territorial, o padrão de conectividade entre os 16 municípios mostra um equilíbrio entre as duas formas de capital social e revela o potencial de comunicação e organização dos atores, como demonstrado no exemplo dos projetos de Agendas 21 locais. Estes resultados demonstram como a análise de redes sociais pode contribuir na definição (ou redefinição) das fronteiras dos territórios de modo a incluir um conjunto de municípios cujos atores mantêm relações sociais efetivas. Ações de governança no Portal da Amazônia são propostas com potencial para fortalecer os processos de diálogo, diminuir os conflitos e promover o uso sustentável dos recursos naturais na Amazônia.The article presents an empirical study where social network analysis is used to map social capital among actors involved in environmental governance processes in the Brazilian Amazon. Using interviews, we carried out the mapping of the dialogue network regarding socio-environmental issues among 505 actors from the Amazonian Gateway Territory. The analysis identified 3384 dialogue relationships. Each actor has an average of 6,7 dialogue partners. The analysis of the structural characteristics of the dialogue network was used to build indicators of social capital of the bonding type, based on the mapping of the organization among actors from the same municipalities, and bridging type, based on the identification of relationships among actors from different municipalities. At the municipal level, the distribution of the two types of social capital allowed the characterization of groups of actors according to their differing participation in the environmental governance of the Territory. At the territorial level, the connectivity pattern among the 16 municipalities exhibits a balance between the two types of social capital and reveals the potential of communication and organization among actors, as demonstrated through the example of the local Agenda 21 projects. These results demonstrate how social network analysis can contribute to the definition (or re-definition) of the territories frontiers in order to include a set of municipalities whose cohesion is based on effective social relationships. We also propose governance actions for the Amazonian Gateway aiming at strengthening dialogue processes, reducing conflicts and promoting the sustainable use of natural resources in the Amazon

Participação e transdisciplinaridade em Ecosaúde: a perspectiva da análise de redes sociais

Ecohealth uses participatory and transdisciplinary approaches to understand the relationships between the components of socio-ecological systems and how these interactions influence the health of human populations. The article aims to use Social Network Analysis (SNA) to understand the role of collaborative relationships between the various actors involved in participatory and transdisciplinary processes in Ecohealth projects. We present a set of SNA indicators to characterize the evolution and equity of participation and to differentiate the inter and the transdisciplinarity. The analysis was based on the collaboration network among the members of the Ecohealth Field Building Leadership Initiative for Vector-Borne Diseases (VBD) in Latin America and Caribbean. The participatory process intensified throughout the project, with more subjects involved and a growing number of collaborations. Cooperation between members from the social, environmental, and health sciences is unbalanced; thus, health scientists predominate. The few environmental scientists are, however, actively involved in interdisciplinary collaborations. The proposed approach has wide application to study participation and transdisciplinarity in projects about health and environment.A Ecosaúde usa abordagens participativas e transdisciplinares com o intuito de compreender as inter-relações entre os componentes dos sistemas socioecológicos e como estas interações influenciam a saúde das populações humanas. O objetivo do artigo é usar a Análise de Redes Sociais (ARS) para entender o papel das relações de colaboração entre os diversos atores envolvidos nos processos participativos e transdisciplinares em projetos de Ecosaúde. Apresentamos um conjunto de indicadores de ARS para caracterizar a evolução e a equidade de participação e diferenciar a inter e a transdisciplinaridade. A análise foi feita com base na rede de colaboração entre os atores da Iniciativa de Liderança em Ecosaúde para as Enfermidades Transmitidas por Vetores (ETV) na América Latina e Caribe. O processo participativo ficou mais intenso ao longo do projeto, com mais sujeitos envolvidos e um número crescente de colaborações. A cooperação entre os atores das ciências sociais, ambientais e da saúde é pouco equitativa; assim, predominam as ciências da saúde. Os poucos cientistas ambientais presentes estão, porém, ativamente envolvidos em colaborações interdisciplinares. A abordagem tem aplicação ampla para estudar a participação e a transdisciplinaridade em projetos sobre saúde e meio ambiente

Acesso de pacientes com AVC à telessaúde: quais são as principais barreiras e como são explicadas pelo modelo teórico UTAUT? Uma revisão sistemática

O acidente vascular cerebral (AVC),como condição crônica de saúde, requer monitoramento.Nesse sentido, a telessaúde surge com o objetivo depossibilitar um melhor acesso aos serviços de saúde.Porém, por estar relacionada ao uso de tecnologia,essa modalidade pode enfrentar novas barreiras.O objetivo desta pesquisa foi identificar, por meio de umarevisão sistemática da literatura, as barreiras percebidaspor pacientes com AVC quanto ao acesso à telessaúdee conceituá-las dentro do modelo da Teoria Unificadade Aceitação e Uso de Tecnologia (UTAUT). A revisãosistemática foi realizada nas seguintes bases de dadoseletrônicas: PubMed, MEDLINE, SciELO, LILACS e PEDro;por meio da combinação dos descritores “barreirasde acesso aos cuidados de saúde”, “telerreabilitação”,“telessaúde”, “acidente vascular cerebral” e “modalidadesde fisioterapia”. Inicialmente, foram encontrados298 artigos, sendo 295 por meio da busca em bases dedados e três por meio de busca ativa, e, destes, apenas seisartigos foram incluídos na revisão. Somados, os artigosrevelaram a percepção de mais de 220 indivíduos quesofreram AVC e oito tipos de barreiras, a maioria delasrelacionadas às dimensões de Expectativa de Esforço eCondições Facilitadoras do modelo UTAUT. As barreirasda dimensão Expectativa de Esforço relacionadas aoconhecimento no uso de tecnologias são passíveis deserem superadas, pois treinamentos podem ser realizadospreviamente ao serviço de telessaúde. No entanto,as barreiras relacionadas à dimensão das CondiçõesFacilitadoras no que se refere a aspectos financeiros,internet e contexto domiciliar são difíceis de superar,podendo, portanto, interferir na aceitação do usuárioquanto ao uso da telessaúde.El accidente cerebrovascular (ACV) como una condiciónde salud requiere de monitoreo. En este contexto, la telesaludemerge como una posibilidad que permite un mejor acceso a losservicios de salud. Sin embargo, dado que esta modalidad estárelacionada con el uso de la tecnología, se pueden surgir nuevasbarreras. El objetivo de esta investigación fue identificar, medianteuna revisión sistemática de la literatura, las barreras percibidaspor los pacientes con ACV con respecto al acceso a la telesaludy conceptualizarlas dentro del modelo de la Teoría Unificada deAceptación y Uso de la Tecnología (UTAUT). La revisión sistemáticase realizó en las siguientes bases de datos electrónicas: PubMed,MEDLINE, SciELO, LILACS y PEDro; a partir de la combinaciónde los descriptores “barreras de acceso a la atención médica”,“telerrehabilitación”, “telesalud”, “accidente cerebrovascular”y “modalidades de fisioterapia”. Inicialmente, se encontraron298 artículos, de los cuales se obtuvieron 295 mediante la búsquedaen la base de datos y tres por la búsqueda activa; de estos, solo seisartículos se incluyeron en la revisión. Los artículos revelaron lapercepción de más de 220 sujetos que sufrieron ACV y ocho tiposde barreras; la mayoría de ellas relacionadas con las dimensionesExpectativa de Esfuerzo y Condiciones Facilitadoras del modeloUTAUT. Las barreras de la dimensión Expectativa de Esfuerzo,relacionadas con el conocimiento en el uso de tecnologías, sepueden superar mediante una capacitación previa antes de utilizarla telesalud. Sin embargo, las barreras asociadas con la dimensiónde las Condiciones Facilitadoras respecto a los aspectos financieros,de Internet y el contexto del hogar son difíciles de superar y,por lo tanto, pueden interferir en la aceptación del uso de latelesalud por parte del usuarioStroke is a chronic health condition thatrequires monitoring. In this sense, telehealth emergesas a tool to enable better access. However, since it isrelated to use of technology, this modality might facenew barriers. Our goal was to identify, with a systematicliterature review, the perceived barriers to telehealthaccess by stroke patients and conceptualize them withinthe Unified Theory of Acceptance and Use of Technology(UTAUT) model. The systematic review was carried out in the following electronic databases: PubMed, MEDLINE, SciELO,LILACS, and PEDro; and the combination of descriptors were:“Barriers to Access to Health Care,” “Telerehabilitation,” “Telehealth,”“Stroke,” and “Physical Therapy Modalities.” The included studiesfocused on telehealth barriers perceived by stroke patients. Initially,298 articles were found, 295 via databases search, and threevia active search; of these, only six articles were included in thisreview. Overall, the articles revealed the perception of more than220 stroke patients, with barriers categorized into eight types,most of them related to the dimensions of Effort Expectancy andFacilitating Conditions of the UTAUT model. The barriers of theEffort Expectation dimension that are related to the knowledge inthe use of technologies are likely to be overcome since training canbe carried out before the telehealth service. However, the barriersrelated to the Facilitating Conditions dimension regarding financialaspects, the internet, and home context are difficult to overcome,possibly interfering with user’s acceptance of telehealth

Drought’s Impact in Irrigated Perimeters in the Brazilian Semi-Arid

Setting up irrigated perimeters (IP) in the northeastern semi-arid of Brazil was an necessary attempt on development agricultural activities in a reality where water is the main limiting factor and the most problematic on account of the irregularities of the climate and droughts. This work aimed to measure the impact of the extensive drought of 2010 through 2015 on the production of 13 irrigated perimeters in the State of Ceará, identifying the most impacted crops and perimeters. In this regard, the data of the irrigated perimeters executive synthesis, publicized by DNOCS (Departamento Nacional de Obras Contra as Secas - DNOCS) with numbers of agricultural production of six years assessed, were systematized. In addition, meteorological data of pluviometry, sourced by Funceme (Fundação Cearense de Meteorologia e Recursos Hídricos - Funceme) and data of water storage volumes of the main reservoirs of the State, sourced by Cogerh (State Company of Water Resources Management) on the data of the rainfall State Water resources management company. The State’s agricultural productions of the irrigated perimeters raised until 2014, when the water’s collapse resulted in rationing and a whole decline in production. The IP, such as Ema, Forquilha, and Quixabinha suffered a substantial decline in production since the early years of drought, which reached a total collapse in 2014, for in the case of the Ema

The role of strong-tie social networks in mediating food security of fish resources by a traditional riverine community in the Brazilian Amazon

Social networks are a significant way through which rural communities that manage resources under common property regimes obtain food resources. Previous research on food security and social network analysis has mostly focused on egocentric network data or proxy variables for social networks to explain how social relations contribute to the different dimensions of food security. Whole-network approaches have the potential to contribute to former studies by revealing how individual social ties aggregate into complex structures that create opportunities or constraints to the sharing and distribution of food resources. We used a whole-network approach to investigate the role of network structure in contributing to the four dimensions of food security: food availability, access, utilization, and stability. For a case study of a riparian community from the Brazilian Amazon that is dependent on fish as a key element of food security, we mapped the community strong-tie network among 97% of the village population over 14 years old (n = 336) by integrating reciprocated friendship and occupational ties, as well as close kinship relationships. We explored how different structural properties of the community network contribute to the understanding of (1) the availability of fish as a community resource, (2) community access to fish as a dietary resource, (3) the utilization of fish for consumption in a way that allows the villagers to maximize nutrition while at the same time minimizing toxic risks associated with mercury exposure, and (4) the stability of the fish resources in local ecosystems as a result of cooperative behaviors and community-based management. The contribution of whole-network approaches to the study of the links between community-based natural resource management and food security were discussed in the context of recent social-ecological changes in the Amazonian region

Complex innovations in agriculture, environment, and health – the perceptions of rice farmers in the Jequetepeque Valley, Peru

The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities.The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities.The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities.The increased use of water in irrigated rice monocultures in the Jequetepeque Valley, on the northern coast of Peru, has exacerbated environmental, socioeconomic and health problems. The Alternate Wetting and Drying (AWD) irrigation technique aims to increase water management efficiency in rice cultivation. The objective of the present article is to understand farmers’ perceptions about the benefits and risks of implementing AWD. Data from interviews with 319 farmers showed that they recognise nine interactions between AWD's economic, environmental and health aspects but prioritise economic factors when assessing its benefits. We also identified the main channels and spaces of communication and debate on issues related to agriculture and health that are likely to be effective in promoting the diffusion of AWD. The study demonstrated the relevance of integrated actions to encourage the adoption of agricultural innovations which consider the interactions between environmental sustainability, health issues, and producers' economic priorities