The Brazilian National Health Agency and the Mental Health Policy in the Context of the Private Health System: developments and challenges

This work analyses the mental health policy-making activity of the Brazilian National Health Agency (ANS), responsible for controlling health insurance companies. Three points are discussed: a) the framework of an economic and private health assistance regulatory activity, b) the ANS and its regulation activity and c) the rules produced by ANS in the mental health care field. It was concluded that, despite advances like the legal obligation to ensure medical treatment to all the diseases listed in ICD-10, the inclusion of suicidal patient damage and self-inflicted damage care, care provided by a multiprofessional team, the increase in the number of sessions with a psychologist, with an occupational therapist and of psychotherapy sessions, and mental health day hospitals included as part of the services offered, the authors identified specific regulatory gaps in this area. Some issues that ANS has to solve so that it can really play its institutional role of defending the public interest in the private health system are: the regulation of co-participation and franchise mechanisms, the increasing co-participation as a limitation of psychiatric hospitalization, and the limited number of crisis intervention psychotherapy sessions

A agência nacional de saúde suplementar - ANS: onze anos de regulação dos planos de saúde

Trata-se de um trabalho com objetivo de apresentar os principais resultados alcançados pela regulação dos planos de saúde exercida pela Agência Nacional de Saúde Suplementar, autarquia instituída para promover o equilíbrio das relações entre operadoras e consumidores, tornando o mercado de planos de saúde mais efi ciente. Como avanços mais significativos oriundos da regulação do setor podem ser citados: as barreiras à entrada e à saída das operadoras no mercado, a ampliação das coberturas assistenciais contratuais, o monitoramento e o controle dos reajustes, a indução a práticas de promoção da saúde e à qualificação do setor, e a possibilidade da portabilidade de carências. Como desafi os a serem enfrentados, podem ser apontados: o monitoramento da qualidade da assistência prestada, a renúncia fiscal, a existência dos cartões de desconto, a operação de empresas como operadoras de planos de saúde sem o registro na ANS e a adoção de alguns mecanismos nocivos de regulação assistencial pelas operadoras de planos de saúde

La Escuela de Enfermería de Ribeirão Preto/USP, y la Sociedad Honorífica de Enfermería Pró Sigma Theta Tau Internacional

The FIERP Honor Society will become a Sigma Theta Tau International chapter in 2002. The Honor Society had to face significant challenges, but the opportunity to participate in this international network will be of great importance to Brazilian and Latin American Nursing.A Sociedade Honorífica da FIERP - Pró Sigma Theta Tau Internacional será transformada em um capítulo da Sociedade Internacional de Enfermagem Sigma Theta Tau Internacional, a partir de 2002. Após uma série de dificuldades e desafios, o Brasil terá o primeiro capítulo da STTI. A possibilidade de participar dessa rede internacional de enfermagem será de grande importância para a enfermagem brasileira e da América Latina.La Sociedad Honorífica de la FIERP - Pro Sigma Theta Tau Internacional será transformada en un capítulo de la Sociedad Internacional de Enfermería Sigma Theta Tau Internacional (STTI) a partir de 2002. Después de una serie de dificultades y desafíos, el Brasil va a crear el primer capítulo de la STTI. La posibilidad de participar de ésta red internacional de enfermería va a ser de gran importancia para la enfermería brasileña y de América Latina

Research Involving Human Subjects and the Role of Institutional Review Boards in Brazil

Background, The regulation of research involving human subjects through the creation of Institutional Review Boards (IRBs) aims to consolidate a culture of respect for human rights, mainly of research subjects. Method, This study discusses the regulations for the development of research involving human subjects and the role of IRBs in Brazil. Results, More than half of the IRBs are located in the South and Southeast, where IRBs are being consolidated. Progress is being made in Brazil as a result of Resolutions 196/96 and 466/12, however, challenges continue. In response to deficits in researchers’ and research institutions’ appreciation of, and lack of commitment to, ethical research practice IRBs have an important educative role. IRBs need to make their work transparent for the entire community and demonstrate the ability to enhance the organizational climate of institutions. Conclusions, Some deficits exist in the scientific community’s understanding of the importance and role of IRBs, as well as in the excessive bureaucratization of the relationship between researchers and IRB members. In a country with so many regional differences, despite national regulations, IRB members should recognize and effectively deal with local particularities to guarantee respect for research subjects’ dignity

Challenges for nursing education in Angola: the perception of nurse leaders affiliated with professional education institutions

Background: Angola is one of the African countries with the highest morbidity and mortality rates and a\ud devastating lack of human resources for health, including nursing. The World Health Organization stimulates and\ud takes technical cooperation initiatives for human resource education and training in health and education, with a\ud view to the development of countries in the region. The aim in this study was to identify how nurses affiliated with\ud nursing education institutions perceive the challenges nursing education is facing in Angola.\ud Methods: After consulting the National Directory of Human Resources in Angola, the nurse leaders affiliated with\ud professional nursing education institutions in Angola were invited to participate in the study by email. Data were\ud collected in February 2009 through the focus group technique. The group of participants was focused on the\ud central question: what are the challenges faced for nursing education in your country? To register and understand the\ud information, besides the use of a recorder, the reporters elaborated an interpretative report. Data were coded using\ud content analysis.\ud Results: Fourteen nurses participated in the meeting, most of whom were affiliated with technical nursing\ud education institutions. It was verified that the nurse leaders at technical and higher nursing education institutions\ud in Angola face many challenges, mainly related to the lack of infrastructure, absence of trained human resources,\ud bureaucratic problems to regularize the schools and lack of material resources. On the opposite, the solutions\ud they present are predominantly centered on the valuation of nursing professionals, which implies cultural and\ud attitude changes.\ud Conclusions: Public health education policies need to be established in Angola, including action guidelines that\ud permit effective nursing activities. Professional education institutions need further regularizations and nurses need\ud to be acknowledged as key elements for the qualitative enhancement of health services in the country.Introdução: Angola é um dos países africanos que apresenta os maiores índices de morbimortalidade e\ud devastadora insuficiência de recursos humanos na área de saúde, incluindo a enfermagem. A Organização Mundial\ud da Saúde estimula e implementa iniciativas de cooperação técnica para a formação e aperfeiçoamento de recursos\ud humanos na área da saúde e educação, visando o desenvolvimento dos países africanos. Este estudo teve como\ud objetivo identificar as percepções dos enfermeiros vinculados a Escolas de Formação em Enfermagem em relação\ud aos desafios para o ensino de enfermagem em Angola.\ud Metodologia: Após consulta ao Diretório Nacional de Recursos Humanos de Angola os líderes em enfermagem\ud vinculados a Escolas de Formação em Enfermagem do país foram convidados a participar do estudo por meio de\ud convites eletrônicos. Para a coleta de dados, realizada no mês de fevereiro de 2009, foi utilizada a técnica de Grupo\ud Focal. O grupo de participantes foi direcionado para a questão central: quais os desafios encontrados para a educação\ud em enfermagem no seu país? Para o registro e compreensão das informações, além do uso de um gravador, um\ud relatório interpretativo foi elaborado pelos relatores. Os dados foram codificados via análise de conteúdo.\ud Resultados: Participaram do encontro 14 enfermeiros, sendo a maioria vinculada a escolas de ensino de\ud enfermagem de nível técnico. Verificou-se que os líderes de Escolas de Nível Técnico e Superior de Enfermagem em\ud Angola enfrentam muitos desafios, relacionados principalmente à falta de infra-estrutura, ausência de recursos\ud humanos capacitados, problemas com a burocracia para a regularização das escolas e escassez de recursos materiais.\ud Em contrapartida, apresentam soluções centradas predominantemente na valorização dos profissionais de\ud enfermagem, o que implica em mudanças culturais e de atitude.\ud Conclusões: É necessário o estabelecimento de políticas públicas de educação em saúde em Angola com diretrizes\ud de ação que permitam a atuação efetiva dos enfermeiros. Salienta-se a necessidade de regularização das Escolas\ud profissionalizantes e o reconhecimento do enfermeiro como elemento chave para o incremento da qualidade dos\ud serviços de saúde do país.To the Health Work and Education Management Secretary of the Brazilian Ministry of Health and the Pan American Health Organization in Brazil for their political and financial support, which enabled the Global Network of WHO Collaborating Centres for Nursing and Midwifery Development to construct a database on Nursing in Angola.To the Health Work and Education Management Secretary of the Brazilian Ministry of Health and the Pan American Health Organization in Brazil for their political and financial support, which enabled the Global Network of WHO Collaborating Centres for Nursing and Midwifery Development to construct a database on Nursing in Angola

A Structural Equations Modeling Approach

COVID-19 vaccine hesitancy (VH) has caused concerns due to the possible fluctuations that may occur directly impacting the control of the pandemic. In this study, we aimed to estimate the prevalence and factors associated with COVID-19 VH in Portuguese-speaking countries. We developed a web survey (N:6,843) using an online, structured, and validated questionnaire. We used Measurement Models, Exploratory Factor Analysis, Exploratory Structural Equation Models, and Confirmatory Factor Analysis for the data analysis. The overall prevalence of COVID-19 VH in Portuguese-speaking countries was 21.1%. showed a statistically significant direct effect for VH: vaccine-related conspiracy beliefs (VB) (β = 0.886), perceived stress (PS) (β = 0.313), COVID-19 Misinformation (MIS) (β = 0.259) and individual responses to COVID-19 (CIR) (β = −0.122). The effect of MIS and CIR for VH was greater among men and of PS and VB among women; the effect of PS was greater among the youngest and of VB and CIR among the oldest. No discrepant differences were identified in the analyzed education strata. In conclusion, we found that conspiracy beliefs related to the vaccine strongly influence the decision to hesitate (not to take or to delay the vaccine). Specific characteristics related to gender, age group, social and cognitive vulnerabilities, added to the knowledge acquired, poorly substantiated and/or misrepresented about the COVID-19 vaccine, need to be considered in the planning of vaccination campaigns. It is necessary to respond in a timely, fast, and accurate manner to the challenges posed by vaccine hesitancy.publishersversionpublishe