Submitted in fulfilment of the requirements of the Master of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Background: The occurrence of absenteeism observed at the Coastal KZN FET College is very large. However, absenteeism of this magnitude is not inconsistent with observations from other educational institutions and work places around the world. Generally, absenteeism is coupled to the absence of good health, the presence of one or more non-communicable disease and the paucity of physical exercise undertaken by the personnel. Absenteeism in the work place results in avoidable financial costs to the employer, the employee, and the country as a whole. The wealth of literature shows that health concerns concerning adults are diet related. Diabetes, heart disease, hypertension, obesity, cancer and other non-communicable diseases (NCD’s) are increasing at an alarming rate, daily. A double-burden plagues South Africa: on the one hand there is over-nutrition (an excessive consumption of nutrients); while on the other there is under-nutrition (an insufficient intake of nutrients by certain groups of individuals). Factors such as urbanisation, globalisation, physical inactivity and consumer financial buying power have a significant influence on these health concerns. Aim: The data gathered in this study will be used to develop nutrition wellness education material as a component of a wellness programme for staff members at the Swinton Campus of the KZN Coastal FET College in Mobeni. Methodology: A needs analysis was undertaken to determine whether nutrition wellness education material as a component of a wellness programme for the institution was appropriate. Three 24-hour recall questionnaires gathered from the staff, data on eating habits and nutrient intake were undertaken/collected. A food frequency questionnaire collected data on the frequency and variety of foods eaten. A health questionnaire gathered data on self-reported illnesses, consumption of alcohol, and smoking habits. The demographics of the group, living conditions, and amount of money earned and spent on food was assessed through a socio-demographic questionnaire. Anthropometric measurements assessed included blood pressure, waist circumference, BMI and Waist-to-height-ratio (WHtR). Results: The sample consisted of 138 participants of which 44% (n=61) were men and 56% (n=77) were women. Less than 50% of the respondents were food secure: only 65 persons (47.1%) in the sample always had money to purchase food. In this group 63.93% of the men and 71.43% of the woman were obese. Subsequently 86% of the women exceeded the waist cut-off point of 88cm while 16.39% of the men were above the 102cm cut-off point. Findings revealed that 42.62% of the men and 25.9% of the women had pre-hypertension while 8.20% of the men and 5.90% of the women were hypertensive. This study indicated that this group was nutrient deficient. The fruit and vegetable intake was between 134.44g - 175.69g per day for men and 124.00g - 183.30g per day for women. Energy, dietary fibre, vitamin A, vitamin D, calcium, magnesium and iodine were below the nutrient adequacy ratio. There were positive correlations between age and systolic blood pressure, waist circumference and systolic blood pressure, waist circumference and diastolic blood pressure and waist-to-height ratio and BMI. Conclusion: Central obesity and to a lesser extent hypertension as well as deficiencies in nutrients and minerals were present in this group. Although the participants indicated a good variety of food, the quality and quantities consumed were not adequate. A link between diet, physical activity and diseases of lifestyle has been demonstrated. A need for nutrition education as a component of the wellness programme is indicated. Nutrition education is important both within and outside the workplace. To make lifestyle changes it is essential that education and knowledge is made available. Behavioural habits including eating habits are principally learnt. If bad behaviour habits can be learnt, good behaviour habits can also be instilled. The proposed intervention is aimed at reducing the incidence of absenteeism and decreasing the presence of non-communicable diseases. It is important for staff members at a FET college to be present in the classroom so that education of quality can be conveyed to learners. Further, the good health of staff members facilitates the ability of teachers to perform their important task of educating young minds at all educational institutions. / M

The collection and utilisation of statistical data is an integral component of rendering primary health care services. This study aimed to assess the utilisation of statistics on certain statistical forms submitted regularly to the Department of Health, by professional nurses at local authority primary health care clinics. Results revealed the following important shortcomings: • Statistics on different forms are viewed in isolation, resulting in a lack of necessary comparisons being made to determine trends. • Several targeted issues in the Reconstruction and Development Programme received insufficient attention, for example, immunisations, teenage pregnancies, tuberculosis treatment, sexually transmitted diseases. • A general managerial inability to analyse, display and utilise collected data by professional nurses. Recommendations centred around increasing the knowledge regarding maternal health care, more focus on prioritised areas of the Reconstruction and Development Programme, appropriate training regarding analysis and utilisation of collected statistics at local primary health care level. / Health Studies / M.A. (Nursing)

The collection and utilisation of statistical data is an integral component of rendering primary health care services. This study aimed to assess the utilisation of statistics on certain statistical forms submitted regularly to the Department of Health, by professional nurses at local authority primary health care clinics. Results revealed the following important shortcomings: • Statistics on different forms are viewed in isolation, resulting in a lack of necessary comparisons being made to determine trends. • Several targeted issues in the Reconstruction and Development Programme received insufficient attention, for example, immunisations, teenage pregnancies, tuberculosis treatment, sexually transmitted diseases. • A general managerial inability to analyse, display and utilise collected data by professional nurses. Recommendations centred around increasing the knowledge regarding maternal health care, more focus on prioritised areas of the Reconstruction and Development Programme, appropriate training regarding analysis and utilisation of collected statistics at local primary health care level. / Health Studies / M.A. (Nursing)

Health related absenteeism was identified as a problem in the schools in the Molopo region, needing a multi-disciplinary approach which included the parents. A conceptual framework on absenteeism was used as a guideline for the descriptive research design. Using a convenience sampling technique 426 absentees, 22 teachers and 2 school nurses filled in three separate questionnaires in ten schools selected to determine the extent of absenteeism due to health related and other problems, the control measures taken and the awareness of school personnel. Health problems were identified as the main reasons for absenteeism. Inadequate communication between the schools and parents as well as lack of guidelines on the control of absenteeism, were other problems identified. Recommendations made related to the provision of school health services that promote the health status of the pupils based on Primary Health Care principles, parental involvement in school health matters and the formulation of policies aimed at controlling absenteeism in schools. / Health Sciences / M.A. (Nursing Science)

INTRODUÇÃO: As intervenções de promoção da saúde mental avançam e atividades não medicamentosas ganham espaço. Neste sentido, estudos apontam a atenção plena (mindfulness) como estratégia integrativa para o enfrentamento do estresse e de transtornos mentais comuns, bem como para obtenção do autocuidado. Mindfulness é referido no contexto laico contemporâneo como um estado mental presente em todos os indivíduos em maior ou menor intensidade que pode ser cultivado diariamente através de práticas meditativas. OBJETIVO: Descrever o nível da autopercepção de comportamentos relacionados à Mindfulness em profissionais da saúde de um Hospital Terciário e analisar a associação dos níveis de mindfulness autopercebidos com determinados indicadores das condições de vida e saúde. MÉTODO: Foi realizado um estudo transversal com 97 profissionais da saúde que compõem o complexo do Hospital das Clínicas - FMUSP por via de caracterização Sociodemográfica, da Escala Filadélfia de Mindfulness (EFM) e de um Questionário de Saúde Geral (General Health Questionnaire -12). Todos os questionários foram aplicados no período de fevereiro/novembro de 2014. RESULTADO: Na EFM, o escore médio apresentado foi maior para o componente \"Consciência\" (média 29,9; desviopadrão 0,62) do que para \"Aceitação\" (média 15,7; desvio-padrão 0,86), sendo a média 45,6 e desvio-padrão 1,1 para o Escore Total (componente \"consciência\" somada a \"aceitação\"); Verificou-se número significativo de indivíduos (41%) com suspeita de transtornos mentais comuns (TMC), aqueles que apresentaram um escore de três ou mais no GHQ-12. Em análise mais detalhada (Teste t e ANOVA) observou-se associações fortemente significantes (p < 0,01) entre maiores níveis de mindfulness autopercebido com o gênero masculino, estado civil casado/amigado, maior satisfação no trabalho, negar uso de medicamentos, sono satisfatório, lazer frequente e ausência de TMC. Na análise da associação GHQ-12 com Mindfulness estratificada por profissão verificou-se escores menores no grupo das categorias \"psicólogo, assistente social, profissional de educação física, biólogo, fisioterapeuta, farmacêutico e profissional administrativo\" com TMC; na análise da associação GHQ-12 com Mindfulness estratificada por tipo de doença concluiu-se que existem diferenças significantes (p < 0,01) no grupo das categorias \"mais de uma doença, neurológica ou psiquiátrica\", das quais o escore \"Total\" e \"Aceitação\" foram menores para quem apresenta TMC. A presença de TMC (referido pelo GHQ-12) está associada a menores escores de Mindfulness, indicando uma possível correlação negativa que se deve ao domínio de \"Aceitação\" CONCLUSÃO: Os níveis de comportamentos autopercebidos à atenção plena apontaram associações significantes com uma variedade de indicadores das condições de vida e saúde nos profissionais de saúde. Sugerindo assim, uma mesma direção de evidências científicas recentes de que mindfulness pode fazer parte de fatores de proteção à saúde favorecendo também o autocuidado e a qualidade de vida / INTRODUCTION: The Mental Health Promotion interventions advance and non-drug activities gain ground. In this case, studies show meditation as an opportunity to cope with stress and the common mental disorders, as well as to obtain self-care. Mindfulness is referred in contemporary laic context as a present mental state in all individuals in greater or lesser degree which can be daily cultivated through meditative practices. OBJECTIVE: This study aimed to describe the self-perceived level of Mindfulness-related behaviors in health care professionals of a tertiary care hospital as well as to analyze the association of self-perceived mindfulness levels with certain indicators of living conditions and health. METHOD: A cross-sectional study is proposed with 97 health professionals who make up the University Hospital complex - FMUSP via Socio Demographic characterization, a study of the Philadelphia Mindfulness Scale (PMS) and a Questionnaire of General Health (General Health Questionnaire -12). All interviews were conducted between February and November/ 2014. RESULT: In PMS, the average score was higher for the component \"awareness\" (mean 29.9, SD 0.62) than for \"acceptance\" (mean 15.7, SD 0.86), with an average 45.6 and SD 1.1 for the Total Score (component \"awareness\" added to \"acceptance\"); There was a significant number of individuals (41%) with suspected common mental disorders (CMD), those with a score of three or higher in the GHQ-12. In a more detailed analysis (T-Test and ANOVA) it was observed strongly significant associations (p < 0.01) with higher levels of self-perceived mindfulness in the masculine gender, married / living together unmarried, greater job satisfaction, not in use of medicinal drugs, satisfactory sleep, frequent leisure and no presence of CMD. In the analysis of the GHQ-12 association with Mindfulness stratified by profession it was observed that the scores were lower for the group of the categories \"psychologist, social worker, physical education professional, biologist, physiotherapist, pharmacist and administrative professional\" with CMD; in the analysis of the GHQ-12 association with Mindfulness stratified by disease type the results showed that there are significant differences (p < 0.01) for the group of the categories \"more than one disease, either neurological or psychiatric\", of which the score \"Total\" and \"Acceptance\" were lower for those who had CMD. The presence of CMD (referred by the GHQ-12) is associated with lower scores of Mindfulness, indicating a possible negative correlation due to the domain of \"Acceptance\". CONCLUSION: The levels of self-perceived behaviors to mindfulness showed significant associations with a variety of indicators of living conditions and health among health care professionals. Suggesting, thus, the same direction of recent scientific evidences that mindfulness may be part of health protective factors also favoring self-care and quality of life

Compared to males in almost any social group in all affluent nations, Australia's Aboriginal and Torres Strait Islander men suffer from substantially more serious illnesses and early death. To date, research done by or in collaboration with Indigenous communities has revealed the extent of the problems that arise from diabetes, heart disease, hypertension, cancers, respiratory diseases, psychological disorders, accidental injuries, violence and other causes. Reproductive health, however, rarely has been studied among Indigenous men. To date, research in this field has been limited mainly to studies of sexually transmitted infections. No data has been published on Aboriginal men's symptoms of prostate disease or erectile dysfunction, nor has the clinical screening and treatment of these disorders among these men been assessed. In-depth search of the worldwide web demonstrated that little information on these issues was available from other Indigenous populations. It does appear that Indigenous men in Australia, New Zealand and North America are less likely than European-ancestry men to die from prostate cancer, or for living cases to be recorded on cancer registries. This may arise because Indigenous men genuinely have a lower risk, or because they are not captured by official statistics, or because they do not live long enough to develop severe prostate disease. We also know very little about other reproductive health problems such as sexual dysfunction and specifically erectile difficulties. One reason for our scant knowledge is that research mainly relies on self-report of sensitive information. The aim of the research study was to improve the understanding of sexual and reproductive health problems experienced by Indigenous men. This is best gathered by Aboriginal males who are inside the culture of middleaged and older Indigenous men, but until now this has not been attempted. In this study we adopted the World Health Organization (WHO) definitions for Reproductive and Sexual Health (WHO, 2001). Thus, we consider reproductive system disorders (prostate disease, erectile dysfunction) and related health care-seeking, and also men's perceptions about a "satisfying and safe sexual life". The methodology was framed within an Aboriginal and Torres Strait Islander research protocol that advocates respect for cultural, social and community customs. A mixed method design combined qualitative inquiry (4 focus groups and 18 in-depth interviews) and quantitative survey (n=301) involving men living in remote, rural and urban communities (Tiwi Islands, Darwin and north and south-east Queensland). Survey data were compared to recently published self-reports from 5990 randomly selected men aged over 40 years in Australia (Holden et al., 2005, The Lancet, 366, 218-224. The qualitative interviews revealed that most men were silent about reproductive health. They were unwilling to reveal their inner feelings to wives or partners, and they were unwilling to discuss such issues with doctors and other health care workers. Men's reaction to sexual difficulties included shame, denial, substance abuse and occasionally violence. On a positive note many men said they want to learn about it, so they understand how to cope with such problems. The Indigenous men reported symptoms of erectile dysfunction at least as much as non-Indigenous men in other Australian studies. Bivariate analysis showed that erectile dysfunction was correlated with many health and lifestyle variable. However multivariate analysis revealed that only three factors significantly predicted ED: presence of chronic disease, presence of pain when working, and living in a remote geographic location The quantitative survey data indicate that Indigenous men have more symptoms of prostate disease than non-Indigenous men. The syndrome appears to be poorly managed in clinical practice (e.g. rates of PSA testing and digital-rectal examination are only one-third the rate reported by non-Aboriginal men, despite equivalent likelihood of GP visits). The research study adds to the literature by providing better insight and depth into the issues impacting on Aboriginal and Torres Strait Islander males experiencing reproductive and sexual health difficulties. It also provides a platform to undertake comprehensive research with Aboriginal and Torres Strait Islander men to explore a wider spectrum of questions in this important but neglected area. Implications for education of primary healthcare workers and community-based awareness campaigns for Indigenous males are discussed. Most of all, this study revealed "layers" of silence around sexual and reproductive health of Indigenous men. This includes silence in the scientific establishments in health services, and in the community. It is hoped that this study puts the voices of the men forward to help to break down this silence.

Health related absenteeism was identified as a problem in the schools in the Molopo region, needing a multi-disciplinary approach which included the parents. A conceptual framework on absenteeism was used as a guideline for the descriptive research design. Using a convenience sampling technique 426 absentees, 22 teachers and 2 school nurses filled in three separate questionnaires in ten schools selected to determine the extent of absenteeism due to health related and other problems, the control measures taken and the awareness of school personnel. Health problems were identified as the main reasons for absenteeism. Inadequate communication between the schools and parents as well as lack of guidelines on the control of absenteeism, were other problems identified. Recommendations made related to the provision of school health services that promote the health status of the pupils based on Primary Health Care principles, parental involvement in school health matters and the formulation of policies aimed at controlling absenteeism in schools. / Health Sciences / M.A. (Nursing Science)

Made available in DSpace on 2011-05-04T12:42:06Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / A proposta aqui apresentada considera a informação gerada pelo setor saúde como resultante da relação entre os processos de destruição e desgaste a que está submetida a população, em seus diferentes estratos, e os processos de resistência e recuperação desenvolvidos pelas mesmas. Dessa forma, a informação gerada, particularmente pelos serviços de saúde, reflete tanto as condições de vida da população como a capacidade de respostas desenvolvidas pela sociedade, naquele momento do seu processo histórico. Para tanto, procura-se descrever a evolução desta informação no tempo e no espaço, procurando identificar os problemas decorrentes de acesso, cobertura e complexidade dos serviços, além de falhas e desvios introduzidos no próprio processo de produção, disseminação e utilização da informação. Este trabalho se organiza em um estudo em três estágios que contribuem para um resultado final com a proposição de uma metodologia ou estratégia de ação. Pretende-se, dessa forma, lançar um debate e contribuir para que os dados do setor saúde possam vir a ser utilizados mais amplamente na construção de indicadores para a gestão do território, tanto por gestores como pela população em geral. O trabalho aqui apresentado envolve o levantamento dos indicadores da relação saúde e ambiente que estão sendo mais utilizados na literatura científica e na definição de prioridades para a gestão do território. Para esse levantamento procurou-se concentrar nas questões que se referem ao saneamento, como sendo as questões mais antigas e gerais da relação saúde-ambiente enfrentadas pela humanidade. Em continuidade, procura-se aplicar uma metodologia, em desenvolvimento, que resgate as informações existentes nos bancos de dados da saúde, buscando identificar situações concretas na população que reside em numa área selecionada, entorno de um ponto, possível foco de contaminação. Esse estudo, realizado em uma cidade do interior do Rio Grande do Norte, onde existe uma planta industrial da PETROBRÁS, inserido em uma pesquisa mais abrangente, funciona como um estudo de caso, onde os dados gerados pelos serviços de saúde puderam ser comparados com outras metodologias de investigação em saúde e ambiente procurando subsidiar a construção de indicadores. Em um segundo estudo de caso, procurou-se aplicar esta mesma estratégia na avaliação de impactos a serem gerados por um projeto de desenvolvimento, na saúde da população, em uma região da Amazônia. Neste estudo também se procurou avaliar o potencial da utilização das informações geradas pelo setor saúde no monitoramento de impactos ambientais, porém em uma região bem mais ampla e de maior diversidade de situações e de estrutura de serviços de saúde. A metodologia empregada parte de um reconhecimento de campo e se utiliza dos dados secundários de saúde disponíveis, que, associados a uma série de entrevistas com informantes-chave e oficinas com gestores, profissionais de saúde e representantes da comunidade, procura traçar os perfis de saúde-doença das localidades, identificando padrões e processos, particularmente, aqueles que poderiam sofrer influência do empreendimento ou processo em questão. Deste estudo, além do perfil de saúde da população, abrangendo a infraestrutura de serviços, acesso e utilização, procurou-se traçar o perfil da própria informação de saúde e seu processo de implantação, desenvolvimento e manutenção dos diferentes bancos de dados. Ao se analisar a informação em saúde num contexto de rápidas transformações e baixa cobertura de serviços, utiliza-se a própria falta do dado, ou baixa qualidade do mesmo, como informação, que, no contexto das formações econômico sociais existentes e no seu processo de desenvolvimento, podem constituir importantes indicadores. Como conclusão, observa-se o potencial da utilização das informações de saúde para o monitoramento e avaliação de impactos de projetos de desenvolvimento e alterações do ambiente. Destaca-se a não utilização das informações, tanto por parte dos setores de planejamento e gestão do território, quanto pelo próprio setor saúde, que se utiliza delas de modo administrativo e burocrático, sem um cuidado com sua qualidade e adequação a usos que, em muito, poderiam auxiliar o planejamento e as ações de saúde, assim como fortalecer o papel da saúde na gestão do território. O adequado tratamento e utilização da informação gerada pelo setor saúde pode promover, a melhoria da qualidade da mesma e o melhor planejamento e utilização dos recursos para a saúde, além de fornecer uma ferramenta de avaliação do processo de desenvolvimento para a sociedade. Esta ferramenta, de baixo custo operacional, permite a introdução de variáveis sobre as condições de vida de diferentes estratos da população na formulação de respostas da sociedade para indagações como: desenvolvimento para que e para quem? / The proposal presented here considers the information generated to the health system as a resultant of the deprived processes to which the population is submitted, in different groups, and the strategies of resistance and recovery developed by them. The generated information, particularly for the health services, reflects the life conditions of the population and the response capacity developed by the society, at that moment of the historical process. The study aims to describe the evolution of the health information over time and space, identifying problems of access, covering and complexity of the services, besides the imperfections and deviation introduced in the own process of production, dissemination and information use. This study is organized in three steps, each of them contributing for a final result proposing a methodology or a strategy of action. There is an intention to launch a debate and to contribute to a widely use of the system health data in the construction of indicators for the management of the territory, touching managers and the population in general as well. The work presented here involves the survey of the indicators related to health and environment that are being used in the scientific literature and in the definition of priorities for the management of the territory. To do this research it was necessary to concentrate on questions related to the sanitation condition, defined as the oldest general questions of the relation health/ environment faced by the humanity. A methodology has been developed, which rescued the existing information in health databases, searching to identify concrete situations in the population living in selected areas that could be a possible focus of contamination. This study, carried through in a city of the interior of the Rio Grande do Norte, where there is a PETROBRAS industrial unity, is part of a larger research and works as a case study, where data generated for the health services could have been compared with other methodologies of inquiry in health and environment, intending to contribute to the construction of indicators. In a second study of case, the same strategy of ―evaluation of impacts in the population health‖ was used in a development project in the Amazon Region. In this study we also intended to evaluate the potential use of the information generated by the system health in monitoring ambient impacts, however in a bigger region with more diversity of situations and structure of health services. The employed methodology starts from a field recognition and uses available secondary data of health that, associated to many key informants interviews and workshops with managers, professionals of health and representatives of the community, showed the local health-illness profiles, identifying standards and processes, particularly those that could have influence the enterprise or the process in question. This study, besides the population health profile, enclosing the infrastructure of services, access and use, aims to trace the profile of the health information itself and the process of implantation, development and maintenance of different data bases. When analyzing the health information in a context of rapid transformations and low covering of services, the lack of information, or its low quality, could be used as an information itself that, in a context of existing socio-economic formations and in its process of development, might constitute important indicators. The conclusion shows the potential of the health information use for monitoring and evaluating impacts in development projects and environment transformation. It is highlighted that the information is not being used in the best way, neither by the part of the planning systems and management of the territory, nor by the health system, which are using them in administrative and bureaucratic way, without taking care to the quality and the adequacy of this utilization that, if used as it should be, could assist the planning and the actions of health, as well as fortifying the role of the health in the management of the territory. The adequate treatment and use of the information generated by the health system might provide, besides the improvement of the quality and the consequent better planning and use of the resources to the population health, an evaluation tool for the society development process. This tool, of low operational cost, allows the introduction of variables on the conditions of different population groups, formulating answers to the society questions as: ―development‖ to what and to whom?

A gestão da saúde pública ainda enfrenta grandes desafios a serem transpostos para que se consiga prover um atendimento de qualidade aos usuários do Sistema Único de Saúde. Nesse sistema, os hospitais universitários federais exercem um papel de referência na região em que estão alocados. A partir de 2010, o governo intensificou os esforços no aprimoramento dessas organizações e criou o Programa Nacional de Reestruturação dos Hospitais Universitários Federais e a Empresa Brasileira de Serviços Hospitalares. A questão investigada por essa pesquisa foi a relação entre o planejamento estratégico de um Hospital Universitário Federal, o Hospital de Clínicas da Universidade Federal do Paraná, e a diretriz de regionalização definida pelos instrumentos das políticas públicas de saúde. O objetivo geral foi analisar a relação entre o planejamento estratégico do Hospital de Clínicas da Universidade Federal do Paraná e a sua atuação regional nas políticas públicas de saúde. A pesquisa é caracterizada como aplicada, quanto a sua natureza, e descritiva, quanto ao seu objetivo. Tem uma abordagem qualitativa-quantitativa e foi realizada através de multitécnicas: pesquisa bibliográfica, pesquisa documental, técnica de mapeamento, estatística descritiva, estudo de caso (análise documental e entrevistas), e análise mediante software Atlas TI 7, com referência no modelo de Bardin (2011). Constatou-se, através de indicadores de saúde, que a assistência do Hospital de Clínicas da Universidade Federal do Paraná tem um papel importante na região. Quanto a insumos, em relação à assistência hospitalar pública de Curitiba, possui 24,75% dos equipamentos, 22,95% dos profissionais e 14,04% dos leitos. Já em relação à produção hospitalar pública do município, tem participação de 18,87% das consultas médicas e 11,74% das internações. Dos usuários atendidos por essa instituição, 85,35% são da região metropolitana de Curitiba. Isso comprova a importância deste hospital para a região e também da inclusão da regionalização e da rede de atenção à saúde, diretriz e estratégia de organização do Sistema Único de Saúde, na gestão estratégica da instituição. Verificou-se, pelos três últimos planejamentos estratégicos (período 2007 a 2017), um avanço tanto em relação à presença dos componentes, à luz de Kaplan e Norton (2008), como também da regionalização e da rede de atenção à saúde. Como principais fatores dessa evolução, aponta-se a capacitação contínua dos gestores e a nova metodologia proposta pela empresa pública. / The management of public health still faces great challenges to be tackled in order to provide quality service to those users of the Sole Health System. In this system, the federal university hospital play an outstanding role in the region in which they are located. As of 2010, the government has boosted its efforts to improve these organizations and has created the National Program for the Restructuring of Federal University Hospitals and the Brazilian Hospital Services Company. The matter investigated by this research was the relationship between the strategic planning of a Federal University Hospital, Hospital de Clínicas da Universidade Federal do Paraná, and the regional guidelines set forth by the public health public policies. The general aim was to analyze the relationship between Hospital de Clínicas da Universidade Federal do Paraná’s strategic planning and its regional performance as to public health policies. The research is characterized as applied, as to its nature, and descriptive as to its objective. It has a qualitative-quantitative approach and was carried out through assorted techniques: bibliographic research, document research, mapping techniques, descriptive statistics, case studies (document analyses and interviews) and an analysis by using the Atlas TI 7 software, with Bardin (2011) model. It was verified, through health indicators, that this hospital’s service plays an important role in the region. As to the supplies for the public hospital services in Curitiba, the Hospital de Clínicas da Universidade Federal do Paraná has 24.75% of the equipment, 22.95% of the professionals and 14.04% of the hospital beds. Concerning the production of the municipal hospitals, the service has an 18.87% participation in medical appointments and 11.74% in hospital admissions. 85.35% of the patients helped by the institution are from the metropolitan area of Curitiba. This highlights the importance that the hospital has for the region, and the inclusion of regional services and the network of health services, Sole Health System’s organization guidelines and strategy, in performing the strategic management. It has been verified, through the last three strategic plannings (2007 to 2017), an improvement as to the presence of components, as per Kaplan and Norton (2008), as well as the regional activities and the health services network. The main factors for such evolution have been the ongoing training of managers and the new methodology suggested by the public company.

A gestão da saúde pública ainda enfrenta grandes desafios a serem transpostos para que se consiga prover um atendimento de qualidade aos usuários do Sistema Único de Saúde. Nesse sistema, os hospitais universitários federais exercem um papel de referência na região em que estão alocados. A partir de 2010, o governo intensificou os esforços no aprimoramento dessas organizações e criou o Programa Nacional de Reestruturação dos Hospitais Universitários Federais e a Empresa Brasileira de Serviços Hospitalares. A questão investigada por essa pesquisa foi a relação entre o planejamento estratégico de um Hospital Universitário Federal, o Hospital de Clínicas da Universidade Federal do Paraná, e a diretriz de regionalização definida pelos instrumentos das políticas públicas de saúde. O objetivo geral foi analisar a relação entre o planejamento estratégico do Hospital de Clínicas da Universidade Federal do Paraná e a sua atuação regional nas políticas públicas de saúde. A pesquisa é caracterizada como aplicada, quanto a sua natureza, e descritiva, quanto ao seu objetivo. Tem uma abordagem qualitativa-quantitativa e foi realizada através de multitécnicas: pesquisa bibliográfica, pesquisa documental, técnica de mapeamento, estatística descritiva, estudo de caso (análise documental e entrevistas), e análise mediante software Atlas TI 7, com referência no modelo de Bardin (2011). Constatou-se, através de indicadores de saúde, que a assistência do Hospital de Clínicas da Universidade Federal do Paraná tem um papel importante na região. Quanto a insumos, em relação à assistência hospitalar pública de Curitiba, possui 24,75% dos equipamentos, 22,95% dos profissionais e 14,04% dos leitos. Já em relação à produção hospitalar pública do município, tem participação de 18,87% das consultas médicas e 11,74% das internações. Dos usuários atendidos por essa instituição, 85,35% são da região metropolitana de Curitiba. Isso comprova a importância deste hospital para a região e também da inclusão da regionalização e da rede de atenção à saúde, diretriz e estratégia de organização do Sistema Único de Saúde, na gestão estratégica da instituição. Verificou-se, pelos três últimos planejamentos estratégicos (período 2007 a 2017), um avanço tanto em relação à presença dos componentes, à luz de Kaplan e Norton (2008), como também da regionalização e da rede de atenção à saúde. Como principais fatores dessa evolução, aponta-se a capacitação contínua dos gestores e a nova metodologia proposta pela empresa pública. / The management of public health still faces great challenges to be tackled in order to provide quality service to those users of the Sole Health System. In this system, the federal university hospital play an outstanding role in the region in which they are located. As of 2010, the government has boosted its efforts to improve these organizations and has created the National Program for the Restructuring of Federal University Hospitals and the Brazilian Hospital Services Company. The matter investigated by this research was the relationship between the strategic planning of a Federal University Hospital, Hospital de Clínicas da Universidade Federal do Paraná, and the regional guidelines set forth by the public health public policies. The general aim was to analyze the relationship between Hospital de Clínicas da Universidade Federal do Paraná’s strategic planning and its regional performance as to public health policies. The research is characterized as applied, as to its nature, and descriptive as to its objective. It has a qualitative-quantitative approach and was carried out through assorted techniques: bibliographic research, document research, mapping techniques, descriptive statistics, case studies (document analyses and interviews) and an analysis by using the Atlas TI 7 software, with Bardin (2011) model. It was verified, through health indicators, that this hospital’s service plays an important role in the region. As to the supplies for the public hospital services in Curitiba, the Hospital de Clínicas da Universidade Federal do Paraná has 24.75% of the equipment, 22.95% of the professionals and 14.04% of the hospital beds. Concerning the production of the municipal hospitals, the service has an 18.87% participation in medical appointments and 11.74% in hospital admissions. 85.35% of the patients helped by the institution are from the metropolitan area of Curitiba. This highlights the importance that the hospital has for the region, and the inclusion of regional services and the network of health services, Sole Health System’s organization guidelines and strategy, in performing the strategic management. It has been verified, through the last three strategic plannings (2007 to 2017), an improvement as to the presence of components, as per Kaplan and Norton (2008), as well as the regional activities and the health services network. The main factors for such evolution have been the ongoing training of managers and the new methodology suggested by the public company.