Esta tese de doutorado tem como foco as limitações que se colocam aos gestores do nível local para produzir serviços de qualidade em sistemas de saúde. A definição tradicional do conceito de gestão de recursos humanos foi ampliada por abarcar questões relacionadas à configuração federalista do país, considerando diversidades estruturais e culturais. Utilizou como fonte primária, dados selecionados a partir de entrevistas com gestores de RH com reconhecida experiência na área. Como fonte secundária, utilizou-se as informações pré-selecionadas de pesquisas disponíveis sobre o campo de gestão do trabalho da saúde. A análise do autor confronta as características estruturais do federalismo brasileiro e os desafios decorrentes da base da concepção do sistema nacional de saúde. Os resultados deste estudo iluminam possíveis caminhos alternativos para superar as limitações presentes na gestão de recursos humanos no nível local. / This doctoral thesis focuses the limitation faced by the local health systems managers to provide quality services at the local level. The concept human resources management goes beyond its traditional definition, to encompass issues related to the Brazilian federalist make up as well as to take into account the structural and cultural diversity of the country. The data selection encompassed primary sources (interviews with experienced managers in the area either at the local or state level) as well as secondary ones (previews research reports available in the field of HR management). Another analysis relies on the confrontation of structural traits of the Brazilian Federalist and challenges built in the key conception and makeup of the national health system. The results of this study bring lights to alternative paths to overcome the present limitations of human recourses management in the level local.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The present work had as objective to realize a study on the space organization of the dynamics and the access to the Program Health of the Family at Núcleo Pampulha, Uberlândia, Minas Gerais. To reach these objectives, we research 160 interviews with users of the area, between September of 2006 and January of 2007, aiming to analyze the users profile being approached on aspects to the age, sort, school level, familiar structure, kind of transport, participation in communitarian groups. Moreover, it was looked to analyze the satisfaction level of the users in relation to the professionals assistance and the infrastructure quality of the Unidade Básica de Saúde da Família (UBSF). Also interviews with nine coordinators of Pampulha team to know them vision about the implantation and development of the Program activities. The results had shown that majority of Program users is feminine, with three basic wages, with low school frequence, half use the bus as main transport and that the participation in communitarian groups is small, were also verified that the Program has good acceptability, with a positive professionals evaluation. But difficulties exist to guarantee specialized consultations and examinations, evidencing problems in the joint of the net with the average services and high complexity. On aspects to the organization of the Núcleo Pampulha space had not been considered in the localization of the UBSFs, to definition of the abrangence area of the teams. The geographic concepts need to be better incorporated in the actions of the Unidade Básica de Saúde da Família (UBSF). / O presente trabalho teve como objetivo realizar um estudo sobre a organização do espaço a partir da dinâmica e do acesso ao Programa Saúde da Família no Núcleo Pampulha em Uberlândia, Minas Gerais. Para atingir esses objetivos, foram realizadas 160 entrevistas com usuários da área da pesquisa, entre os meses de setembro de 2006 e janeiro de 2007, visando analisar o perfil dos usuários, abordando aspectos ligados à idade, ao gênero, ao nível de escolaridade, à renda familiar, ao meio de transporte, à participação em grupos comunitários. Além disso, procurou-se analisar o nível de satisfação dos usuários em relação à assistência dos profissionais e à qualidade da infra-estrutura da Unidade Básica de Saúde da Família (UBSF). Também foram realizadas entrevistas com nove coordenadoras de equipe do Núcleo Pampulha, para sabermos sua visão em relação à implantação e ao desenvolvimento das atividades do Programa. Os resultados mostraram que a maioria dos usuários do Programa é do gênero feminino, que possuem renda média de um a três salários mínimos, com baixa escolaridade, que utilizam o ônibus como principal meio de transporte e que tem pequena participação em grupos comunitários. Verificouse, também, que o Programa tem boa aceitabilidade, com uma avaliação positiva dos profissionais da equipe. Mas existem dificuldades para garantir consultas e exames especializados, evidenciando problemas na articulação da rede com os serviços de média e alta complexidade. Não foram considerados aspectos ligados à organização do espaço do núcleo Pampulha na localização das UBSFs, quando da definição da área de abrangência das equipes. Os conceitos geográficos precisam ser melhor incorporados nas ações do Programa Saúde da Família. / Mestre em Geografia

Made available in DSpace on 2016-12-23T14:38:06Z (GMT). No. of bitstreams: 1 Dissertacao para Biblioteca.pdf: 712753 bytes, checksum: 0c0473cf68b8c3d93fee6bb0a21edc2b (MD5) Previous issue date: 2005-05-10 / As mudanças pelas quais a saúde pública brasileira passou nas últimas décadas, com a criação do Sistema Único de Saúde (SUS) e do Programa Saúde da Família (PFS), trouxeram à tona grandes desafios no que tange à assistência prestada à população. Nesse novo contexto, o Agente Comunitário de Saúde (ACS) revela-se como de fundamental importância para a qualidade dessa assistência, uma vez que tem por função básica desenvolver uma aproximação/interlocução entre os serviços oferecidos e os universos cultural, lingüístico e político das comunidades assistidas. Esta pesquisa analisa a dimensão ético-política presente nas práticas dos ACSs, ou seja, observa que tipo de relação esses profissionais têm estabelecido com a comunidade e em que medida sua atuação tem se mostrado comprometida com a transformação das condições concretas de vida da população. Para tal, foi selecionada uma Unidade de Saúde da Família do município de Vitória/ES e realizado o acompanhamento de dez agentes de saúde durante aproximadamente 6 meses (março/agosto 2004). Adota o Método de Observação Participante, que constituiu no acompanhamento das atividades cotidianas dos agentes. Foi utilizada a técnica de grupos focais, como forma de acesso às concepções desses trabalhadores acerca do próprio trabalho e ao conceito de saúde que permeia suas práticas, além de questionários individuais e conversas informais. Analisa os dados a partir de uma perspectiva histórico-genealógica, entendendo-os como efeitos de forças sociais, políticas e históricas. Conclui que a atuação do agente traz avanços, uma vez que possibilita a criação de formas de assistência mais contextualizadas, acolhedoras das reais necessidades da população assistida. Entretanto, verifica que, embora os agentes entendam a saúde como efeito de múltiplas determinações (sociais, biológicas e subjetivas), sua atuação ainda permanece centrada nos sujeitos individualmente, sem propor ações com um caráter mais amplo, que visem a intervir sobre os determinantes sociais e políticos do fenômeno saúde/doença. Essa limitação aparece como fruto de múltiplos determinantes e não simplesmente como uma postura pessoal. A exigência de produção imposta pela Secretaria Municipal de Saúde; a eleição que esta elabora das prioridades, em sua maioria distantes das reais necessidades da população; a desvalorização, por parte dos demais profissionais da equipe, do discurso e do trabalho realizado pelos agentes, entre outros aspectos, indicaram a necessidade de reformulação na forma como a proposta vem se concretizando, para que se torne possível a efetivação do trabalho do agente, como preconizado pelo PSF. Por fim, percebe o quanto as relações estabelecidas entre os profissionais das equipes e o lugar ocupado pelos agentes dentro do Programa têm produzido, nesses trabalhadores, um estado de sofrimento e adoecimento por não terem legitimado o seu papel e discurso dentro do processo de formulação e execução das propostas de intervenção com a população. / The changes that the Brazilian public health went through the last decades, with the Sistema Único de Saúde (SUS) and the Programa de Saúde da Família (PFS), arose big challenges referred to the assistance given to the population. In this context, the community health agent (ACS) is revealed as fundamental importance to this assistance quality, once its basic function is to develop an approximation/interlocution between the offered services and the cultural, linguistic and political universes of the assisted communities. This research analyses the ethical-political dimension present in ACS practices, or rather, it observes what kind of relation these professionals have been establishing with the community and what measure its acting has been shown as engaged to the transformation of concrete life conditions of the population. To make it possible, Unidade de Saúde da Família (Family Health Unity) from Vitória /ES was selected and ten agents were attended. It adopts the Participatory Observation Method that constituted the agents every day life activities follow up. The focal group technique was used in a way to access these workers conceptions about their own work and the health concept that permeates its practices. Data is analyzed through a genealogical-historical perspective, making them to be understood as social, political and historical force effects. It concluded that the agent acting brings progress, once it makes possible the assistance creation ways to be more contextualized, cordial to the assisted population real necessities. However, it ascertains that, even though agents see health as multiple determination effects (social, biological and subjective), their acting is still individually centered on people, proposing action with a broader character, aiming at mediating the social and political determinants of the illness/health phenomenon. This limitation is shown as the result of multiple determinants and not simply as a personal posture. The production demand imposed by Secretaria Municipal de Saúde; the election that elaborates the priorities, most of the time far from the real population necessities; the value not given by the professional team to the discourse and work made by agents, among other aspects, indicated the reformulation necessity just like the propose has been made real, to make possible the accomplishments of the agents work, as determined by PSF. Finally, it notes how established relations between the professional teams and the places occupied by the agents in the Program, have produced, in these workers, a state of suffering and sickness for not have legitimated its role and discourse within the formulation and execution process of the intervention proposes in the population.

Made available in DSpace on 2014-07-29T15:13:47Z (GMT). No. of bitstreams: 1 Tese Maria Goretti Queiroz.pdf: 1426704 bytes, checksum: f92e4adfd3239c3f1eb3bd31a2733347 (MD5) Previous issue date: 2006-11-16 / The aim of this documental exploratory study was to investigate the evolution of dental education in Brazil based on three main organizations: the Pan American Health Organization (PAHO), the Kellogg Foundation (KF) and the Brazilian Dental Education Association (BDEA). The study covers the period since the institutionalization of dental education in Brazil in 1856, until the National Curriculum Guidelines for Undergraduate Courses in 2002. References: high education and health education legislation, the history of high education in Brazil, and PAHO, KF and BDEA documents and recommendations about health human resources. Changes until 1961 were determined by government and were not attended by professional categories. Education was not in accordance with norms and disciplines were not homogeneous in different courses despite of the existence of legislation. In 1961, the Education Basis and Guidelines law, some distortions were amended. Universitary Reform in 1968, influenced by the North-American model, introduced changes like modernization of high education, and inclusion of levels of education in Dentistry. Learning and practice models had structural limits due to high costs and difficulties for implementation. Many interventions tried to adjust dental education to the regional and national scenario and to include Dentistry in the health area. It must be highlighted the importance of the National Curriculum Guidelines for Undergraduate Courses, as a result of the Viña del Mar Seminar (1955), and the involvement of PAHO, KF and BDEA in this process. The collective construction of the National Curriculum Guidelines emphasized the need of an effective public health system and professional education in accordance with public services. Different protagonists and concepts originated many discussions and tensions, often not understudied by professionals. Concepts and political and pedagogical projects in dental education need to be more cleared and professional categories must lead the construction of a new dentist and reinforcement of the Sanitary Reform. Local and regional disparities also may be taken into account in this process. Dental profession must also conduct discussion about dental personnel, including auxiliary dental professionals / Pesquisa visou compreender processo de constituição do ensino da odontologia no Brasil a partir da contribuição de três agentes: OPAS, Fundação Kellogg e ABENO. Pesquisa documental, exploratória desenvolvida no Programa de Pós-Graduação em Educação FE/ UFG, linha de pesquisa Estado e Políticas Educacionais . Período do estudo abrangeu desde a institucionalização do ensino da odontologia no Brasil, em 1856 até a adoção das Diretrizes Curriculares Nacionais para os Cursos de Graduação em Odontologia (DCNO) em 2002. Fontes de pesquisa foram: legislação do ensino superior e da saúde no Brasil, pesquisas na área da História da Educação Superior, documentos e recomendações elaborados pela OPAS, Fundação Kellogg, ABENO, Ministério da Saúde e da Educação, acerca da formação de recursos humanos em odontologia. As mudanças até 1961 foram realizadas por determinação do Estado e à revelia da categoria profissional. Evidenciou-se o descompasso entre a legislação e a situação efetiva dos cursos; que, apesar da existência da legislação não havia uma padronização das matérias ministradas e da carga horária de duração dos cursos. Com a LDB, em 1961, algumas distorções foram superadas e outras alterações se efetivaram na educação superior no Brasil, tendo por base a suposta proposta de modernização desse nível de ensino, referendada pela Reforma Universitária de 1968, fortemente influenciada pelo modelo norte-americano. Modelo de ensino e prática da saúde adotado no Brasil apresentou limites estruturais, devido ao crescente custo e à impossibilidade de os países pobres ou em desenvolvimento virem a implantálo. Várias ações de formação profissional foram implementadas, a fim de adequar os cursos à realidade nacional e, ao mesmo tempo, avançar no sentido de garantir a consolidação da odontologia na área da saúde. Nesse movimento de consolidação de um novo padrão de formação situam-se as DCNO. Essas são fruto, portanto, dos desdobramentos das discussões acerca do ensino da odontologia construídas a partir das recomendações do Seminário de Viña del Mar -1955, divulgadas pela OPAS e pela Fundação Kellogg e assumidas pela ABENO, atualizadas pelos estudos e pesquisas desenvolvidas pela área. Resultou, também, de uma construção nacional coletiva, cujos atores se posicionaram estrategicamente, preparando-se teoricamente para a defesa de um serviço de saúde pública de qualidade e uma formação profissional compatível com essa possibilidade de atuação. Elas foram construídas a partir dos mais diversos embates, revelando a tensão entre diferentes atores e concepções, nem sempre compreendidos pelos profissionais da área. Tal constatação enseja a necessidade de maior clareza por parte dos profissionais, no que concerne às concepções e propostas político-pedagógicas para a área; a necessidade de que a categoria profissional assuma a autoria e a construção de uma proposta de formação profissional que pressuponha o fortalecimento da Reforma Sanitária. É fundamental que a categoria esteja atenta para a possibilidade, cada vez mais presente, da forte tendência de hierarquização do ensino da odontologia, em função das políticas de diversificação e diferenciação da educação superior no país. Compete também à categoria assumir a discussão da formação dos recursos humanos auxiliares em odontologia, objetivando resgatar o seu papel histórico nesse processo.

L'inscription perpétuelle sur l'agenda politique des problèmes récurrents liés à la « crise du système de santé » français depuis les années 1970-1990 justifie l’intérêt de la science politique.Tandis que l’affirmation forte d’un État, seul responsable légitime de la politique de santé, était la marque de la réforme en 2004, les discours de la réforme de 2014-2016 sont emprunts d’une nouvelle grammaire conjuguant territorialisation et gouvernance.La territorialisation comme réponse à la crise de l’État providence et la nouvelle gouvernance comme réponse à la crise de la gouverne de l’État sont des phénomènes décrits par les analystes des politiques publiques dans d’autres secteurs.Cependant, la « crise du système de santé » se présente comme étant de nature économique, fonctionnelle et organisationnelle et non pas politique. La rhétorique de la réforme promeut des solutions en tant que réponses à des problèmes décrits à l’aune de ces motifs.Nous nous proposons d’étudier non pas les problèmes justifiant la mise sur l’agenda, mais la fabrique de la réforme, l’étiquetage des problèmes, les solutions mises en mots dans les discours, les éléments de légitimation des solutions, la trame cognitive et les éléments normatifs constitutifs du discours de la réforme.Nous montrerons qu’une approche pluridisciplinaire associant courant cognitif de l’analyse des politiques publiques empruntant à la théorie de Kuhn, démarche pragmatique en référence à John Dewey, et théorie politique, ainsi qu’épistémologie de la santé croisée avec la connaissance en santé publique, permet de renouveler l’analyse de cette politique publique finalement singulière.La première étape de notre travail sera de procéder à une généalogie de l’ère de la réforme ayant débuté dans les années 1970, en intégrant deux oubliés, politique de santé publique et décentralisation en santé. Puis, nous nous attacherons à une déconstruction des deux notions communes de la rhétorique de la réforme : « santé » et « système de santé ». Enfin, nous analyserons cette dernière à l’aide des outils théoriques empruntés à la sociologie.Ayant ainsi repéré le cadre cognitif et normatif de la politique de santé en France et défini les thèmes-clefs qui la constituent, nous aborderons par une étude de contenu les discours des moments 2004 et 2014.À l’issue de cette étude, nous approfondirons notre étude par l’analyse du fondements de la crise et des éléments les plus signifiants constitutifs des derniers discours étudiés : gouvernance et démocratie en santé.Notre enquête met en évidence le motif central de la réforme : la fabrique d’une réforme perpétuelle comme processus de légitimation de l’État républicain. Au-delà de la réforme, se manifestent, un public en démocratie ainsi qu’un problème public, la question des principes de la politique de santé ainsi que de sa finalité / The repeated and persistent appearance of issues related to the Health System crisis on every political agenda justifies the interest of political science in this field of research.As the 2004 reform’s bottom line was a strong affirmation that only the government can be legitimately responsible for health policy -a statement still favored by recent reforms- numerous official speeches about the last year’s reform contain a new language, using the “ territorialisation” and “gouvernance ” words.In fact, “territorialisation” as an answer to the Welfare State crisis, and “gouvernance” as an answer to the crisis in the ways of State governing, are both well-known Political Science subjects.Yet, the health crisis is not purported to be a political issue, but due to economics rather, mainly a functional and organizational one. As a consequence, matching solutions are usely thought in an economic and administrative way.Using cognitive and pragmatic approaches, our study neither aims at defining the terms of said crisis, nor justifying its presence on the political agenda. Rather, it addresses the solutions that are brought forward in the so-called ‘reform factory’ that are political speeches, as they have the power to legitimate deciding actors or their action.The first step taken in our method will consist in reporting bibliographic references for a political and historical deconstruction of the French health system, as well as analyzing the ‘health’ concept, in order to describe the cognitive framework of health policy. Special attention vill be paid to decentralization et public health.Then, these categories should prove to be helpful to study the current trends in the 2004 and 2014 periods of health reform in a discursive analysis, as we intend to do.To further investigate health reform manufacturing, we will focus on the new themes observed in these speeches : « gouvernance » et health democracy.Our thesis is that, through the language at play among these actors, there is a semantic fight loaded with power challenges to the State role in health Policy and therefore in the place ought to be given to the various actors in health public Policy. Finally, throw reforms, a new public for democracy came forward and new issues, that are principles and goals of health policy, appeared.

Os Núcleos de Apoio à Saúde da Família (NASF) foram criados em 2008 para ampliar a abrangência, o escopo e a resolubilidade das ações da Atenção Básica (AB). Passados 10 anos desde a sua criação, mecanismos de monitoramento, avaliação das ações e resultados alcançados pelo NASF ainda são insuficientes. O Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), lançado em 2011, visa incentivar os gestores e as equipes de saúde para a melhoria da qualidade dos serviços oferecidos aos usuários do SUS e o fortalecimento da AB. O objetivo dessa pesquisa foi analisar a organização e a prática profissional do NASF no Brasil, com base nos dados coletados no segundo ciclo do PMAQ-AB (2013 - 2014). Para este estudo quantitativo e descritivo utilizou-se a base de dados secundários provenientes da avaliação externa das equipes de AB que participaram do PMAQ-AB. Foram utilizados dois instrumentos de avaliação externa: 1) Equipes de Atenção Básica (Saúde da Família e Equipe Parametrizada); e 2) Núcleos de Apoio à Saúde da Família – NASF. Do primeiro, foram escolhidos três domínios do Módulo II: Adequação da composição das equipes às necessidades do território; Acesso das equipes ao NASF; e Articulação das ações de apoio técnico-pedagógico e clínico-assistencial. Do segundo, os seguintes domínios: Educação permanente; Organização do apoio matricial às EAB; e Gestão da demanda e da atenção compartilhada. Para a análise dos dados utilizou-se o SPSS versão 22.0. Os resultados indicaram a inserção de novos profissionais na AB, em especial o Fisioterapeuta, o Profissional de Educação Física e o Médico Veterinário. Ficou evidente o planejamento de ações conjuntas entre o NASF e a eSF, embora a literatura aponte muitas dificuldades para essa atividade. Principais meios de contato entre as equipes: em dias programados ou pelo telefone, já o e-mail era pouco usual. Dentre as atividades realizadas em conjunto, as visitas domiciliares e as consultas individuais foram destaque para as eSF. Para os profissionais do NASF: discussão de casos e visitas com profissionais da sua equipe. Discussões sobre monitoramento e avaliação de resultados da atenção compartilhada tiveram um resultado pouco expressivo na rotina das equipes. Público-alvo atendido pelo NASF: adultos e idosos, destacando-se atividades voltadas para a atenção nutricional e atenção às pessoas com doenças crônicas. / The Family‟s Health Support Centers were created in 2008 to broaden the coverage, scope and solvability of Basic Attention‟s programs. Ten years after its creation, monitoring mechanisms, measurement of programs and results achieved by NASF are still scarce. The National Improvement Program of Access and Quality of Basic Attention (PMAQ-AB), launched in 2011, aims to motivate managers and health teams to improve quality of services offered to SUS‟ users and to strengthen Basic Attention. The goal of this research was to analyze the organization and the professional practice of NASF in Brazil, based on data collected in the second cycle of PMAQ-AB (2013-2014). To this quantitative and descriptive study, we used the secondary database from the external evaluation of AB teams that participated in PMAQ-AB. Two instruments were used for the external evaluation: 1) Attention Basic teams (Family‟s Health and Parameterized Teams); and 2) Family‟s Health Support Centers – NASF. From the first, we picked three domains from the II module: adjustment of team‟s composition to the territory needs; access from teams to NASF; and articulation of actions from technical-pedagogical support, as well as clinical-care. From the second, the following domains: Perennial education; organization of matrix support to the EAB; and demand and shared attention management. For data analysis we used SPSS version 22.0. Results pointed to the insertion of new professionals at AB, especially Physical Therapist, Physical Education professional and Veterinarian. It was evident the lack of joint action planning between NASF and eSF, although literature references many difficulties in this activity. The main points of contact between teams: in scheduled days or thought the phone, since e-mail was barely used. Among shared activities, residential visits and individual appointments were highlights for eSF. To NASF professionals: discussions of cases and visits with team professionals. Discussions about monitoring and evaluation of results from shared attention had a small impact in the team‟s routine. Target audience supported by NASF: adults and senior citizens, especially activities designed to nutritional attention and people with chronic diseases.

Made available in DSpace on 2011-05-04T12:36:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / Este estudo trata das questões que envolvem a flexibilização com precarização dos vínculos de trabalho dos enfermeiros do Programa Saúde da Família PSF, procurando confrontar com os limites e possibilidades oferecidos pelas ações e políticas de Gestão do Trabalho e da Educação em Saúde do Ministério da Saúde. O tema da flexibilização que não é setorial afeta a economia brasileira como um todo e, portanto há que se entender o processo histórico da Reforma de Estado no Brasil, a Regulação do Trabalho em Saúde e o Mercado de Trabalho em Saúde. A categoria de Enfermagem ocupa uma função estratégica na política de organização da Atenção Básica no PSF, o que inviabiliza vinculações precárias, pois fragiliza sua fixação no exercício profissional. Para analisar e discutir a precarização para os enfermeiros foram utilizados dados retirados de pesquisas realizadas pela Estação de Pesquisa e Sinais de Mercado de Trabalho em Saúde - Observatórios de Recursos Humanos em Saúde NESCON/UFMG, 2001 e 2006 e a Pesquisa do NERHUS / ENSP / FIOCRUZ, ambas em torno do PSF e sua equipe. Consolidamos as informações que mais particularmente afetavam aos enfermeiros e foram produzidos gráficos e tabelas que apuram a situaçãoda seleção, vinculação, percentual de permanência, salários carga horária e qualificação desses profissionais. A pesquisa conclui que embora a categoria de enfermagem não seja a que evidencie em maior percentual sua vinculação precária com as secretarias de saúde, sua situação, no entanto não é de total amparo social. As políticas eleitas como prioritárias no âmbito da Secretaria de Gestão do Trabalho e da Educação em Saúde muito embora sejam adequadas para a abordagem em desprecarização e em qualificação da força de trabalho em saúde não adquiriram ainda total adesão por parte da gestão estadual e municipal de saúde. / This study treats the questions that involve flexibility with growing instability of nurses’ work links in the Family Health Program – PSF, trying to confront with the limits and possibilities offered by Work Management and Education in Health actions and politics provided by Health Ministry. The subject of flexibility, which is not sectorial, affects Brazilian economy as a whole. Therefore, we can understand the historical process of the State Reform in Brazil, the Work Regulation in Health and the labor market in Health. The Nursing category occupies a strategic function in the organizational politics of the Basic Attention in the PSF – it does not permit precarious contractual forms,because it weakens its fixation in the professional service. To analyze and discuss growing instability for nurses, it was used retired data of researches carried out by Inquiry Station and Labor Market Signs in Health - Human Resources Observatories in Health – NESCON/UFMG, 2001 and 2006 and ERHUS/ENSP/FIOCRUZ Inquiry, both about PSF and its team. We consolidate the information which was more particularly affecting the nurses and it was produced graphs and charts that check the situation of selection, contractual forms, percentage of permanence, salaries, workload and qualification of these professionals. The inquiry ends presenting that nursing category is not the one which shows in a big percentage its precarious links with the general health offices, however its situation does not have total social support. The elected politics as a priority in the context of Work Management and Education in Health General Office are right for betterment and health workforce qualification approach, but they have not acquired total adhesion for part of the State and Municipal Health Management yet.

This dissertation" Specialized education in the field of practitioners for children and adolescents in the Czech Republic " focuses on the development of specialized postgraduate medical uducation in the context of social change in the Czech Republic after 1989 and their impact on staffing in the field of health care practitioners for children and adolescents . The first part describes the theoretical and factual basis , which is closely related to the issues . These concepts explained the functioning and development of the health system, providing primary care by practitioners for children and adolescents, impact of transformation of the labor market and human resources in health care and human rights in health care. To analyze the empirical part of the thesis i used the method of historical institutional analysis. I explained formal and informal relationships in time cohorts between major actors and their influence in shaping the institutional framework of specialized education of physicians over time, especially in the legislative documents. Attention is paid especially to organization and financing of specialist medical education in the field of practitioner for children and adolescens, aging of population present practitioners, and their generational replacement in the context of demographic...

Sex-education in Canada has predominantly been informed by an abstinence-based content, leaving the sexual literacy of adolescents hanging in the balance. As public health statistics indicate, sexually transmitted infection, early and unwanted pregnancy, and rates of HIV/ AIDS are staggeringly high. At the center of these statistics is the young Black female, as they are disproportionately over-represented in negative public health statistics. Many factors have been theorized to be the cause; from socioeconomic factors to educational limitations, it has been historically concluded that the individual failings and class issues of Black women are the root cause of sexual decision making that causes negative health implications. However, adopting a critical perspective may lead to a different conclusion. This qualitative study sought to explore if the lack of comprehensive, racially attentive, and reflective sex-education as well as the influential societal discourse that shapes Black women and their sexuality in stereotypical lights, may have an impact on the sexual decision making of Black women. Through centering and highlighting the lived experiences, perspectives, and insights of a diverse pool of Black women, the stereotypes and scripts of Black femininity and sexuality, their root causes, and the impacts on young Black girl’s sexual decision making were captured to collaboratively redefine and reclaim Black femininity and sexuality while capturing what would be helpful to include in sex-education, specific to Black girls and women. This study’s theoretical underpinnings are Black Feminist Theory, Critical Race Theory, and Hip-Hop Feminism, which has been coined by me as “the trifecta”. A focus group with Black female-identified participants was conducted and facilitated through open-ended question and discussion based processes. Thematic analysis was adopted to explore themes, meanings and to gain a better understanding of the participant’s collective perspectives regarding sex-education and Black femininity and sexuality. The main finding of this study, based in the lived experiences and insights of the participants, were that harmful societal scripts and stereotypes about Black femininity and sexuality historically and as they are presented in popular media, coupled with inconsistent and bare sex education, has the ability to affect the sexual decision making of young Black girls in a way that feeds participation in unsafe sexual practices. This study fills gaps in literature because it contributes to the limited critical body of research that paramount the voices and insight of Black women in regards to sexual practice. This study also fills gaps by extending the conversation of Black women and sexual decision making, by suggesting tangible solutions of how the participant’s insights can be injected into larger policy and practice as well as social work research. The information supplied by the participants of this study will help social workers, policy makers, and educators create racially attentive, comprehensive, and accessible sex-education. / Thesis / Master of Social Work (MSW) / Sex-education in Canada has predominantly been informed by an abstinence-based content, leaving the sexual literacy of adolescents hanging in the balance. As public health statistics indicate, sexually transmitted infection, early and unwanted pregnancy, and rates of HIV/ AIDS are staggeringly high. At the center of these statistics is the young Black female, as they are disproportionately over-represented in negative public health statistics. Many factors have been theorized to be the cause; from socioeconomic factors to educational limitations, it has been historically concluded that the individual failings and class issues of Black women are the root cause of sexual decision making that causes negative health implications. However, adopting a critical perspective may lead to a different conclusion. This qualitative study sought to explore if the lack of comprehensive, racially attentive, and reflective sex-education as well as the influential societal discourse that shapes Black women and their sexuality in stereotypical lights, may have an impact on the sexual decision making of Black women. Through centering and highlighting the lived experiences, perspectives, and insights of a diverse pool of Black women, the stereotypes and scripts of Black femininity and sexuality, their root causes, and the impacts on young Black girl’s sexual decision making were captured to collaboratively redefine and reclaim Black femininity and sexuality while capturing what would be helpful to include in sex-education, specific to Black girls and women. This study’s theoretical underpinnings are Black Feminist Theory, Critical Race Theory, and Hip-Hop Feminism, which has been coined by me as “the trifecta”. A focus group with Black female-identified participants was conducted and facilitated through open-ended question and discussion based processes. Thematic analysis was adopted to explore themes, meanings and to gain a better understanding of the participant’s collective perspectives regarding sex-education and Black femininity and sexuality. The main finding of this study, based in the lived experiences and insights of the participants, were that harmful societal scripts and stereotypes about Black femininity and sexuality historically and as they are presented in popular media, coupled with inconsistent and bare sex education, has the ability to affect the sexual decision making of young Black girls in a way that feeds participation in unsafe sexual practices. This study fills gaps in literature because it contributes to the limited critical body of research that paramount the voices and insight of Black women in regards to sexual practice. This study also fills gaps by extending the conversation of Black women and sexual decision making, by suggesting tangible solutions of how the participant’s insights can be injected into larger policy and practice as well as social work research. The information supplied by the participants of this study will help social workers, policy makers, and educators create racially attentive, comprehensive, and accessible sex-education.