Submitted by Gabriela Cristina Braga Bisco (gabrielacristina.bragabisco@gmail.com) on 2018-11-23T13:23:21Z No. of bitstreams: 1 DISSERTAÇÃO FINAL -converted.pdf: 2506755 bytes, checksum: d1cad9ebb16e9b26461c3d6852ded050 (MD5) / Approved for entry into archive by Jacqueline de Almeida null (jacquie@franca.unesp.br) on 2018-11-23T17:21:22Z (GMT) No. of bitstreams: 1 Bisco_GCB_me_fran.pdf: 2506755 bytes, checksum: d1cad9ebb16e9b26461c3d6852ded050 (MD5) / Made available in DSpace on 2018-11-23T17:21:22Z (GMT). No. of bitstreams: 1 Bisco_GCB_me_fran.pdf: 2506755 bytes, checksum: d1cad9ebb16e9b26461c3d6852ded050 (MD5) Previous issue date: 2018-05-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O direito à saúde no Brasil foi conquistado a partir de lutas e reivindicações da classe trabalhadora por melhores condições de vida. A criação do Sistema Único de Saúde (SUS) a partir da Constituição Federal de 1988 foi um marco para a população, ao garantir a saúde como direito de todos e dever do Estado. Diante dos retrocessos no campo dos direitos sociais, com o avanço do neoliberalismo a partir dos anos de 1990, o trabalho do/a assistente social na saúde é tensionado com desafios de diferentes naturezas, seja na direção social do trabalho profissional no cotidiano e na defesa dos princípios do projeto profissional e em sua própria condição de trabalhador/a. O estudo tem como pressuposto que o Serviço Social na Santa Casa de Franca/SP contribui de maneira efetiva para o acesso ao direito social à saúde, ainda que com todos os limites, a profissão avançou de maneira significativa neste espaço sócio ocupacional. Portanto, a pesquisa tem como objetivo geral estudar a política pública de saúde e a contribuição do trabalho do/a assistente social para a efetivação do direito à saúde na Santa Casa de Franca/SP. Como objetivos específicos, refletir o direito à saúde tendo como referência as atribuições do assistente social na saúde e, evidenciar as principais demandas do Serviço Social e como a categoria apresenta respostas qualificadas a essas demandas. Os resultados mostram que as demandas institucionais são complexas e demonstram as mais variadas expressões da questão social, exigindo cada vez mais um profissional crítico, propositivo e interventivo, capaz de refletir a realidade social dos sujeitos atendidos e dar respostas qualificadas às necessidades sociais e de saúde. Considera-se que o posicionamento ético e político do assistente social na defesa e na afirmação do direito universal à saúde, contribui para o acesso dos usuários ao SUS e cria possibilidades para uma transformação social, na direção de uma sociedade justa e igualitária, como apresentado pelo Serviço Social na Santa Casa de Franca/SP. / Healthcare right in Brazil was conquered through struggling and demands from the working class for better life conditions. The creation of the Unified Health System (SUS) in the Federal Constitution of 1988 was a landmark to the population, by granting the healthcare as a universal right and a State’s responsibility. In view of the setbacks on social rights, due to the advance of neoliberalism in the 1990’s, the social assistant’s work on healthcare social policies is stressed with challenges of several natures, either as a social drive of its daily routine of work or on its condition as a worker. The research adopts as premises that the Social Service in the Santa Casa of Franca/SP contributes effectively to the access of healthcare right, even with all the limitations involved, the profession has moved significantly forward in this occupational space. Therefore, the research has as a general objective to study healthcare policies and the contribution of the social assistant’s work to the effectiveness of the healthcare right in the Santa Casa of Franca/SP. As a specific objectives, to reflect healthcare right having as reference the attributions of the social assistant in field, to evidence main demands of the Social Service and to state how the category presents qualified answers to such demands. The results collected state that the institutional demands are complex, demanding a professional increasingly critic, propositional and inventive, able to reflect the social reality of the subjects addressed and to give qualified answers to social and healthcare issues. It is considered that an ethical and political positioning in defense of the healthcare right’s affirmation contributes for universal access of SUS’ users and creates possibilities for a social transformation toward a fairer and more egalitarian society, as presented by the Social Service in the Santa Casa of Franca/SP. / CAPES -1617827

This case-study provides a critical evaluation of the effects of neo-liberal (market-driven) reforms in achieving the goal of human security in Sierra Leone after the civil conflict in 2002. In the context of Sierra Leone, there are fundamental questions about the basic security of the population. This mean the ability to live without fear of conflict and the security to do with the ordinary lives of Sierra Leoneans. This is absolutely central to the post-war reconstruction of that country. It represents a major concern for the international community, the Sierra Leone Government, foreign government donors as well as the NGO communities. Underlying these issues is the subject of which development paragon is best suitable in addressing these questions, and what impact will it have on the people. To understand this, the study has framed the issues of education and health, the two aspects which this thesis focuses upon, as a commitment to human security. Human security has become a dominant theme for many development organisations around the world because of it connection with security and development. Education and health are important because they are crucial social and basic human right that should be provided without any form of unfairness by the state. Because of their multiplier effect, they assist in eradicating poverty and further the attainment of human security. The reforms, which includes privatisation and decentralisation, has been imposed primarily by the World Bank and the IMF to transform the education and health system in order to improve the human security of the Sierra Leonean people. Proponents of these reforms argued that it would provide equal access, make the system more efficient, provide more choices for the population, and enhances accountability and citizens’ participation in governance. As a result of these, the study is important for three reasons: first, it assesses the success of these reforms; second, it offers a better understanding of socio-economic development related to education and health as they are now viewed as a commodity; and third, it suggests ways of enhancing the performance of its delivery intended to assist the population. The evaluation is informed by critical theory, the theoretical framework because: of its usefulness in understanding the concept of power/knowledge, ideology and governance, as neo-liberalism has become a discourse of global common sense that frames policy options as though they were natural or not to be questioned, and yet serve to reinforce the interests of dominant groups. Critical theory enable us to make sense of the hidden power relations in the way knowledge/policy is constituted. Second, critical theory is also a qualitative approach and hence comes as a way of critiquing quantitative methodology. The study argues that it is very problematic to imagine that this strategy (neo-liberal reforms) is actually for the great masses of people living in poor conditions, while it does not address their needs and does nothing to deal with the security of their lives. The study found that the reforms were considered undemocratic, and has led to unequal access thus augmenting fears of stratification on the basis of an individual being rich or poor. Therefore, the study recommends that if the goal of human security is to be achieved, it is important to strengthen citizens’ and other local actors’ voices in governance to develop effective local policies; and government intervention and commitment is also needed to improve the performance of public schools and health care institutions in order to make them more competitive so that they can co-exist with their private counterparts. Key Words: Neo-liberalism, critical theory, education policy, health policy, human security, privatisation, decentralisation, social justice, socio-economic development.

ABSRACT: Liver transplantation and allocation has been a controversial issue in the United States for decades. One of the main concerns in the allocation system is the trade-off between the two main objectives, efficiency and equity. Unfortunately, it is difficult to reach consensus on how to develop allocation policies that aim at balancing efficiency and equity, among transplantation policy makers, administrators, transplant surgeons and transplant candidates.Our research identifies and classifies the outcomes of liver allocation into two major categories, efficiency and equity, that are, often times, conflicting. Previous researchers did not consider how to balance outcomes in these two categories. Our research uses Analytic Hierarchy Process, a Multi-Criteria Decision Analysis methodology, to build a framework that quantifies the decision-making process and help decision makers to reach a valid consensus in terms of balancing these outcomes. Latest available patient registration and follow-up data are used in data analysis. Results from this analysis serve as inputs for the simulation model that is capable of evaluating alternative hypothetical policies.This research addresses the deficiencies of the current liver transplantation policy and is intended to refine the policy that will result in a more balanced allocation system with respect to efficiency and equity. Our proposed methodology can be applied to incorporate further changes in policy selection and refinement.