Submitted by Maria do Carmo Meirelles Toledo Cruz (carminhameirelles@gmail.com) on 2017-10-26T16:55:42Z No. of bitstreams: 2 Volume1_CarminhaMeirelles.pdf: 3744928 bytes, checksum: e15cc07fc32a2de6ea871e466fd06bb5 (MD5) Volume2_CarminhaMeirelles.pdf: 2463254 bytes, checksum: 51f0d71f5718fe7c260cf7aebce97fc2 (MD5) / Approved for entry into archive by Pamela Beltran Tonsa (pamela.tonsa@fgv.br) on 2017-10-30T09:20:12Z (GMT) No. of bitstreams: 2 Volume1_CarminhaMeirelles.pdf: 3744928 bytes, checksum: e15cc07fc32a2de6ea871e466fd06bb5 (MD5) Volume2_CarminhaMeirelles.pdf: 2463254 bytes, checksum: 51f0d71f5718fe7c260cf7aebce97fc2 (MD5) / Made available in DSpace on 2017-10-30T12:29:50Z (GMT). No. of bitstreams: 2 Volume1_CarminhaMeirelles.pdf: 3744928 bytes, checksum: e15cc07fc32a2de6ea871e466fd06bb5 (MD5) Volume2_CarminhaMeirelles.pdf: 2463254 bytes, checksum: 51f0d71f5718fe7c260cf7aebce97fc2 (MD5) Previous issue date: 2017-09-27 / This study analyzes intergovernmental and intersectoral relations in the implementation of daycare centers and the Brasil Carinhoso (BC) program, with a focus on cooperation between the Federal government and municipalities, from the municipal perspective. It seeks to understand how this policy is implemented locally and what the federal government (and on a lesser scale, the state government) has done to support municipalities in policies aimed at this educational segment. It recognizes the importance of actions of the Federal government through their regulatory and equalization functions that seek to ensure a certain uniformity and parameters in the implementation of public policies. It also shows that there is cooperation between the federal government and municipalities through programs and other forms of technical support, especially since the first decade of this century. The study starts with an analysis of Federal regulations between 1988 and 2015 and their influence on enrollment (2001-2015) and variations between States. It acknowledges that the expansion of access to daycare and municipal participation in federal programs occurred gradually and unevenly between municipalities. The study shows that the Fund for the Maintenance and Development of Basic Education and Enhancement of Education Professionals and the Brasil Carinhoso (BC) program, an initiative of the Brazil Without Misery plan both had an impact on enrollment and had mechanisms to influence municipal actions. BC was chosen because of the extensive participation in this initiative in the educational field (97% of Brazilian municipalities in 2015), because of impact it had on access to daycare for children from low-income families and because it was conceived as an intersectoral intervention. To complement this analysis, multiple case studies were carried out in 6 municipalities in two Brazilian states to identify the different ways day care policy and BC were implemented in Farias Brito, Horizonte, and Sobral in the State of Ceara, and Tarumã, Votuporanga and Osasco in the State of São Paulo). The study reveals different interpretations regarding the implementation of the right to daycare and about technical and financial cooperation between states, as well as differences in the implementation in municipalities. The Legacy of educational policy and child services in the two states explain part of these differences. The Federal government has expanded its coordination and cooperation with municipal governments, through a range of strategies, but decision-making authority has remained with the federal government, while implementation is by the municipalities, with restricted and at times informal spaces for negotiation. Contrary to expectations, states turned out to have an important role in intergovernmental cooperation, but very few states have played this role. The research suggests that, despite advances in access to daycare, there is a need to improve intersectoral coordination and BC has not led to effective intersectoral action at the local level. The challenge remains of meeting the goal established by the PNE of meeting 50% of children in daycare by 2024, and reducing inequality of access. / A pesquisa analisa as relações intergovernamentais e intersetoriais na implementação da política de creches e na ação Brasil Carinhoso (BC), com destaque à cooperação da União com os municípios, a partir da perspectiva municipal. Busca-se compreender como se dá a implementação desta política localmente e o que o governo federal (e, em menor escala, o governo estadual) tem feito para apoiar os municípios nas políticas voltadas a este segmento educacional. Reconhece a importância da ação da União com suas funções reguladora e equalizadora que procuram garantir certa uniformidade e parâmetros na implementação de políticas públicas; mas também mostra que há cooperação do governo federal com os municípios por meio de programas e outras formas de apoio técnico, em especial a partir dos anos 2000. O trabalho parte da análise dos atos normativos da União, de 1988 a 2015, e identifica sua influência nas matrículas (2001-2015) e a variação entre os estados. Reconhece que a ampliação do acesso às creches e a adesão municipal aos programas federais ocorre de forma gradual e desigual nos municípios. O estudo mostra que o Fundo de Manutenção e Desenvolvimento da Educação Básica e de Valorização do Magistério (Fundeb) e a ação Brasil Carinhoso (BC), iniciativa do plano Brasil sem Miséria, impactaram o acesso às matrículas e ambos tinham mecanismos de indução. O BC foi escolhido pela grande adesão à iniciativa no eixo da educação (97% dos municípios brasileiros em 2015), pela extensão com que promoveu o acesso à creche de crianças pobres e por ter sido concebido de forma intersetorial. Complementarmente à análise, são desenvolvidos estudos de casos múltiplos em seis municípios de dois estados brasileiros para identificar as diferentes implementações da política de creches e do BC (Farias Brito/CE, Horizonte/CE, Sobral/CE, Tarumã/SP, Votuporanga/SP e Osasco/SP). A pesquisa revela diferentes interpretações sobre a materialização do direito à creche e sobre a cooperação técnica e financeira dos estados, bem como diferenças na implementação nos municípios. O legado da política educacional e da atenção à criança nos dois estados explica em parte essas diferenças. A União tem ampliado a coordenação e a cooperação com os governos municipais, utilizando-se de diversas estratégias, permanecendo a autoridade decisória com o governo federal, ficando a implementação com os municípios, com espaços de negociação restritos e por vezes informais. Diferentemente do que era esperado, observou-se que os estados têm um papel importante na cooperação intergovernamental, mas são poucas unidades federativas que realizam este apoio. A pesquisa sugere que, apesar de avanços no acesso às creches, ainda é preciso aprimorar a articulação intersetorial e o BC não promoveu a intersetorialidade no âmbito local. Persiste como um desafio atingir a meta estabelecida pelo PNE, de atendimento de 50% das crianças em creches até 2024, e reduzir a desigualdade de acesso.

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Made available in DSpace on 2011-05-04T12:36:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / O Programa Bolsa Família, criado em outubro de 2003, propõe a articulação do benefício monetário à implementação de programas complementares, com o objetivo oficial de promover o desenvolvimento de capital humano e de fomentar o processo de autonomização das famílias beneficiárias. O objetivo deste estudo foi analisar a implementação dos programas complementares a nível local, identificando as potencialidades e os entraves deste processo em Manguinhos, região localizada na Zona Norte do município do Rio de Janeiro. Foi realizado um estudo de caso, utilizando como instrumentos de levantamento de dados consultas documentais, grupos focais com beneficiários do Programa, além de entrevistas semi-estruturadas com atores governamentais, não-governamentais e beneficiários do Programa. Foram também coletados dados secundários que pudessem contribuir para a análise sócio-demográfica de Manguinhos. Os principais programas que configuram ações complementares voltadas à capacitação profissional e ampliação das possibilidades de inserção social de jovens são o Plano Setorial de Qualificação e Inserção Profissional (PlanSeQ), o Programa de Mobilização da Indústria Nacional de Petróleo e Gás Natural (PROMINP) e o Programa Nacional de Inclusão de Jovens (PROJOVEM). No entanto, o desenho, a cobertura e a avaliação destas iniciativas mostram-se frágeis na região. As famílias desconhecem a oferta de cursos de qualificação profissional voltados aos beneficiários e afirmam que as oportunidades de trabalho que surgem não são vinculadas ao Bolsa Família. Os gestores reconhecem a debilidade das ações e destacam que os cursos do PlanSeQ não se adéquam à demanda local, ainda que pensados como estratégia de qualificação profissional voltada às obras do Programa de Aceleração do Crescimento e à vocação turística da cidade do Rio de Janeiro. Considerando que a perspectiva de inclusão social defendida pelo Programa Bolsa Família está atrelada ao acesso às políticas de promoção da saúde, de segurança alimentar e nutricional, de educação e de trabalho, a oferta e o acompanhamento destas ações pelas esferas governamentais e organizações civis constituem um eixo essencial para a efetividade do combate à pobreza e à fome, contribuindo para as chamadas portas de saída do Programa Bolsa Família. / The Bolsa Família or “Family Grant” Program, created in October 2003, proposes the articulation of monetary benefit to the implementation of complementary programs with the official aim of promoting human capital development and encourage the process of empowering the beneficiary family. The objective of this study was to analyse the implementation of complementary programs at the local level, identifying the potentialities and obstacles of this process in Manguinhos, region located in the northern zone of Rio de Janeiro. A case study was conducted, using as instruments for data collection document review, focus groups with beneficiaries of the program, and semi-structured interviews with governmental, nongovernmental stakeholders and beneficiaries of the Program. We also collected secondary data that could contribute to the socio-demographic analysis of Manguinhos. The main complementary programs targeting professional training and expansion of possibilities for social inclusion are Plano Setorial de Qualificação e Inserção Profissional (PlanSeQ), Programa de Mobilização da Indústria Nacional de Petróleo e Gás Natural (PROMINP) and Programa Nacional de Inclusão de Jovens (PROJOVEM). However, the design, coverage, and evaluation of these initiatives have been precarious in the area. Families are unaware of the supply of vocational training courses and claim that the area’s new work opportunities are unrelated to Bolsa Família. The program administrators admit to the activities’ weakness and emphasize that the courses offered under PlanSeQ are not adapted to the local demand, even though they were conceived as a vocational training strategy aimed at filling construction jobs in the Growth Acceleration Program (GAP) and the tourist industry in Rio de Janeiro. Considering that the social inclusion perspective defended by the Bolsa Família Program is tied to access to policies for health promotion, food and nutrition security, education, and work, the supply and follow-up of these activities by government agencies and civil society organizations are an essential thrust for the effectiveness of the fight against poverty and hunger, aimed at contributing to the “exit routes” or “graduation” from the Bolsa Família Program.

Made available in DSpace on 2011-05-04T12:36:29Z (GMT). No. of bitstreams: 0 Previous issue date: 2009 / O programa federal de transferência condicionada de renda Bolsa Família (PBF) criado em 2003 no Brasil tem como eixo principal a redução da pobreza e o combate à fome e,como um de seus objetivos, a promoção de ações intersetoriais do Poder Público. Com o objetivo de analisar as possibilidades e limites destas ações, esta pesquisa abordou a experiência de implementação local do programa em Manguinhos, RJ. Através da estratégia metodológica de estudo de caso foram realizadas entrevistas semi-estruturadas com gestores e profissionais das áreas da saúde, assistência social e educação e observação local. Além disso, foi realizado levantamento documental privilegiando a consulta à legislação e aos documentos oficiais do programa, durante os anos de 2007 e 2008. A análise do processo de implementação do Bolsa Família em Manguinhos mostrou que a criação de instâncias locais como o Grupo Intergestor e o Grupo Descentralizado viabilizou parcerias e interlocução voltada à construção de iniciativas comuns entre as secretarias municipais de saúde, educação e assistência social. No entanto, a comunicação vertical e horizontal entre os setores e os atores chave locais permaneceu frágil. Os sistemas de informação eram superpostos e não apoiavam a integração das ações e a centralização das decisões em torno do uso do Índice de Gestão Descentralizada (IGD) na secretaria de assistência social dificultava a consolidação de compromissos entre os diferentes parceiros e setores ligados ao programa. Ao mesmo tempo, o envolvimento das equipes de Saúde da Família, através de treinamento com profissionais das Coordenações regionais de saúde e assistência social, em junho de 2008, apontou novas possibilidades principalmente em relação à compreensão sobre o Programa, à proximidade com a comunidade, e o alcance de metas no contexto local. O estudo revela, portanto, a necessidade de repensar os fluxos de informação e decisão através do fortalecimento de arenas locais onde técnicos, gestores, lideranças comunitárias e população beneficiária possam compartilhar esforços para o fortalecimento de ações intersetoriais. / The federal program of conditioned transfer of income Bolsa Família (BFP), which was created in Brazil in 2003, has as principal issue the reduction of poverty and the combat against hunger and, as one of its objectives, the promotion of intersectoral actions of the government. With the objective of analyzing the possibilities and limits of these actions, this research approached the experience of local implementation of the program at Manguinhos, RJ. Through the methodological strategy of case-study, semi-structured interviews with managers and professionals of the health, welfare and education areas were done and local observation. Besides, a documental survey was done, privileging the consultation of the legislation and of the program official documents, during the years of 2007 and 2008. The analysis of Bolsa Família implementation process at Manguinhos showed that the creation of local instances as the Intermanaging Group and the Decentralized Group made feasible partnerships and interlocution referring to the construction of common initiatives between health, education and welfare municipal departments. However, the vertical and horizontal communication between the sectors and the local key-actors continued fragile. The information systems were overlapped and didn’t support the integration of the actions, and the centralization of the decisions related to the use of the Decentralized Management Index (Indice de Gestão Descentralizada - IGD) in the welfare department made difficult the consolidation of commitments between the different partners and sectors linked with the program. At the same time, the involvement of the Family Health (Saúde da Família) teams, through training with professionals of the health and social assistance regional co-ordinations, in June 2008, pointed to new possibilities especially in respect to the comprehension about the Program, to the proximity with the community, and the aims reach in the local context. The study revels, therefore, the necessity of reconsidering the information and decision flows through the strengthening of local arenas where technicians, managers, stakeholders, community leaderships and beneficiaries can share efforts to the strengthening of the intersectoral actions.

Depuis son introduction en santé publique en 1978 et son intégration en promotion de la santé en 1986 avec la Charte d’Ottawa, la gouvernance intersectorielle (GI) est devenue une des stratégies les plus utilisées en santé publique et en promotion de la santé pour aborder les déterminants sociaux de la santé. La GI met en relation des acteurs de différents secteurs avec des intérêts divers qui décident de travailler ensemble dans le but de réaliser un objectif commun. La réalisation de cet objectif nécessite que les acteurs harmonisent leurs intérêts organisationnels pour aboutir à un intérêt collectif mutuellement bénéfique. Il a été démontré que la conciliation des intérêts est un des facteurs déterminants de l'efficacité des processus de gouvernance intersectorielle. S’il est traditionnellement reconnu que dans un processus de gouvernance intersectorielle les acteurs concilient leurs intérêts organisationnels et collectifs, à notre connaissance, l’étude des stratégies d’influence déployées par les acteurs intersectoriels pour aligner leurs intérêts est un peu négligée. Cette thèse se propose de combler cette lacune. La thèse porte sur un cas de gouvernance intersectorielle aux niveaux régional et local à Montréal : l’Initiative montréalaise pour le développement social coordonnée par un comité de quatre partenaires provenant de quatre secteurs différents. Nous nous intéressons plus précisément au processus de révision du Cadre de référence de l’Initiative montréalaise (IM) qui a été marqué par une crise et qui a eu de grands impacts sur le fonctionnement et la dynamique du processus de gouvernance de l’IM. L’objectif principal de la thèse est d’identifier les stratégies d’influence développées par les acteurs intersectoriels pour concilier leurs intérêts organisationnels et collectifs dans un processus délibératif. Plus spécifiquement, nous nous proposerons i) de retracer et de décrire les évènements critiques qui ont marqué le processus délibératif de révision de l’Initiative montréalaise de 2011 à 2015 ; ii) de caractériser les évènements critiques du point de vue des acteurs de chaque secteur afin de reconstruire les stratégies d’influence déployées pour concilier leurs intérêts et d’examiner les conditions d’utilisation des stratégies d’influence. Pour atteindre nos objectifs, nous avons mobilisé la théorie de l’acteur-réseau (TAR) combinée au modèle conceptuel de Dewulf et Elbers (2018) et de l’approche de Heckscher (2013). Pour la collecte de données, nous avons eu recours à la recherche documentaire, la technique d’incidents critiques, des entrevues semi-structurées et des groupes de discussion. Les résultats révèlent que pour reconstruire à postériori un processus de gouvernance intersectorielle à l’aide d’évènements critiques, il est important d’identifier les évènements en lien avec les controverses survenues au cours de son déroulement. Concernant les stratégies d’influence, l’étude montre que les secteurs ont déployé deux grandes catégories de stratégies que nous avons qualifiées de stratégies intersectorielles et de stratégies intra sectorielles. Les premières comprennent les stratégies communes et les stratégies de médiation. Les stratégies intra sectorielles regroupent les stratégies unilatérales créatives, les stratégies de pouvoir et les stratégies multilatérales. Les deux catégories de stratégies se différencient principalement par leurs objectifs, leur lieu de déploiement et par leurs mécanismes de base. Pour ce qui est des conditions d’utilisation, la recherche indique que : i) le contexte interne de la gouvernance intersectorielle caractérisé par l’existence ou non de conflit entre les intérêts sectoriels et collectifs; ii) les contraintes organisationnelles définies par les valeurs, missions et objectifs de l’organisation d’appartenance des acteurs et iii) les atouts qui désignent les ressources matérielles, la légitimité et l’autorité dont disposent les secteurs constituent les principales conditions dans lesquelles les stratégies d’influence sont utilisées. À noter également que les différents secteurs ont eu recours aux mêmes stratégies d’influence - exception faite des stratégies de pouvoir - dans les mêmes conditions. Ces résultats apportent un nouvel éclairage au fonctionnement interne de la gouvernance intersectorielle pour la santé. Ils mettent en évidence l’importance des stratégies d’influence des acteurs dans la conciliation des intérêts et du même coup dans la dynamique interne de la gouvernance. À ce titre, nous pensons que les chercheurs gagneraient à inclure le concept de stratégie à la liste des facteurs qui favorisent ou qui entravent le fonctionnement de la gouvernance intersectorielle régionale/locale en promotion de la santé. / Intersectoral governance (IG) has become one of the most widely used strategies in public health and health promotion to address the social determinants of health since its introduction into public health in 1978 and its integration into health promotion in 1986 formulated/highlighted in the Ottawa Charter. Intersectoral governance brings together actors from different sectors with diverse interests to work together to achieve a common goal. Achieving this goal requires that actors align their organizational interests to achieve a mutually beneficial collective interest. It has been shown that the reconciliation of interests is one of the determining factors in the effectiveness of cross-sectoral governance processes. While it is traditionally recognized that actors in an intersectoral governance process reconcile their organizational and collective interests, to the best of our knowledge, the study of strategies deployed by intersectoral actors to align their interests is somewhat neglected. This thesis proposes to fill this gap. The thesis focuses on a case of intersectoral governance in Montreal: the Montreal Initiative for Social Development coordinated by a committee of four partners from four different sectors. Specifically, we focus on the process of revising the Montreal Initiative's (MI) Terms of Reference, which was affected by a crisis and had major impacts on the functioning and dynamics of the MI's governance process. The main objective of the thesis is to identify the strategies developed by intersectoral actors to reconcile their organizational and collective interests in a deliberative process. More specifically, we will propose to a) reconstruct and describe the critical events that marked the deliberative process of revising the Montreal Initiative from 2011 to 2015; b) characterize the critical events from the point of view of the actors in each sector in order to reconstruct the strategies deployed to reconcile their interests and to examine the conditions of use of the strategies. To achieve our objectives, we mobilized the actor network theory (ANT), using the conceptual model of Dewulf and Elbers (2018) and the approach of Heckscher (2013). For data collection, we conducted literature review, critical incident technique, semi-structured interviews, and focus groups. In terms of critical events, our results reveal that it is important to identify events related to controversies that occurred during the process. Regarding influence strategies, the study shows that the sectors have deployed two main categories of strategies including, intersectoral strategies and intra-sector strategies. The former includes joint strategies and mediation strategies. The latter, intra-sectoral strategies consist of creative unilateral strategies, power strategies and multilateral strategies. The two categories of strategies differ mainly in their objectives, their place of deployment and their basic mechanisms. Regarding the conditions of use, the results indicate that: i) the internal context of intersectoral governance are characterized by the existence or not of conflict between sectoral and collective interests; ii) organizational constraints are defined by the values, missions and objectives of the organization that the actors belong; and iii) assets, which refer to the material resources, legitimacy and authority available to the sectors, constituting the main conditions under which influence strategies are used. It should be also noted that the different sectors used the same strategies - except for power strategies - under the same conditions. These results shed new light on the internal workings of intersectoral governance. This study highlights the importance of the actors' strategies in reconciling interests and, at the same time, in the internal dynamics of governance. As such, we believe that researchers would benefit from including the concept of strategy in the list of factors that promote or hinder the functioning of intersectoral governance in health promotion.