Submitted by Nadir Basilio (nadirsb@uninove.br) on 2015-08-05T15:34:52Z No. of bitstreams: 1 Douglas Murilo Siqueira.pdf: 4021222 bytes, checksum: 5b399d6c252e6414042fce67052a1eb1 (MD5) / Made available in DSpace on 2015-08-05T15:34:52Z (GMT). No. of bitstreams: 1 Douglas Murilo Siqueira.pdf: 4021222 bytes, checksum: 5b399d6c252e6414042fce67052a1eb1 (MD5) Previous issue date: 2015-04-29 / The problem that triggered this thesis to investigate the relation between trust and power of internal stakeholders belong to cooperatives of collection and treatment of solid residues within the context of the principles of solidarity economy and how they happen. The object of study used a sample of six cooperatives, five ones from ABC region and one from Cotia city, all of them in São Paulo state. Through secondary data and interviews were identified the stakeholders from their cooperatives – internal and external ones. To respond the research question, its objectives and propositions the investigation was conducted by an exploratory and descriptive research, using the multiple case study strategy with three analysis units: organization, managers and collectors workers. The documentary research, interviews, direct observations, semistructured research questionnaire and the social networks analysis (Social Network Analysis) methods were used, to find out the existing typology of trust and of power in the enterprises and the relationship between themselves. The problematic context about solid residue in Brazil was the background scenario to support the development of this study research. The results showed that majority of cooperatives, present trust relationship based on utilitarianism. Only two cooperatives presented the relational trust type which generates long term relations guided on mutual trust. In regards the power typology, two cooperatives were characterized as autocratic, one as an instrument, and one is over transition phase from autocratic to missionary and remaining two are marked as missionary type. Taking in consideration that relational trust and missionary power are expected typologies for solidary enterprises, the conclusion is that just two cooperatives match to solidarity economy principles, even though just one of these cooperatives demonstrated economic sustainability through mutual trust. This cooperative presents managerial skill on its manager as as centric element of trust typology formatting which differentiates it from others. The trust and power relationship study shows that those variables coexist simultaneously. The solidarity economy enterprises do not have in their strategy capital earnings even though they must surviving in the capitalist world and need to maintain their economic sustainability to strengthen their chains through mutual trust and collaboration. / O problema desta tese foi o de investigar as relações de confiança e de poder dos stakeholders internos das cooperativas de coleta e tratamento de resíduos sólidos, no contexto dos princípios da economia solidária e como elas ocorrem. O objeto de estudo foram seis cooperativas, sendo cinco da região do grande ABC paulista e uma da cidade de Cotia na região metropolitana de São Paulo. Por meio dos dados secundários e entrevistas em profundidade, foram identificados os stakeholders internos e externos destes empreendimentos. Para responder à questão de pesquisa, seus objetivos e proposições, a investigação utilizou a pesquisa de caráter exploratório e descritivo, com estratégia de estudo de caso múltiplo e incorporado, com três unidades de análise: organização, gestores e catadores (unidade central). A pesquisa documental, entrevistas em profundidade, observações diretas, questionário semiestruturado e análise de redes sociais (Social Network Analysis) foram utilizadas para identificar a tipologia existente das variáveis confiança e poder nos empreendimentos e a relação entre elas. A problemática dos resíduos sólidos no Brasil serviu de pano de fundo para a elaboração dessa pesquisa. Os resultados mostraram que os empreendimentos, em sua maioria, possuem uma relação de confiança pautada no utilitarismo. Somente duas cooperativas foram identificadas com confiança do tipo relacional, que gera relações mais duradouras pautadas na confiança mútua. Quanto à tipologia de poder, duas foram caracterizadas como autocráticas, uma como instrumento, uma em transição de autocrática para missionária e duas do tipo missionário. Ao considerar que a confiança do tipo relacional e o poder do tipo missionário seriam as tipologias esperadas nos empreemdimentos solidários, conclui-se que somente duas cooperativas mostraram maior aderência aos princípios da economia solidária, por outro lado, destes dois empreendimentos, somente um demonstrou sustentabilidade econômica por meio da confiança mútua. Este empreendimento, por sua vez, demonstrou possuir a componente habilidade gerencial presente em sua gestora, como elemento central na formação da tipologia de confiança, diferindo dos demais. A relação entre a confiança e poder mostrou que as variáveis caminham lado a lado. Os empreendimentos econômicos solidários não possuem, em sua estratégia, o acúmulo de capital, mas devem sobreviver no mundo capitalista e para tanto precisam manter sua sustentabilidade econômica, fortalencendo seus vínculos por meio da confiança mútua e da colaboração.

La question de l’accès financier des personnes socialement défavorisées aux soins de santé est aujourd’hui un enjeu éthique de grande importance dans de nombreux pays à faible revenu ou en voie d’émergence. On peut se demander comment l’équité dans l’accès aux soins peut être rendue effective puisque l’égalité des chances pour tous et la santé sont des pré-requis aux choix de vie et à la réalisation de soi. Les soins de santé sont donc d’une importance éthique particulière du fait qu’ils contribuent à préserver notre statut comme citoyens pleinement fonctionnels. Au Cameroun, bien que des efforts considérables soient consentis par les pouvoirs publics et leurs partenaires extérieurs pour favoriser l’accès aux soins des personnes défavorisées, le secteur de la santé reste encore très marqué par l’inégalité dans l’accès financier aux prestations sanitaires. Les médicaments les plus essentiels ne sont pas financièrement à la portée de tous et les coûts d’accès aux soins ambulatoires et hospitaliers dans les formations sanitaires sont manifestement prohibitifs pour une large frange de la population. Lors des épisodes de maladie, l’accès aux soins se fait par le paiement direct au point d’accès, et la pratique de l’automédication s’est répandue du fait de l’incapacité des personnes socialement défavorisées à payer leurs soins sans courir le risque de perdre l’essentiel de leur revenu. Les mesures de prise en charge sociale ou des systèmes de financement qui garantissent la réduction des inégalités entre les classes sociales sont fortement limitées par les faibles capacités d’une économie qui repose essentiellement sur l’informel. Sur la base de cette réalité, cette thèse analyse à partir du cas des travailleurs vulnérables du secteur informel urbain, la pertinence du choix politique de la couverture universelle santé au Cameroun à travers les principes de responsabilité et de solidarité. La population d’étude choisie est celle des travailleurs vulnérables du secteur informel en considération des problématiques liées à leur accès aux soins de santé, de l’importance de leur apport dans l’économie du pays ( 90 % des travailleurs) et du rôle qu’elle pourrait jouer dans l’atteinte de l’objectif de la couverture universelle santé. La thèse analyse donc, d’une part, les conditions et les modalités de répartition des biens sociaux qui répondent à la nécessaire redistribution équitable des ressources, en l’occurrence l’accès aux soins de qualité. Après avoir montré les préoccupations d’ordre politique, social, économique et éthique liées au problème d’accès universel aux soins, la thèse propose des stratégies opérationnelles susceptibles de conduire à l’amélioration de la qualité des soins et à un assainissement de la gestion du secteur des services de soins (éthique du care et éthique de bonne gouvernance). Aussi, dans la perspective de la recherche d’un financement local soutenable et durable de l’accès de tous aux soins, la thèse propose une approche participative. L’exploration de cette perspective aboutit au résultat qu’une approche inclusive et intégrée de promotion de l’économie informelle (dynamisation de ses activités et potentialisation de ses acteurs) pourrait faire de ce secteur un véritable levier de développement économique et social. Un développement social et solidaire durable et susceptible, sur le long terme, de réaliser l’objectif de la couverture universelle santé. En d’autres termes, elle propose des stratégies de capabilisation et de responsabilisation des travailleurs du secteur informel, en vue d’une société plus impliquée, plus responsable et plus solidaire. Une approche susceptible de matérialiser le droit à la santé, de construire l’autonomie des travailleurs en situation de vulnérabilité et de renforcer leurs capacités contributives à travers une opérationnalisation adaptée au contexte des principes de responsabilité et de solidarité. / Financial access to health services for socially disadvantaged groups is an important ethical stake in many low-income countries or in process of emergence. Equity achievement in the healthcare system, equal opportunities and good health are prerequisite to wellbeing. Thus, access to healthcare represents a key ethical issue for people to keep their full functional citizens status. In Cameroon, efforts have been made by public authorities and their foreign partners to favour access to healthcare for the disadvantaged groups. However the incentives fall short to guarantee a sufficient healthcare access level. Basics medicines still are not affordable. Furthermore, the high financial costs of ambulatory and hospitals care do not help. In case of sickness, access to health service occurs unless a cash payment before the service, leading to a situation of health care non-affordability. Hence, self-medication is a direct outcome. The economy is mostly informal in the country, so it is not have the capacity to finance welfare and social systems, which are tools usually used to reduce disparities. This thesis analyzes the relevance of the political choice of universal health coverage in Cameroon through the principles of social responsibility and solidarity. The analysis was performed using the case of vulnerable urban workers of the informal sector, who represent 90% of all the workers in the country. The population of study is the vulnerable workers of the informal sector, who faced issues in accessing healthcare. This thesis analyzes the conditions and modalities of distribution of social goods (access to quality care) in order to establish equity in resources redistribution. Lickewise, political, social, economic and ethical issues related to the universal problem of access to care have been assessed. The operational strategies that lead to improved quality of care and a better management of the healthcare services (good care and ethics of good governance in the system) come forward. Furthermore, a participatory approach is advocated here under the form of the mobilisation of a sustainable local funding of universal access to care. The exploration of this perspective leads to the result that an inclusive and integrated approach to promoting the informal economy (boosting its activities and potentiating its actors) could make this sector a real social and economic development lever. A social and inclusive sustainable development over the long term, might lead to the goal of universal health coverage. This thesis recommends the accountability of the informal sector`s workers for a more involved, responsible and caring society. Hence, this approach is likely to materialize the right to health, to build the autonomy of workers in vulnerable situations and strengthen their ability to contribute through an adapted operationalization to the principles of responsibility and solidarity.