Made available in DSpace on 2015-04-14T14:34:08Z (GMT). No. of bitstreams: 1 461708.pdf: 179754 bytes, checksum: 0a0ff4f0badb5b81e7863e628e1210a5 (MD5) Previous issue date: 2013-08-27 / Ce travail se propose de v?rifier l effectivit? de l accomplissement du devoir fondamental de la sant? ? travers la r?glementation. D abord, il est pr?sent? le concept de sant?, en utilisant celui d?fini pour l Organisation Mondiale de la Sant? et ceux du droit et du devoir fondamental dans les termes de la Constituition de la R?pub relation de la sant? par rapport au principe de la dignit? humaine et son droit ? la vie. L ?tat, destinataire du devoir fondamental, formule les politiques publiques sectorielles et les structures n?cessaires ? sa mise en place. Au Br?sil a ?t? la constitution du Syst?me Unique de Sant? (SUS) qui s occupe des actions et services de sant?, inclues celles de la vigilance sanitaire. Dans la deuxi?me partie, premi?rement il est v?rifi? la situation de l ?tat br?silien que de Gestionnaire est devenu un R?gulateur. La r?glementation de la sant?, elle n est pas la m?me que celle de l ?conomie, cette r?glementation sociale exige un regard sur la pr?vention et dans ce contexte qui est int?gr?e l Agence Nationale de la Vigilance Sanitaire (ANVISA). Pour v?rifier l option de l??tat br?silien, il est n?cessaire d ?tablir la diff?rentation entre r?gulation et r?glementation ? travers la structure administrative et ses possibles formes d agir. Finalemente, la troisi?me partie montre une d?cisition r?glementaire de l Agence, la R?glementation de la Direction Coll?giale (RDC num?ro 56/2009), dans laquelle l agence interdit l usage des cabines de bronzage ? des fins esth?tiques. De plus, cette d?cision est discut?e dans la perspective de la r?gulation et de la r?glementation, dans le contexte de la politique publique d?finie par l ?tat. / Este trabalho tem por objetivo verificar a efetividade do cumprimento do dever fundamental ? sa?de atrav?s da regula??o. Na primeira parte ? apresentado o conceito de sa?de, adotando-se aquele definido pela Organiza??o Mundial da Sa?de; e, o direito e o dever fundamental nos termos da Constitui??o da Rep?blica Federativa do Brasil de 1988. Para tanto aborda a conex?o da sa?de com o princ?pio da dignidade da pessoa humana e com o direito ? vida. O Estado como destinat?rio do dever fundamental atua formulando as pol?ticas p?blicas setoriais e as estruturas necess?rias para a sua implementa??o. O Brasil constituiu o Sistema ?nico de Sa?de com compet?ncia para as a??es e servi?os de sa?de, inclu?das as de vigil?ncia sanit?ria, tema analisado na segunda parte. Num primeiro momento verifica o mudan?a do Estado Brasileiro, de Gestor para Regulador. A regula??o em sa?de n?o tem o mesmo conceito da regula??o econ?mica. A regula??o social exige o enfoque de preven??o e dentro desta vis?o ? que se apresenta a Ag?ncia Nacional de Vigil?ncia Sanit?ria (ANVISA). Para que seja verificada a op??o do Estado Brasileiro ? necess?rio fazer a diferencia??o entre regula??o e regulamenta??o. Isto se verifica por meio da estrutura administrativa e das poss?veis formas de atua??o. Na terceira parte ? apresentada uma decis?o regulat?ria da Ag?ncia, a Resolu??o de Diretoria Colegiada (RDC n? 56/2009), a qual pro?be o uso das denominadas c?maras de bronzeamento para fins est?ticos, discutida na perspectiva da regula??o e da regulamenta??o, dentro da pol?tica p?blica definida pelo Estado.

Submitted by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:21:34Z No. of bitstreams: 2 roselia_maria_ferreira_sousa.pdf: 1875651 bytes, checksum: 8bbe8dfebfd8ec06a419b5737fab6604 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:23:02Z (GMT) No. of bitstreams: 2 roselia_maria_ferreira_sousa.pdf: 1875651 bytes, checksum: 8bbe8dfebfd8ec06a419b5737fab6604 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:22:54Z (GMT) No. of bitstreams: 2 roselia_maria_ferreira_sousa.pdf: 1875651 bytes, checksum: 8bbe8dfebfd8ec06a419b5737fab6604 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2015-01-09T16:23:57Z (GMT) No. of bitstreams: 2 roselia_maria_ferreira_sousa.pdf: 1875651 bytes, checksum: 8bbe8dfebfd8ec06a419b5737fab6604 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) / Made available in DSpace on 2015-01-09T16:23:57Z (GMT). No. of bitstreams: 2 roselia_maria_ferreira_sousa.pdf: 1875651 bytes, checksum: 8bbe8dfebfd8ec06a419b5737fab6604 (MD5) license_rdf: 22974 bytes, checksum: 99c771d9f0b9c46790009b9874d49253 (MD5) Previous issue date: 2013 / Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (FUNDAEPE) / Funda??o de Amparo ? Pesquisa do estado de Minas Gerais (FAPEMIG) / O presente trabalho se constitui em uma pesquisa qualitativa, cujo objetivo ? levantar, analisar e desvelar o processo de constitui??o da atividade do trabalhador da Vigil?ncia Sanit?ria nos munic?pios da jurisdi??o da Superintend?ncia Regional de Sa?de de Diamantina (SRSD), Minas Gerais e especificamente, na Microrregi?o de Sa?de Ara?ua?. Buscamos desvelar os dificultadores e facilitadores da execu??o das a??es de Vigil?ncia Sanit?ria, bem como os sentidos atribu?dos pelos trabalhadores a este processo de execu??o. Adotamos como eixo te?rico-metodol?gico a Psicologia S?cio-Hist?rica e a Cl?nica da Atividade. A primeira concebe o homem a partir da ideia de ?condi??o humana?, em que os sujeitos s?o vistos como hist?ricos, datados, concretos, criadores de ideias e consci?ncia que, ao produzirem e reproduzirem dialeticamente a realidade social s?o, ao mesmo tempo, produzidos e reproduzidos por ela. A Cl?nica da Atividade prop?e um m?todo de an?lise da atividade de trabalho, onde a subjetividade dos trabalhadores ocupa lugar central. Para a coleta de informa??es, utilizamos question?rio semiestruturado, entrevistas centralizadas, semiestruturadas e entrevistas de narrativa de hist?ria de vida. Os sujeitos da pesquisa foram os trabalhadores de Vigil?ncia Sanit?ria de vinte e quatro munic?pios da jurisdi??o SRSD. Para an?lise das informa??es dos question?rios foi utilizado o software Epiinfo?6.04d, sendo calculadas frequ?ncias absolutas e relativas, medianas e desvio padr?o. As entrevistas foram analisadas ? luz de n?cleos de significa??o. Como facilitadores ? execu??o das a??es de Vigil?ncia Sanit?ria foram apontados: a parceria de outros profissionais, o apoio de gestores e da popula??o, recursos materiais e humanos e treinamentos/capacita??es. Os dificultadores apontados foram: insufici?ncia de recursos humanos, de equipamentos e recursos materiais, aus?ncia ou d?ficit na legisla??o, profissionais n?o capacitados ou pouco capacitados. Observamos que a atividade de trabalho na Vigil?ncia Sanit?ria ? constitu?da por sentidos de des?nimo, impot?ncia, negocia??o e pela dial?tica satisfa??o/frustra??o. As condi??es concretas, aliadas aos sentidos atribu?dos pelos trabalhadores ? sua atividade de trabalho apontam para a necessidade da implementa??o de pol?ticas de sa?de e de Vigil?ncia Sanit?ria que propiciem aos trabalhadores o poder de agir, como sujeitos concretos, na defesa e promo??o da sa?de coletiva. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Tecnologia, Sa?de e Sociedade, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2013. / ABSTRACT This work is based on qualitative research, the objective of which is to examine, analyze, and unfold the process that constitutes the activity of Health Surveillance workers in the municipalities under the jurisdiction of the Regional Health Superintendency of Diamantina, Minas Gerais state - Brazil, and specifically in the Ara?ua? Health Microregion. We seek to reveal the factors hindering and facilitating the implementation of Health Surveillance actions, as well as the meanings attributed by workers to this implementation process. Socio-Historical Psychology and Activity Clinic are adopted as the theoretical and methodological framework. Socio-Historical Psychology conceives man based on the idea of the ?human condition?, wherein subjects are regarded as ?historical?, dated, concrete, creators of ideas and awareness, and when such subjects dialectically produce and reproduce social reality, they are, at the same time, produced and reproduced by it. The Activity Clinic, in turn, proposes a method for analyzing work activities, where the subjectivity of workers takes center stage. A semi-structured questionnaire, centralized and semi-structured interviews and life-story narrative interviews were used for data collection. The research subjects were people who work with Health Surveillance in the twenty-four municipalities under the jurisdiction of the Regional Health Superintendency of Diamantina. The information in the questionnaires was analyzed using Epi Info? 6.04d software. Absolute and relative frequencies, medians and standard deviation were calculated. The interviews were analyzed in the light of meaning cores. As factors that facilitate the implementation of the actions as appointed: partnerships with other professionals, the support of health managers and of the population, material and human resources, and training and qualification activities. The hindering factors appointed were: absence of human resources, of equipment and material resources, failure to apply the legislation concerned or shortfalls in the enforcement thereof, and unqualified or poorly trained professionals. We observe that the work activity in the Health Surveillance service is constituted by feelings of dismay and powerlessness, as well as by negotiation, and the satisfaction/frustration dialectics. The concrete conditions, combined with the meanings attributed by workers to their work activity, indicate the need to implement heath and Health Surveillance policies that provide workers with the power to act, as concrete subjects, in the defense and promotion of collective health.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-04-17T23:56:46Z No. of bitstreams: 1 RosiresMagaliBezerraDeBarros_TESE.pdf: 1574061 bytes, checksum: a01c26f110eb8054e9105f7d91b33ab7 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-04-24T18:48:40Z (GMT) No. of bitstreams: 1 RosiresMagaliBezerraDeBarros_TESE.pdf: 1574061 bytes, checksum: a01c26f110eb8054e9105f7d91b33ab7 (MD5) / Made available in DSpace on 2017-04-24T18:48:40Z (GMT). No. of bitstreams: 1 RosiresMagaliBezerraDeBarros_TESE.pdf: 1574061 bytes, checksum: a01c26f110eb8054e9105f7d91b33ab7 (MD5) Previous issue date: 2016-12-09 / A vigil?ncia sanit?ria ? a??o de promo??o no campo da sa?de coletiva, com atividades voltadas para o controle da produ??o e comercializa??o de bens, de produtos e de servi?os, na perspectiva de eliminar ou minimizar riscos, em prol da sa?de da coletividade. O objetivo desse estudo ? analisar as rela??es de poder estabelecidas na descentraliza??o da vigil?ncia sanit?ria na cidade de Natal/RN e desvelar esse processo a partir da an?lise das pol?ticas formuladas pela esfera federal, das rela??es de poder evidenciadas entre os entes federativos e os atores envolvidos nesse processo. Esta pesquisa foi desenvolvida em tr?s etapas: a primeira foi o estudo do referencial te?rico e emp?rico para a an?lise da pol?tica de descentraliza??o da vigil?ncia sanit?ria; a segunda foi a constru??o do relato e a discuss?o de como aconteceu a descentraliza??o da vigil?ncia sanit?ria em Natal/RN e a terceira contemplou a an?lise das rela??es de poder entre os entes federativos nesse munic?pio, ? luz do referencial te?rico e da pol?tica de descentraliza??o no pa?s. A abordagem metodol?gica ? qualitativa, descritiva e explorat?ria. O estudo de caso foi realizado a partir de pesquisa documental e de entrevistas com informantes chaves que ocuparam cargos de gest?o na vigil?ncia sanit?ria no Munic?pio de Natal e no Estado do Rio Grande do Norte. A revis?o da literatura sobre a descentraliza??o da vigil?ncia sanit?ria foi realizada a partir da metass?ntese das publica??es no per?odo de 1990 a 2014, com o apoio do software IRAMUTEQ. A an?lise das entrevistas foi realizada com o apoio desse software e com o instrumental da an?lise de conte?do de Bardin. Os resultados revelam que a descentraliza??o da vigil?ncia sanit?ria, em Natal, aconteceu a partir da correla??o de for?as, entre Estado e Munic?pio, marcada, mais frequentemente, por momentos de tens?o. Essas rela??es de poder foram assim?tricas, e os avan?os e os retrocessos, nesse processo, aconteceram em fun??o dessas rela??es. Ao final deste estudo, foi poss?vel ampliar a compreens?o da descentraliza??o da vigil?ncia sanit?ria, no munic?pio de Natal e contribuir para o entendimento dessa diretriz do SUS no campo da vigil?ncia sanit?ria, uma vez que esse processo ainda n?o foi conclu?do em Natal nem no restante do pa?s. / Sanitary surveillance is a promotion action in the field of collective health, with activities aimed at controlling the production and sale of goods, products and services, with a view to eliminating or minimizing risks, for the health of the community. The objective of this study is to analyze the power relations established in the decentralization of sanitary surveillance in the city of Natal / RN and to unveil this process from the analysis of the policies formulated by the federal sphere, from the power relations evidenced between the federative entities and the actors involved in this process. This research was developed in three stages, the first was the study of theoretical and empirical reference for the analysis of the policy of decentralization of health surveillance; The second was the construction of the report and the analysis of how the decentralization of sanitary surveillance in Natal / RN occurred and the third contemplated the analysis of the power relations between the federative entities in this municipality, in the light of the theoretical reference and the decentralization policy in the parents. The methodological approach is qualitative, descriptive and exploratory. The case study was based on documentary research and interviews with key informants who held management positions in health surveillance in Natal and Rio Grande do Norte State. The review of the literature on the decentralization of health surveillance was carried out based on the metassynthesis of the publications from 1990 to 2014, with the support of IRAMUTEQ software. The analysis of the interviews was carried out with the support of this software and with the instruments of the Bardin content analysis. The results show that the decentralization of sanitary surveillance in Natal happened from a correlation of forces, between State and Municipality, marked, more frequently, by moments of tension. These power relations were asymmetric and the advances and setbacks, in this process, happened in function of these relations. At the end of this study, it was possible to expand the understanding of the decentralization of sanitary surveillance in the city of Natal and to contribute to the understanding of this guideline in the field of sanitary surveillance, since this process has not yet been concluded in Natal, nor in the rest from the country.

Submitted by Jorge Silva (jorgelmsilva@ufrrj.br) on 2017-06-21T17:56:23Z No. of bitstreams: 1 2016 - Ros?ngela Pezza Cintr?o.pdf: 3487632 bytes, checksum: b58a311d44d01ef224bccf9be913f986 (MD5) / Made available in DSpace on 2017-06-21T17:56:23Z (GMT). No. of bitstreams: 1 2016 - Ros?ngela Pezza Cintr?o.pdf: 3487632 bytes, checksum: b58a311d44d01ef224bccf9be913f986 (MD5) Previous issue date: 2016-09-06 / CNPq / The dissertation focuses on conflicts and disputes about the sanitary (il)legalization of artisanal raw milk cheese in the state of Minas Gerais, which have become stronger since the 1990?s. It shows how State apparatus, laws, rules and regulations conceived with the aim of protecting the health of the population and usually presented as neutral and scientific end up, through various and complex ways, serving as instruments to establish barriers to entry amidst the disputes on dairy products? markets. The sanitary regulation of artisanal cheese is analyzed as a part of a process of progressive governamentalization of the State, which favors industrial, large-scale patterns of production, processing and distribution of food. The need to pasteurize and the minimum time for ripening are in the core of the debates and of the international regulations (Codex Alimentarius). In the case in focus, the legitimization of sanitary regulation is achieved by means of standards of ?quality?, ?risk?, and ?food safety? based in laboratory exams that search for the presence, in levels higher than legally permitted, of two groups of microorganisms (faecal coliforms and Staphiylococcus aureus), leading to the legal classification as ?improper for human consumption?. This conflicts with the population?s perception of these cheeses as a tasty and safe food, part of the cultural identity of people from Minas Gerais. As cheese is an essentially ?living? product, that may have ?bad? microorganisms but also has ?good? microorganisms that are responsible for unique characteristics of flavor and texture, sanitary rules based on industrial criteria are in conflict with traditional ways of producing and consuming cheese. Thus, illegalization processes lead to reactions, such as looking for possibilities of legalization amidst legal and institutional tangles that are ever more complex and permit the inclusion of only a minority of cheese-producing families. The majority of these families remain informal, which is increasingly constructed as illegal. Fieldwork was done in two municipalities in the region of the cheese known as Canastra, and the analysis points to a set of elements enabling people to remain in cheese-related activities, both as producers and as traders, in forms that are culturally established as part of a way of life and that ensure the families? social reproduction and their resiliency in face of external pressures. The study of this case thus brings forth more general issues about the relation between State, Law, Science and markets, and about their relation with peasant populations. It also discusses hegemonic notions of risk concerning health and food, and its effects on the way of life of peasant populations and on the consumers? possibilities of choice. / A tese aborda os conflitos e disputas em torno da (i)legaliza??o sanit?ria dos queijos artesanais de leite cru em Minas Gerais, que se acentuam ap?s a d?cada de 1990. Aponta como aparatos estatais, leis, normas e regulamentos, criados tendo como objetivo a defesa da sa?de da popula??o e normalmente apresentados como neutros e cient?ficos, por caminhos m?ltiplos e complexos acabam servindo como instrumentos para a cria??o de barreiras ? entrada em disputas por mercados de produtos l?cteos. A regula??o sanit?ria dos queijos artesanais ? analisada como parte de um processo de progressiva governamentaliza??o do Estado, que termina favorecendo padr?es industriais de produ??o, processamento e distribui??o de alimentos em maior escala. No centro das controv?rsias est? a exig?ncia de pasteuriza??o dos queijos ou de tempos m?nimos de cura, presentes em normas internacionais (Codex Alimentarius). No caso analisado, a legitima??o da regula??o sanit?ria se d? atrav?s da constru??o de padr?es de 'qualidade', 'risco' e 'seguran?a do alimentos', baseados em exames laboratoriais que apontam a presen?a, acima dos n?veis legais, em especial de dois grupos de microorganismos (coliformes fecais e Staphylococcus aureos), que levam ? classifica??o legal dos queijos como 'impr?prios ao consumo humano', entrando em choque com a percep??o da popula??o desses queijos como alimentos saborosos e seguros, parte da identidade cultural dos mineiros. Por serem produtos essencialmente 'vivos', contendo 'maus microrganismos' mas tamb?m 'bons microrganismos', respons?veis por caracter?sticas ?nicas de sabor e textura, as normas sanit?rias baseadas em crit?rios industriais entram em choque com tradi??es de produ??o e consumo dos queijos. Assim, os processos de ilegaliza??o geram rea??es, que buscam possibilidades de legaliza??o em emaranhados legais e institucionais cada vez mais complexos e que permitem a inclus?o apenas de uma minoria de fam?lias produtoras. A grande maioria permanece na informalidade, cada vez mais constru?da como ilegalidade. O trabalho de campo analisa dois munic?pios na regi?o do queijo Canastra e aponta um conjunto de elementos que comp?em um modo de se manter na atividade do queijo, que envolve tanto formas de produ??o quanto de comercializa??o, inseridas culturalmente num modo de vida, que garantem a reprodu??o das fam?lias e sua resili?ncia frente ?s press?es externas. O estudo desse caso coloca quest?es mais gerais sobre a rela??o entre Estado, Direito, Ci?ncia e mercados, assim como destes com popula??es camponesas. Discute tamb?m com no??es hegem?nicas de risco no que diz respeito ? sa?de e ? alimenta??o e seus efeitos sobre o modo de vida dessas mesmas popula??es e sobre as op??es de escolha dos consumidores.

Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2017-04-17T19:29:20Z No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) deborah_braga_oliva_audebert_rezende.pdf: 2694348 bytes, checksum: 0b7854978be13bd95e78e6982cf6c80a (MD5) / Approved for entry into archive by Rodrigo Martins Cruz (rodrigo.cruz@ufvjm.edu.br) on 2017-04-20T16:48:03Z (GMT) No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) deborah_braga_oliva_audebert_rezende.pdf: 2694348 bytes, checksum: 0b7854978be13bd95e78e6982cf6c80a (MD5) / Made available in DSpace on 2017-04-20T16:48:03Z (GMT). No. of bitstreams: 2 license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) deborah_braga_oliva_audebert_rezende.pdf: 2694348 bytes, checksum: 0b7854978be13bd95e78e6982cf6c80a (MD5) Previous issue date: 2016 / A Vigil?ncia em Sa?de ? considerada uma ?rea estrat?gica para a redefini??o das pr?ticas sanit?rias brasileiras, todavia a operacionaliza??o descentralizada das a??es de sa?de ainda ? deficiente. Neste contexto, o governo do Estado de Minas Gerais lan?ou, em 2012, o Projeto de Fortalecimento em Vigil?ncia em Sa?de. No presente trabalho objetivou-se analisar a situa??o da Vigil?ncia Sanit?ria dos 53 munic?pios, subdivididos em cinco regi?es de sa?de, sob jurisdi??o da Superintend?ncia Regional de Sa?de de Montes Claros, por meio do estudo das Planilhas de Monitoramento e Avalia??o das a??es de Vigil?ncia em Sa?de destes munic?pios, em oito per?odos, compreendidos entre os anos de 2012 a 2014. Buscou-se comparar, ao longo dos tr?s anos de implanta??o do Programa, as mudan?as verificadas nos percentuais de cumprimento de a??es de cada ?rea da Vigil?ncia em Sa?de, bem como discutir as facilidades e dificuldades encontradas para a execu??o das a??es na ?rea de Vigil?ncia Sanit?ria. Observou-se que o percentual de a??es executadas aumentou a partir do 4? per?odo de avalia??o (julho a setembro/2013), para todas as regi?es analisadas. Entretanto, pode-se detectar que, na maior parte das regi?es, os menores percentuais m?dios foram ?queles relativos ? ?rea da vigil?ncia sanit?ria. Emboratenha havido uma melhora dos indicadores, eles ainda est?o inferiores ?s m?dias do Estado de Minas Gerais, o que provavelmente pode-se relacionar com as heterogeneidades geogr?ficas e socioecon?micas das regi?es que constituem a Superintend?ncia Regional de Sa?de de Montes Claros. Nota-se ainda dificuldades na organiza??o dos servi?os de VISA municipais no ?mbito da SRS/Montes Claros. Conforme as an?lises, percebeu-se uma oscila??o do percentual de execu??o das a??es em alguns munic?pios, sendo que alguns fatoresdificultadores, tais como a alta rotatividade de profissionais, a insufici?ncia de recursos materiais, a falta de pessoal qualificado para o servi?o dificultadores, podem ter contribu?do para a n?o execu??o de v?rias a??es no ?mbito da vigil?ncia sanit?ria nestas localidades. Diante das informa??es neste estudo, verifica-se que existem tamb?m facilidades na execu??o das a??es de VISA, como a exist?ncia pr?via do servi?o de VISA, a ea ea extens?o territorial do munic?pio, a infraestrutura m?nima de funcionamento e o apoio de gestores e da popula??o. No entanto,as facilidades ainda s?o pouco frequentes.Assim, pode-se concluir que embora tenham ocorrido avan?os, de forma geral, no servi?o de vigil?ncia em sa?de ap?s implanta??o do Projeto de Fortalecimento da Vigil?ncia em Sa?de, ainda se notam fragilidades e fraquezas na organiza??o dos servi?os, especialmente os de Vigil?ncia Sanit?ria, nos munic?pios objeto deste estudo. A insufici?ncia de insumos, ferramentas, instrumentos materiais e equipe multidisciplinar qualificada para o setor demonstram a dist?ncia entre as pol?ticas do Sistema ?nico de Sa?de, as necessidades sociais, a miss?o da vigil?ncia sanit?ria na prote??o da sa?de e a realidade concreta dos munic?pios da jurisdi??o da Superintend?ncia Regional de Sa?de de Montes Claros. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2016. / The Health Surveillance is considered a strategic area for the redefinition of Brazilian health practices, however decentralized operationalization of health actions is still deficient. In this context, the state government of Minas Gerais launched in 2012, the Strengthening Project in Health Surveillance. This work aimed to analyze the situation of the Health Surveillance of 53 municipalities, divided into five health regions under the jurisdiction of Regional Health Superintendency of Montes Claros, through the study of the Monitoring Sheets and Evaluation of Surveillance actions in health these municipalities in eight periods, ranging from the years 2012 to 2014. We attempted to compare, over the three years Program implementation, the changes in the percentage of enforcement actions in each area of health surveillance and discuss the advantages and difficulties encountered in the implementation of actions in the health surveillance area. It was observed that the percentage of executed shares increased from the 4th assessment period (July-September / 2013), for all analyzed regions. However, one can detect that in most regions, the average lowest percentages were those relating to the area of health monitoring. Emboratenha been an improvement in indicators, they are still below the average of the state of Minas Gerais, which probably can be related to the geographical and socioeconomic heterogeneity of the regions that make up the Regional Health Superintendency of Montes Claros. Note also difficulties in the organization of municipal VISA services within the SRS / Montes Claros. According to the analysis, it was noticed a wobble in the percentage of implementation of actions in some municipalities, and some fatoresdificultadores, such as high staff turnover, lack of material resources, lack of qualified personnel for hindering service may have contributed to the non-implementation of various actions under health surveillance in these locations. On the information in this study, it appears that there are also facilities in the implementation of VISA shares, as the prior existence of the VISA service, the territorial extension of the municipality, the minimum infrastructure operation and support managers and the public. However, the facilities are still poorly frequentes.Assim, it can be concluded that although there were advances, generally, the surveillance service health after implementation of health surveillance Strengthening Project, still noticeable weaknesses and weaknesses in organization of services, especially health surveillance in municipalities object of this study. The lack of supplies, tools, materials, instruments and qualified multidisciplinary team for the sector demonstrate the distance between the Health System policies, social needs, the mission of health surveillance in the health protection and the concrete reality of the jurisdiction of the municipalities of Regional Health Superintendency of Montes Claros.