Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

O objetivo deste artigo é discutir sobre o desenvolvimento do direito à saúde no Brasil. Parte-se do processo de construção dos direitos sociais, passando pela assunção destes direitos na Carta Magna Brasileira até chegar às compreensões atuais de certos segmentos sociais sobre o direito à saúde. A análise baseia-se na pesquisa realizada em Porto Alegre, Rio Grande do Sul, a respeito da atuação conjunta entre conselhos de saúde e Ministério Público. Pode-se observar que o direito à saúde tem sido associado à ideia de acesso a serviços de saúde. Isto, no entanto, tem se mostrado ser um aspecto limitador na luta pela garantia e ampliação deste direito. Por este motivo, determinados segmentos da sociedade vêm adotando uma postura mais ativa em relação à compreensão sobre este direito. Tal compreensão tem rendido ganhos substanciais na luta pela ampliação do direito à saúde no Brasil. Assim, explicitar as diferentes concepções sobre o direito à saúde de um conselho de saúde que tem se demonstrado atuante no cenário nacional pode dar indícios sobre as formas de atuação possíveis e as estratégias desenvolvidas nestas instituições para a garantia deste direito.

This article analyzes the practices of a waste recycling cooperative located in Baixada Fluminense, Rio de Janeiro, focusing on the organization and labor relations, the knowledge generated in the work processes, and networks of collective action established with the community. The data was obtained through interviews with the workers and their leaders and with the technicians of the NGO Autre Terre, which supports the project. The results of the qualitative research suggest that this experience of solidary and popular economy has become an alternative for social inclusion, creating employment, income, knowledge, and values, in the perspective of a popular and critical education. In the relations of the cooperative with the community are established networks of collective action, recovering the public space in which the awareness of the diversity of ideas and concepts can make it possible to be a good citizen.

Surveillance in Occupational Health (Visat) comprises a set of practices legally entered in the National Health System (SUS) and recommended by the policy guidelines that address the health-work relations in Brazil. However, the Visat is still uncommon and, when available, depends on proactive attitudes of some professionals at the service level. Aside from the failure of the management of the health system to implement Visat, another reason it is not implemented is the lack of technical capacity of public officials. The article presents a methodological proposal for the training of Surveillance in Occupational Health using experiences developed some years ago in the field of education in services. We discuss the theoretical and conceptual foundations that guide the development of the field of occupational health and the problem-based pedagogy used in the process of continuous education of the SUS.

The 'bonus strategy' is defined by employers as a way to seek to make the workers work more and better using grants for additional monetary benefits towages as an incentive, conditional on an increase in productivity. Two examples of the strategy are mentioned, one of them referring to the Department ofEducation of the State of São Paulo and the other to the University of São Paulo (USP). It examines the following three assumptions of the strategy – the conception of painful labor, workers imbued with the spirit of capitalism, and monetary reward as the only form of incentive – in an attempt to show that none of them have universal validity and are therefore strictly false. Then we present the additional evidence for the invalidity of the assumptions, derived from the work of retired teachers and teachers who have the credentials to retire, but that are still working. In the last section, the most disastrous consequence of the use of the bonus strategy is exposed: the 'idiotization' of society.

Taken from concrete examples gathered over two years of study on the health of teachers, this article proposes a discussion about the strategies that teachers create to face the adversities of everyday school life. With the use of concepts of health and psychodynamics of work, we try to reflect on how teachers deal with adversities such as learning difficulties, the undisciplined behavior of students, the lack of teaching resources, and the teachers fatigue or unwillingness to teach the classes. These strategies - known as coping and escape strategies - which would apparently enhance learning, are also activities that reduce the teacher's burnout, which leads to the trivialization of the educational process.

This report describes the experience of the technical professional training of 250 indigenous community health agents linked to the Special Indigenous Sanitary District of Rio Negro in the state of Amazonas. The initiative promotes the increase of the level of education and the respect towards the specific cultural features of the students. The main pedagogical elements, 'culture', 'territory', 'policy', 'care', 'information', 'education', and 'health planning' form a curriculum matrix that is operationalized through teaching based on research, multilinguism, multi-disciplinarism, and intersectoralism, in tune with the principles of indigenous education, the special attention to the health of indigenous peoples, and of curriculum references of the technical training of community health agents. The pedagogy process fosters the acquisition of skills and competencies to diagnose and monitor health conditions and the risk and vulnerability of indigenous populations, in order to support preventive actions, promotion, treatment, and rehabilitation at the different stages of life, and develop political and communal action in the fight for better health. Preliminary results of the experience show the recognition and strengthening of the indigenous health agents work, the improving the quality of health work in the community, and the highest level of satisfaction of the leaders of the indigenous movement, by broadening the access to a qualified and specialized education.

The purpose of this article is to highlight the importance of the analysis of the political, social, and economic context to confirm the conceptual framework as the base for the development of the qualification programs for health professionals. The analysis is defined in four moments. The first, ever since the end of the 19th century through the early 20th century, was characterized by being 'physician-centric'. The second, in which the medical administration and data and statistics registration were included, the medical practice gained new dimensions that allowed it to turn into a social, rather than an individual practice. In the third, with the transference of the hospital organization from Europe to America and the incorporation of modern technology, hospitals became part of a medical and social organization with the mission of allowing for medial and sanitary assistance. A fourth took place in the midst of a contradiction between what had progressed in the development of the health systems, with the acknowledgement of the universal rights to health and citizen participation as the subject and object of the care, and the appearance of the neoliberal globalizing trend, which considered the complex process of health care as merchandise.

This essay seeks to discuss political participation in the Single Health Service (SHS) based on the problematization of the options and conceptions that guide its definition as social control, made operational by means of mechanisms of representation of interests. As such, the goal was to drive reflection on how political participation in the SHS is transferred to daily institutional life, as a challenge to build modes of participative management. The Policy concept we adopt is defined not in terms of equality (formal), which opposes differences (social), rather as the co-production of a reality that is made concrete in the relationship between equality and difference, such as the access to and use of common goods, in its undetermined capacity, one that is open to the creation of value. Thinking of participation in these terms means to weave participation as the possibility to institute norms, and not only as the control of the execution and inspection of the existing norms. As such, participation in health is thought out based on the problem of constituting a public policy that can remain open and unpredictable, safeguarding, nonetheless, the material conditions of equality. In this regard, a public policy that breaks away from the modern sovereignty mechanisms by incorporating itself into its institutional design the unpredictability of normative production, becoming an ethical device for the production of value.

The article seeks to build, based on a memory of the Brazilian Sanitary Reform and on approximations between the scientific areas of Education and Health, a microperception (matter for thought, learning, and getting to know) about the surfacing of a domain of knowledge designated by Health Education and Teaching. This emerging domain would seem to be largely associated to the invention of Collective Health, in the scientific field of health, and to the invention of Social Control in Health, in the field of political intervention in this sector. The new knowledge domain would be characterized by a singular implication of teaching with citizenship, allowing the bridging of the boundaries between education and health via permanent education in health. The teaching and citizenship themes are problematized with explicit help or not (via its readers) from a few philosophers and contemporaneous thinkers such as Michel Foucault, Michel Serres, Gilles Deleuze, Félix Guattari, Francisco Varela, Humberto Maturana, and Ilya Prigogine.