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

This article seeks to characterize the different forms of mediation present in the daily work of the community health agent - an innovative element in the functional framework of the Family Health Strategy - , which oscillate between convincement an transformation. It believes that the mediating role the agents have can be of major importance to change the assistential model as it takes-on a transforming character, and sees popular education as a path towards strengthening this type of mediation and to change the assistential model. The study allowed community health agent practices to be known and to point to issues that are considered as fundamental in order for the assistential model to be able to meet the needs and expectations of the population and come closer to the principles of integrality, equity, humanization and popular participation.

How can those who formulate policies deal with the aspiration of producing a universal health context in a context of fiscal restrictions of the State? There seems to be a contradiction between the redistributive model the Brazilian Constitution predicates and the level of public expenditure with health. In this scenario, increasing financial resources is a precondition in order to deny the 'non-universal' and 'non-decentralized' SUS, so it will not deny itself as a social right. Such as the model of decentralization professed by SUS ideologues, a system that suffered from the scarcity of resources, most of the management problems result from the chronic funding crisis, and adopting efficiency measures cannot serve as the base to cut the SUS' level of financial or organizational resources. On the contrary: improved efficiency can, in fact, mean and require increased spending.

The article analyses the appearance of community health agents as a worker category in a context of labor relation flexibilization, in a double sense: valuing work, greater autonomy, continued education, and social skills as primordial elements in the State's implementation of social services; and the atypical character represented by labor agreements outside of the public servents' stability, a condition for the activity that is carried out, on one hand, and, on the other, a factor of social vulnerability of the worker by the preponderance of outsourcing and informal agreements, among others, which are marked by unstable work ties.

The article deals with the relationships between fiscal federalism and the decentralized funding of the Single Health System (SUS), from 1990 to the early 2000's, and singles out the problems of the Brazilian tax system, which is unable to compensate for fiscal unbalance among the different spheres of the government.

The text describes a group experience in education in health carried out in a family health unit in Joinville, state of Santa Catarina, in which an attempt was made to cover issues that were relevant to that population's health. The approach was experienced by five students and an undergraduate professor of Nursing from the Associação Educacional Luterana Bom Jesus/Ielusc, in 2005. Education in health in groups allowed us to put the teaching acquired in the Collective Health III class into practice. The activity focused mainly on getting all of the professionals, the students and the users of the health system present there involved and participating with their knowledge and experience. We approached issues related to diabetes mellitus and systemic arterial hypertension, with emphasis on diet. During the activity, we sought to adapt the materials and the language to the users' reality. The activity began with speeches made by the participants to discuss changes in habit to improve quality of life. As reflections, we believe that working with preestablished popular knowledge and culture requires caution, persistence, patience, and professional motivation; respecting them and, above all, developing listening skills. To us, the opportunity was to learn and to teach.

Nelson Rodrigues dos Santos made a long testimonial, in December 2005, to the Health Technician Observatory of the Joaquim Venâncio Polytechnic School of Health (Fiocruz). The goal was to record the trajectory of a historical leader, both in the fight for democracy and in the sanitary reform in a project developed by the Observatory about the memory of professional education for health in Brazil. It focused on the 1980's and 1990's, which witnessed moments of great political tension in the country, as represented by re-democratization, sanitary reform, the National Constituent Assembly, and the neoliberal turn in the health policies. In this interview, a revised and updated synthesis of that testimonial, "Nelsão," as he is called by his friends, talks about his background and about the choice he made for Collective Health, discusses themes related to the Brazilian health sector in the past few decades, ranging from the genesis of the SUS to the victories and defeats of the public policies in the social area. A graduate in medicine and holding a doctoral in preventive medicine from the University of São Paulo, respectively in 1961 and 1967, he was a full professor of Collective Health at the Federal University of Londrina and a Consultant for Opas/OMS. Nelsão is currently a collaborating professor at the State University of Campinas and the president of the Applied Sanitary Law Institute (Instituto de Direito Sanitário Aplicado, Idisa).

'Education of quality' and 'quality of education' are terms repeated in documents and speeches that go with propositions of action in educational field and that are used to justify specific strategies of educational policies. This article intends to explain these concepts, considering that the different uses or different interpretations might be consequences of historical-social processes that pervaded countries in the last decades. The study sustains that the concept of 'quality' becomes a dilemma for the definition of educational policies, because it can be used with very different senses and contents and, in some cases, antagonical, and recognizes the existence of an ideological content of the concept when linked to education.

The purpose of the article is to discuss the challenges that are faced in the task of building the national education system in the context of the Plan for the Development of Education, an issue that has come back under the spotlight by initiative of the Ministry of Education. Based on the inaccuracies and confusion that prevail in this area, the discussion begins with the meaning of the expression 'national system' itself, as based on its historical configuration. It then approaches the theme, i.e., the hurdles that must be overcome to build the system, which are grouped in four modes: economics, translated in the traditional and persistent resistance to maintaining public education in Brazil; political, expressed by the lack of continuity in educational reform initiatives; ideological, represented by ideas and interests that are contrary to the national education system; and legal, involving the resistance against the approval of legislation that may make organizing education as a national system in our country viable.

This essay seeks to contribute to building a methodological key to interpret the course and the current status of field education, a recent phenomenon in the Brazilian educational reality which has peasant social movements as its main actors. The article begins with an analysis of the original Field Education constitution, identifying its context, practices, and subjects. It then discusses the main tensions and contradictions in its course, particularly those that are produced in the relationship between the social movements and the State, in the affirmation of an emancipatory pedagogic tradition, and in the struggle for public policies that ensure peasant access to formal school education in their own territory. Finally, a few of the impasses and challenges that were singled out regarding the modern day Field education, relating them to the current global crisis of capitalism and to how it materializes itself in the issues related to work in the field.

This comment is inspired in the article written by Luciana Dias de Lima regarding the relationships between fiscal federalism and the process of decentralization of the Single Health System. It highlights and expands issues regarding the transformations that have taken place in the intergovernmental relationships and the changes in public institutionality that marked the period the author analyzed. The comment calls the reader's attention to the potential deconstruction of the federative relationships of the Single Health System described and analyzed in the text proposed for, if the Executive's new tax reform, which is currently proceduring, is approved.