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

This The study assessed the work process of the professionals of an Extended Health of the Family Center (Núcleo Ampliado de Saúde da Família, in Portuguese) in Primary Health Care regarding the establishment of collective educational activities for the promotion of a healthy and proper diet. We used the qualitative approach method, based on a pilot study of a randomized and controlled community trial, with the participation of six professionals. The interviews followed a semi-structured script. Content analysis was employed to reveal the meanings of the speeches of the participants. Three categories emerged: integration of the team as the driving force of the work process; liberating education and engagement as the guiding axes for the implementation of collective activities regarding healthy eating; and challenges to the implementation of educational activities on healthy eating. The results show that the group methodology recommended by the Brazilian Ministry of Health is a good strategy for the organization and management of the work process. Moreover, it boosted the integration of the work force of professionals from different categories, resulting in the strengthening of the team in the practice of interdisciplinarity and in the development of collective spaces for exchanges, care and empowerment of the assisted individuals.

Since January 2020, the world has been experiencing an unprecedented health crisis, after the World Health Organization declared the Public Health Emergency of International Importance as a surveillance strategy and immediate response to the COVID-19 pandemic. In Brazil, the economic and political chaos resulting from the 2016 coup d’état deepened the pandemic crisis, exposing the gap in social inequalities and, in particular, health inequalities, and the neglect of life in all its dimensions. This reflection brings to the scene conjunctural elements (economic-political and socio-environmental) necessary for the understanding of technical surveillance interventions, with emphasis on quarantine and social isolation, as emergency normative strategies for individual and collective life, used to control bodies and places. In this catastrophic scenario, vulnerable territories are doubly penalized, for their peripheral condition in the space of cities and for their systematic exclusion of citizenship rights, requiring, from governments, interventions that consider the continental dimension and the country’s economic-cultural heterogeneity; social and health inequalities; and the ability to respond in a timely manner to each sphere of management that is the exclusive responsibility of the State, within the scope of Health Surveillance, Specialized Assistance and Primary Health Care in the Unified Health System.

Based on political, economic and social conditions prior to the pandemic, the text discusses the dramatic consequences of the privatization processes of the Brazilian Unified Health System for the implementation of effective actions against COVID-19. The reforms promoted by the Brazilian State in recent years, namely tax adjustments, labor and social security reforms and Constitutional Amendment 95, correlate, as preconditions to the current scenario and related to the privatization of the national health system, the effects of which have been harmful to the working class, as well as to the public health. In this context, determined by the devastating corporate form of capital, the transfer of public resources to private health sector is brutal. It is deduced, therefore, that the pandemic deepens the impacts in term of the vulnerability of labor and the de-financing of the Unified Health System in its multiple dimensions. The text concludes by emphasizing that the pedagogy of the catastrophe caused by the pandemic does not ensure the improvement or overcoming the current sociability, and may even result in more barbarism, which, ultimately, can only be prevented if new social norms are created for the benefit of the entire of humanity.

The pharmacist plays an important role in the care for the users of primary health care by providing emancipatory self-care actions, education in health, promotion of health and of the reasonable use of medications. In this context, the present study, through an integrative review of the literature, had the goal of analyzing the types and benefits of the clinical pharmaceutic services developed in primary health care in Brazil. In the SciELO and PUBMED/MEDLINE databases, we gathered articles on the clinical pharmaceutic services developed in primary health care in Brazil published in Portuguese, English and Spanish between 2007 and 2017. The pharmacotherapeutic follow-up is the most studied service, while dispensation and guidance are the activities most often performed by the primary health care pharmacists. Regarding the benefits, the literature shows the coexistence, the importance and the multidimensionality of the clinical pharmaceutic services in the promotion of health and in the reasonable use of medications by the circumscribed community.

The text discusses the difficulties to face COVID-19 raised by the speech and the actions defended by the federal government. In contrast to the governments of countries that have achieved effective results in controlling the pandemic, representatives of the Brazilian government, among which the President of the Republic stands out, are continually disqualify publicly both risks and the adoption of scientifically based prevention measures, in particular social isolation, defending, in its place, the so-called ‘herd immunity’. The reiterated argument is that there is an opposition between the preservation of the economy and life, the former being a priority. Such manifestations are accompanied by constraints on state and municipal governments in carrying out locally defined preventive measures. This attitude expresses contempt for human life and an acute disregard for the socially most vulnerable population, which, in countries with chronic inequalities, such as Brazil, suffer the most serious effects of an epidemic.

Racism is a structural system that generates behaviors, practices, beliefs and prejudices that underlie unfair and avoidable inequalities, based on race or ethnicity. In health, racism can manifest itself in several ways, including institutional racism, which often occurs covertly. The coronavirus pandemic has been a challenge for countries with profound inequalities. In Brazil, despite the absence of information disaggregated by race or ethnicity, and even when collected, oftentimes recorded with errors; it is known that black people will suffer more sever impacts of the pandemic as well as its various negative outcomes. In this article we recall historical aspects and their relationship with the vulnerability of black population as well as suggest specific actions to combat racism and its devastating consequences in the context of COVID-19.

The theory of social conditions as fundamental causes of health, in conjunction with the notions of social class and territory, is used in reflections about the trajectory and distribution of the effects of the Covid-19 pandemic in the country. It starts with theoretical syntheses, approaches and evidences from the author’s works on health inequality in Brazil. It is understood that the ‘social environment’, of a relational and structured nature, affects the spread and distribution of the disease among the groups. Class differences in circumstances of work, location and housing are mentioned. Regarding social differences in the risk of fatal outcome of the disease, the previous distribution of adverse conditions and differences in the way health institutions process people are considered. As proposed by the theory, inequalities in resources, information, dispositions and capacity would be affecting the social distribution of the effects of the pandemic in Brazil.

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