Cadernos de saúde pública
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This paper analyzes the policy model of the Brazilian Ministry of Health from 1990 to 2002. The methodology included interviews with key actors in the national health policy, document review, and analysis of the Federal budget and official databases. ⋯ The model in the late 1990s featured strong Federal induction of States and municipalities and the adoption of market regulation strategies. There is no record of a long-term planning effort, which favors distortions in the Federal intervention model and hinders solutions to structural problems in the Brazilian health system.
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Cadernos de saúde pública · Sep 2007
Review[Cross-cultural adaptation to Brazil of the instrument Caregiver Abuse Screen (CASE) for detection of abuse of the elderly by caregivers].
This first of two papers focuses on the first part in the cross-cultural adaptation of the Portuguese-language version of Caregiver Abuse Screen (CASE), a brief instrument for detecting domestic violence against the elderly. CASE was originally developed in Canada and used to screen violence against the elderly by interviewing their caregivers. ⋯ It was possible to establish high-quality conceptual, item, and semantic equivalence for the Portuguese-language version. Although the results shown here were encouraging, they should be reevaluated in light of a forthcoming psychometric analysis (measurement equivalence) to be performed by the research group.
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Cadernos de saúde pública · Sep 2007
[Moral and operational challenges for the inclusion of palliative care in primary health care].
Palliative care, a model in end-of-life care, is currently undergoing expansion in Brazil. This article emphasizes the need to implement palliative care in primary health care, with an important role in end-of-life care, especially in areas without specialized palliative-care teams. The article discusses key aspects in the organization of this treatment modality and analyzes how palliative care could and should be implemented within primary health care in Brazil. The article describes several challenges for health teams to provide such care, related to the primary caregiver, inherent ethical conflicts, and human resource allocation.
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Cadernos de saúde pública · Aug 2007
Multicenter Study Comparative Study[A comparative study of two mental health services: relationships between popular participation and social representations related to the right to health].
The present paper originated from a qualitative study that analyzed social representations related to the right to health, expressed by users of two types of mental health services, one with participation by users and families and the other without such participation. The aim was to analyze such representations not only in relation to the awareness of the right to health, but also concerning associated factors, such as: popular participation; illness; public health care; perception of social intervention capacity; and concepts concerning the state. ⋯ Users of the mental health service without user/family participation tended to be more resigned and pessimistic. The group with participation views the service it has built as having characteristics denied by the official system and view advocacy as a possible alternative focus for forming new social representations.
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Cadernos de saúde pública · Apr 2007
[The Health Information System for Indigenous Peoples in Brazil (SIASI): design, structure, and functioning].
The Brazilian Health Information System for Indigenous Peoples (SIASI) was created in 1999 as part of the Sub-System for Indigenous Peoples' Health Care. The aim was to improve availability and access to crucial health information for planning, implementation, and evaluation. The current study analyzes the SIASI, focusing on its creation, implementation, functioning, potential, and limitations. ⋯ The system's main limitations involve data collection instruments, human resources training, lack of interface with other national health information systems, difficult access to the data, and non-utilization of the data to plan subsequent health activities. The potentialities include the system's simplicity, comprehensiveness, and possibilities for disaggregating data. The study highlights the importance of a specific health information system for indigenous peoples, due to their socio-cultural and demographic specificities.