Nos bastidores da gestão da Saúde Pública: Ensaio-discussão sobre um itinerário por lugares onde habita o poder gestionário / Behind the scenes of Public Health Management: essay-discussion on an itinerary where management power resides

O gerenciamento da Saúde pública refere-se a um lugar que lida diretamente com os recursos para a promoção, prevenção e recuperação da vida humana. Esse movimento representa a prática de um direito constitucionalmente garantido. Todavia, ao fazer parte dos seus microprocessos, experienciando o agir daqueles que os impulsionam (ou não), tanto no aspecto individual como coletivo, compreendi a necessidade de apresentar minha vivência nos bastidores da gestão nas esferas governamentais que atuei. Assim, tornou-se urgente descrever a rotina instaurada pelo poder gestionário, bem como a forma que se geraram/geram tomadas de decisões nas políticas públicas. Para tanto, parto do pressuposto de que o Estado hesita em propiciar o bem-estar e a qualidade de vida para o seu povo, fazendo com que o seu poder (constitucionalizado) institucionalize o controle e a administração da governança sob o seu território, submetendo-os aos interesses que não estão associados às necessidades sociais. Na intenção de construir um espaço de reflexão, emerge a hipótese de que as instituições que representam a governança estatal se apresentam funcional e intencionalmente abstratas, indiferentes ao seu real dever constitucional, fomentando a regulamentação e a manutenção do caos, produzindo uma fragilidade no sistema e, como consequência, permitindo os privilégios dos amantes do poder, promovendo o vazio assistencial e a morte de seu povo. Portanto, com o propósito de elaborar uma narrativa de todo esse processo vivido, elaboro um pout-pourri de ideias propostas por autores com os quais me identifico metodologicamente, balizando os contornos que considero necessários, sendo o mais fidedigna possível nos relatos. Nesse processo, destaco o arcabouço do método de Richard Sennett e a experiência de campo de Simone Weil. Ademais, realizo um diálogo acerca dos sentidos de gestão, dos seus impactos estabelecidos no universo das relações do trabalho em saúde e das necroses ­ tanto emocionais quanto físicas ­ produzidas nas vidas abaladas pelo descuidado em saúde. Dessa forma, aproprio-me do saber constituído pela prática, exemplificando por intermédio da narrativa, o ato de sentir na pele a magnitude do vigor amoral da gestão, na intenção de expor elementos que são cruciais à execução e à manutenção de seu poder. Por fim, reconhecendo o conhecimento estabelecido pelas experiências, aponto as sequelas no âmbito do trabalho da Saúde pública, revelando os seus ilimitados ditames que ocasionam a morte em suas diferentes versões. Diante das críticas lançadas ao longo deste trabalho, sobre a forma de fazer a gestão, entendendo a necessidade de pensarmos em outras maneiras de construirmos esse lugar, lamento não ser capaz de produzir argumentos e direções possíveis. A conjuntura não permite que eu ocupe outra posição, a não ser a da incredulidade. Não acredito em possibilidades concretas de modificação do nosso cenário. Contudo, não deixa de ser urgente a necessidade de encontrar outras formas possíveis de se fazer gestão em prol, de fato, da vida coletiva. É imprescindível que, ainda assim, haja firmeza de caráter o suficiente para manter o propósito focado no cuidado em saúde do usuário, assim como uns dos outros, também, ao longo desse processo. (AU)

Public Health Management refers to a place that directly deals with resources to promote, prevent and recover human life. This movement represents the practice of a constitutionally guaranteed right. However, by being part of their microprocesses, experiencing the actions of those who drive them (or not), both individually and collectively, I understood the need to show my experience behind the scenes of management in the government fields in which I worked. Thus, it became urgent to describe the routine established by the management power, as well as the way in which decision-making in public policies was generated. Then, I assume that the Government hesitates to provide well-being and quality of life to the people. Besides that, it has the power to institutionalize the control and administration of governance under its territory, subjecting them to interests that are not associated with social needs. In order to build a space for reflection, the hypothesis states that the institutions which represent state governance are functionally and intentionally abstract. So, they are indifferent to their real constitutional duty, encouraging regulation and the maintenance of chaos, producing fragility in the system and, as a consequence, allowing the privileges of lovers of power, promoting a vacuum in assistance and the death of people. Therefore, with the purpose of elaborating a narrative of this process, I elaborate a mix of ideas proposed by authors connected to my thoughts, so defining the contours that I consider necessary, being as reliable as possible in the reports. In this process, I highlight the framework of Richard Sennett's method and Simone Weil's field experience. Furthermore, I carry out a dialogue about the meanings of management, its impacts established in the field of health work relationships and the damages ­ both emotional and physical ­ produced in lives shaken by carelessness in health. In this way, I receive the knowledge constituted by practice, exemplifying through narrative, the act of feeling firsthand the magnitude of the amoral vigor of management. So, as a consequence, I am exposing elements that are crucial to the execution and maintenance of government's power. Finally, recognizing the knowledge established by experiences, I pointed out the consequences in the scope of public health work, revealing its unlimited dictates which cause death in different versions. In view of the criticisms launched throughout this work about the way of managing and thinking of other ways of building this place, I regret not being able to produce possible arguments and directions. This situation does not allow me to occupy any other position than that of disbelief. I do not believe in real possibilities of changing our reality. However, it is still urgent to understand the need to find other possible ways of managing for the benefit, in fact, of collective life. It is essential that, even so, there must be enough firmness of character to maintain the purpose to focus on the health care of the user, as well as each other, throughout this process. (AU)

Characterization of young graduates perceiving underemployment: Assessment of well-being and discomfort associated with this perception / Caracterización de jóvenes egresados que perciben subempleo: evaluación del bienestar y malestar asociadas a esta percepción

Resumen Investigaciones previas han demostrado que el subempleo subjetivo está inversamente asociado a la satisfacción laboral, el bienestar psicológico y la salud. Hasta donde conocemos, este es el primer estudio que explora el subempleo subjetivo en egresados de pregrado en Colombia. Ciento cuarenta y dos trabajadores participaron en un estudio correlacional y comparativo. Los resultados replicaron hallazgos previos: a medida que aumentaba la percepción de subempleo subjetivo, disminuían la satisfacción laboral y la satisfacción con la vida en general. Se encontraron diferencias significativas en los indicadores de satisfacción laboral y satisfacción con la vida en general entre quienes perciben subempleo y quienes no. Por último, se discute el potencial ro del subempleo subjetivo en la salud de los empleados.

Abstract Previous research has shown that subjective underemployment is inversely associated to job satisfaction, psychological well-being and health. To our knowledge, the current is the first study that explores subjective underemployment in undergraduates in Colombia. One hundred and forty-two workers participated in a correlational, and comparative study. Results replicated previous findings: as subjective underemployment perception increased, job satisfaction and general life satisfaction decreased. Significant differences were found in the indicators of job satisfaction and general life satisfaction among those who perceive underemployment and those who do not. Finally, the potential role of subjective underemployment on employees' health is discussed.

Determinantes del subempleo en Colombia: una aproximación a partir de un modelo PROBIT / Determining factors of underemployment in Colombia: An approach based on a Probit model

Resumen El subempleo es un indicador de la calidad del empleo, así como del nivel de subutilización de la capacidad productiva de la población ocupada. En este artículo se analizan los determinantes de la probabilidad de caer en el subempleo en Colombia. Se utilizaron los datos de la Gran Encuesta Integrada de Hogares del año 2017, para estimar un modelo Probit. Se encontró que mayor educación y experiencia se asocia con una menor probabilidad de caer en el subempleo. Las mujeres, los trabajadores cabeza de hogar, los trabajadores por cuenta propia y los empleados domésticos, tienen una mayor probabilidad de ser subempleados.

Abstract Underemployment is an indicator of the quality of employment, as well as the level of underutilization of the productive capacity of the occupied population. This article discusses the determinants of the likelihood of falling into underemployment in Colombia. Data from the Large Integrated Household Survey was used to estimate a Probit model. It was found that better education and experience are associated with a lower likelihood of falling into underemployment. Women, men or women who are heads of family, self-employed workers, and domestic workers, are more likely to be underemployed.

Identidad y narrativas de profesionales en condiciones de subempleo en Bolivia / Professional Identity in conditions of underemployment in Bolivia

La profesión como sinónimo de movilidad social y estabilidad económica está en entredicho, esta actividad se ve marcada por la presencia de contratos de trabajo que eluden y disfrazan la relación obrera/patronal, generando espirales de fuerza laboral que terminan en condiciones de subempleo. El objetivo de la presente investigación es comprender la vivencia de profesionales bolivianos ante las condiciones laborales de subempleo, analizando cuáles eran sus expectativas antes de la graduación y cómo conllevan su situación laboral actual. Se empleó el método cualitativo, realizándose un análisis de contenido a siete entrevistas en profundidad de profesionales con diferentes tipos de contrato laboral. Los resultados permiten comprender la vivencia de los participantes ante el subempleo, entendiendo el éxito profesional como pura responsabilidad individual (atribución interna); y cómo algunos elementos comunes de la identidad profesional de los participantes permite sobrellevar las condiciones laborales de subempleo. Se discute estos resultados en referencia a la primacía del "ser" sobre el "conocer" y se propone una reflexión sobre el papel de las universidades, empresas y gobiernos, sobre esta situación.

The profession as a synonym of social mobility and economic stability is in question, this activity is marked by the presence of labor contracts that elude and disguise the worker / employer relationship, generating spirals of labor that end in underemployment. This research aims to understand the experience of Bolivian professionals in the face of underemployment working conditions, analyzing what their expectations were before graduation and how they bring their current employment situation. The qualitative method was used, performing a content analysis to seven in-depth interviews of professionals with different types of employment contract. The results allow to understand the experience of the participants before the underemployment, understanding the professional success as pure individual responsibility (internal attribution); and how some common elements of the participants' professional identity make it possible to cope with underemployment working conditions. These results are discussed in reference to the primacy of "being" over "knowing" and proposes a reflection on the role of universities, companies and governments, on this situation.

La juventud NINI, un agujero negro psicosocial / The NEET youth, a psychosocial black hole

El objetivo general de este texto consiste en describir y discutir, a partir de una revisión de literatura, el panorama actual del fenómeno "NiNi", el de las personas jóvenes que ni trabajan, ni estudian, ni tampoco realizan actividad alguna relacionada con la formación ocupacional, atendiendo especialmente a su desarrollo europeo, y particularmente español, articulando cinco criterios de exposición principales: (a) el contexto histórico y cultural de su emergencia y expansión, (b) su vinculación con metamorfosis y megatendencias socioeconómicas como la crisis de la sociedad salarial del pleno empleo estable, la desregulación de las relaciones laborales y la precarización de las condiciones de trabajo en el marco de la nueva gestión flexible del mismo, que determinan la transición hacia el posfordismo, (c) la información empírica acumulada sobre su tipología y prevalencia, (d) los discursos sociopolíticos y las lecturas teóricas relativos a sus causas y consecuencias y las consiguientes propuestas de afrontamiento (e) la reflexión y discusión sobre sus implicaciones teóricas y prácticas en cuanto a la necesidad de repensar constructos como juventud, ciudadanía, transición de la escuela al trabajo u orientación para el empleo...

The overall objective of this paper is to describe and discuss, based on a literature review, the current situation of the "NEET" phenomenon, concerning young people Not in Employment, Education or Training, with special attention to its European development, particularly in Spain, articulating five major criteria of exposure: (a) the historical and cultural context of its emergence and expansion, (b) its relationship with socioeconomic megatrends and metamorphosis, such as the crisis of the full stable employment wage society, the deregulation of labor relations, and the rise of precarious working conditions under its new flexible management, which determine the transition to post-Fordism, (c) empirical information accumulated on its typology and prevalence, (d) the socio-political discourses and theoretical readings concerning its causes and consequences, and subsequent proposals for coping, and (e) reflection and discussion of its theoretical and practical implications in terms of the need to rethink constructs such as youth, citizenship, transition from school to work, or employment guidance...