Financiamento de pesquisas sobre dengue no Brasil, 2004-2020 / Funding for research on dengue in Brazil, 2004-2020

RESUMO A dengue representa um importante problema de saúde pública no Brasil devido às constantes epidemias causadas pela doença no País. Este estudo objetivou analisar o financiamento de pesquisas sobre dengue pelo Departamento de Ciência e Tecnologia do Ministério da Saúde e parceiros no período de 2004 a 2020. Analisou-se a tendência do financiamento por regressão linear generalizada do tipo Prais-Winster e sua distribuição entre as regiões e Unidades Federadas brasileiras, modalidades de contratação das pesquisas, instituições beneficiadas e temas estudados. Entre 2004 e 2020, financiaram-se 232 pesquisas (R$ 164,03 milhões), realizadas, em sua maioria, em instituições da região Sudeste (77,55%), abordando especialmente a temática controle vetorial (37,93%). A tendência de financiamento foi estacionária nos anos estudados. As chamadas estaduais foram a principal forma de modalidade de contratação das pesquisas (65,95%). Houve diferença estatisticamente significante na distribuição do valor financiado entre as modalidades de contratação, bem como no número de pesquisas financiadas e valor financiado entre as regiões brasileiras. Esses achados demonstram a importância de monitorar o financiamento de pesquisas sobre dengue no Brasil e de implementar estratégias de avaliação das pesquisas financiadas, para subsidiar e aprimorar a política de enfrentamento da doença e de seu vetor.

ABSTRACT Dengue represents an important public health problem in Brazil, due to the constant epidemics caused by the disease in the country. This study aimed to analyze the funding of research on dengue by the Department of Science and Technology of the Ministry of Health of Brazil and partners between 2004 to 2020. Was analyzed the trend of the funding by generalized linear regression using Prais-Winster and its distribution between Brazilian regions and Federated Units, research contracting modalities, benefited institutions, and studied themes. Between 2004 and 2020, 232 research studies were funded (R$ 164.03 million), carried out mostly in institutions in the Southeast Region (77.55%), addressing especially the vector control theme (37.93%). The funding trend was stationary in the years studied. The state calls were the main form of contracting modality for the research (65.95%). There was a statistically significant difference in the distribution of the loan amount between the contracting modalities, and in the number of researches funded and loan amount among Brazilian regions. These findings demonstrate the importance of monitoring the research funding on dengue in Brazil and of implementing strategies to evaluate the research funded, to support and improve the policy to combat the disease and its vector.

Policy evaluation of human organ transplantation based on policy modeling consistency index model / 器官移植

Objective To evaluate the policy of human organ transplantation in China, aiming to provide theoretical basis for further optimizing the policy of human organ transplantation. Methods Based on text mining and statistical analysis, seven normative policies of human organ transplantation formulated by national government from 2000 to 2022 were quantitatively evaluated by constructing policy modeling consistency (PMC) with 10 first-level variables and 35 second-level variables. Results Among the seven policies, six were graded as excellent policies and one as perfect policy, with an average PMC index of 8.476. Except X8 policy audience, the scores of other second-level variables of P5 were higher than or equal to the mean. The scores of all second-level variables of P1 were lower than or equal to the mean. P1 and P5 significantly differed in X3 policy timeliness, X4 policy norms and X6 policy tools. P5 was more specific and relatively comprehensive in these aspects, and its score was significantly higher than that of P1. Conclusions Human organ transplantation policies in China are generally excellent, scientific and rational. Health administrative departments at all levels should pay attention to the grasp of policy timeliness, the combination of policy tools, and fully mobilize the initiative and enthusiasm of all policy audience to participate in organ transplantation management when formulating organ transplantation policies.

Planos Municipais de Saúde do Estado do Tocantins: uma análise com foco no enfrentamento da obesidade / Municipal Health Plans in Tocantins, Brazil: an analysis focusing on obesity

Resumo O objetivo deste estudo foi avaliar a abrangência do enfrentamento da obesidade nos Planos Municipais de Saúde (PMS) do Estado do Tocantins, dado que, diante da crescente prevalência da obesidade no Brasil, seu enfrentamento deveria estar no foco de ação da saúde pública e previsto nos instrumentos de gestão. Trata-se de um estudo qualitativo, com análise documental, que analisou os PMS no período de vigência de 2018 a 2021 nos 139 municípios desse estado. Foram selecionados dezessete termos relacionados à obesidade e verificada a frequência e contexto nos PMS. Do total de 139 PMS, foram avaliados 129 (92,8%). Os termos "academia da saúde" e "Sisvan" foram os mais frequentes, e "obesidade" apareceu em apenas 28% dos planos, totalizando 71 citações. Destas, somente 32,4% relacionavam-se diretamente com o enfrentamento da doença, com destaque nas regiões de saúde Bico do Papagaio e Médio Norte Araguaia. Os contextos relevantes de abordagem da obesidade mais frequentes foram a caracterização da situação epidemiológica, quadros de metas de ações e indicadores. Concluiu-se que o enfrentamento da obesidade pactuado nos PMS está ausente em mais de 70% dos municípios do Tocantins, e que ações de direcionamento para inclusão dessa doença dentro dos instrumentos de gestão são urgentes.

Abstract This documentary analysis evaluated the scope of addressing obesity in the Municipal Health Plans (PMS) in the state of Tocantins, Brazil, since the growing prevalence of obesity in Brazil should put its confrontation at the center of public health action and management instruments. To analyze the PMS performance from 2018 to 2021 in the 139 municipalities of this state, 17 terms related to obesity were selected and had their frequency and context in the PMS verified. Of the existing 139 PMS, 129 (92.8%) were evaluated. "Health academy" and "SISVAN" were the most frequent terms used, whereas "obesity" appeared in only 28% of the plans, totaling 71 mentions. Of these, only 32.4% were directly related to combating the disease, mainly in the health regions of Bico do Papagaio and Médio Norte Araguaia. Relevant contexts for addressing obesity included the characterization of the epidemiological profile, tables of action goals, and indicators. PMS's role in combating obesity is absent in more than 70% of municipalities in Tocantins, which points to the urgent inclusion of this disease within the management instruments.

Programa Minha Casa Minha Vida (2012-2016): análise da eficiência relativa dos municípios brasileiros na execução de programas federais / Programa Minha Casa Minha Vida (2012-2016): análisis de la eficiencia relativa de los municipios brasileños en la implementación de programas federales / Minha Casa Minha Vida Program (2012-2016): analysis of the relative efficiency of Brazilian municipalities in the implementation of federal programs

Resumo A presente pesquisa busca avaliar a eficiência relativa dos municípios brasileiros na execução do programa Minha Casa Minha Vida. Pretende-se que os resultados deste trabalho permitam a discussão de quais características ou fatores parecem afetar a eficiência municipal na implementação de políticas públicas, de forma a fornecer subsídios teórico-empíricos às pesquisas na área. O programa Minha Casa Minha Vida (MCMV), caso escolhido, compõe o eixo Infraestrutura Social e Urbana do Programa de Aceleração do Crescimento (PAC). O trabalho foi estruturado em duas etapas: a primeira é a classificação de municípios em grupos homogêneos; a segunda refere-se ao levantamento da eficiência relativa dos municípios na implementação do MCMV, por meio da aplicação de Análise Envoltória de Dados (DEA). Como resultado, foi identificado que os municípios brasileiros possuem padrões diversos de estruturação, sendo a maioria classificada como pouco estruturados ou com estrutura mínima, com claro padrão regional, em que Sul e Sudeste apresentam, com maior frequência, municípios bem estruturados em comparação com o Centro-Oeste, o Norte e o Nordeste. Ao analisar a eficiência relativa no MCMV, tendo como universo apenas os municípios que concluíram empreendimentos do PMCMV entre 2012 e 2016, os municípios com melhor estrutura também apresentaram melhores resultados, indicando que a estrutura deve ser determinante para o desempenho no programa. Em contrapartida, a análise regional apresentou o Centro-Oeste, o Norte e o Nordeste com mais municípios eficientes na execução do programa.

Resumen Esta investigación tiene como objetivo evaluar la eficiencia relativa de los municipios brasileños en la implementación del programa Minha Casa Minha Vida (MCMV). Se pretende que los resultados de este trabajo permitan discutir qué características o factores parecen afectar la eficiencia municipal en la implementación de las políticas públicas, a fin de proporcionar apoyo teórico y empírico a la investigación en el área. El programa Minha Casa Minha Vida, si se elige, forma el eje de Infraestructura Social y Urbana del Programa de Aceleración del Crecimiento (PAC). El trabajo fue estructurado en dos etapas: la primera es la clasificación de los municipios en grupos homogéneos; la segunda se refiere al relevamiento de la eficiencia relativa de los municipios en la implementación del MCMV, mediante la aplicación del análisis de envoltura de datos (DEA). Como resultado, identificamos que los municipios brasileños tienen diferentes patrones de estructuración. La mayoría de ellos fueron clasificados como mal estructurados o mínimamente estructurados. Podríamos observar en los datos analizados un patrón regional claro, donde el Sur y el Sudeste tienen municipios mejor estructurados en comparación con el Centro Oeste, el Norte y el Noreste. Al analizar la eficiencia relativa en el MCMV, considerando como universo solo los municipios que completaron proyectos del PMCMV entre 2012 y 2016, los municipios mejor estructurados también presentaron mejores resultados, lo que indica que las condiciones estructurales pueden ser determinantes del desempeño del programa. En contrapartida, el análisis regional presentó el Centro Oeste, Norte y Nordeste con más municipios eficientes en la implementación del programa.

Abstract: This research aims to evaluate the relative efficiency of Brazilian municipalities in the implementation of the Brazilian federal program for affordable housing Minha Casa Minha Vida (MCMV) program. The study discusses characteristics or factors that seem to affect municipal efficiency in policy implementation providing theoretical and empirical support to research in the area. The MCMV program is part of the Social and Urban Infrastructure axis of the Growth Acceleration Program (Programa de Aceleração do Crescimento - PAC). The work was divided into two stages. The first step is the classification of municipalities into homogeneous groups. The second refers to the municipalities' relative efficiency in the MCMV, through the application of data envelopment analysis (DEA). As a result, we identified that Brazilian municipalities have different structuring patterns. The majority of them were classified as poorly structured or minimally structured. In the analyzed data, we observed a clear regional pattern, where South and Southeast have more well-structured municipalities compared to the Central-west, North, and Northeast. By analyzing the relative efficiency in MCMV, considering as universe only municipalities that completed MCMV projects between 2012 and 2016, better-structured municipalities also presented better results, indicating that structural conditions may be determinants of program performance. In contrast, the regional analysis presented that Centralwest, North, and Northeast demonstrated efficient municipalities more often, on average, in implementing the program.

2．Response to COVID-19 from a Social Welfare Policy Perspective / 薬剤疫学

Novel coronavirus infection（COVID-19）is having a significant impact on diverse areas of society. We investigated the features of Japan's policies from the perspective of analogies used in social welfare policy and policy science. The results revealed that Japan's statistics do not represent reality； the government is unable to respond with world-class policies； the system is maintained through excessive workloads in the workplace； local governments adopt different directions to national policy； non-experts are confusing society； and other areas are affected due to the inability to implement concentrated investment and support. If we apply these findings to the current COVID-19 response, there are problems including statistical issues, an inability to respond with world-class policies, confusion of policy objectives and means of implementation, increased public opinion guidance that disregards human life, and the inability to adopt optimal measures due to a lack of resources, which worsened the situation and affected other areas. Therefore, it is presumed that insufficient care and compensation to individuals adversely affected by the social effects of COVID-19 would delay economic and social recovery. Accordingly, as a future response, we will present policies including establishment of a crisis management organization, accumulation of experience, and implementation of suitable statistical information to deal with infectious diseases that exceed a certain disaster level. We also recommend that preparations be implemented during normal times, rather than waiting until a crisis has occurred, and a system for finding and supporting people who have suffered due to these events should also be considered. All these issues can be resolved by politics. In other words, all of Japan's problems can be said to converge on the political arena； hence, it is predicted that the current society that excessively burdens its citizens will persist for a long time unless suitable policies are implemented through the political process.

Ouvidoria como instrumento de participação, controle e avaliação de políticas públicas de saúde no Brasil / Ombudsman as instrument of participation, control and evaluation of public health policies in Brazil

Resumo As Ouvidorias Públicas representam um avanço na Administração Pública brasileira no campo da gestão democrática. Nessa perspectiva, este artigo objetiva analisar a atuação da Ouvidoria-geral do SUS. Portanto, como a Ouvidoria-geral do Sistema Único de Saúde atua no âmbito das políticas de saúde? Para responder tal pergunta, foi realizada pesquisa documental utilizando relatórios gerenciais da Ouvidoria-Geral do SUS do Ministério da Saúde, produzidos entre 2010 e 2017. Para classificar a informação, utilizou-se como categorias de análise a participação, o controle social e a avaliação. Observou-se que a participação dos cidadãos-usuários do sistema de saúde via ouvidoria vem aumentando e consolidando-se. A Ouvidoria-Geral do Sistema Único de Saúde disponibiliza uma série de canais para a participação da cidadania, incluindo telefone e internet, que são atualmente as formas de participação mais acessadas. Instrumentos como Carta SUS, Lei de Acesso a Informação e manifestações do tipo "denúncia" permitem o exercício do controle social. A satisfação do usuário é uma vertente avaliativa pouco fomentada, demonstrando descontinuidade ou despriorização de ações nesse sentido. Assim, no campo da saúde, as ouvidorias permitem a participação cidadão, o controle social e o aprimoramento das políticas e serviços, sendo importante avançar ainda mais no seu desenvolvimento.

Abstract The Public Ombudsmen represent a breakthrough in the Brazilian Public Administration, in the democratic management field. In this perspective, this paper aims to analyze the performance of the Ombudsman-General of the Unified Health System. So, how does the Ombudsman-General of the Unified Health System act within the scope of health policies? To answer this question, it was conducted documentary research using management reports from the Department of Ombudsman-General of the Unified Health System of The Brazilian Health Ministry produced between 2010 and 2017. To classify the information, participation, social control and evaluation were used as categories of analysis. It was noted that the participation of citizens-users of Unified Health System via Ombudsman has been increasing and consolidating. The Ombudsman-General of the Unified Health System provides many channels for citizen participation, including telephone and internet which are currently the most accessed forms of participation. Instruments such as the SUS Letter, the Access to Information Law and "whistleblowing" manifestations allow the exercise of social control. User satisfaction is an evaluative aspect that is little promoted, demonstrating discontinuity or devaluation of this kind of action. Thus, in the health field, the ombudsman allow citizen participation, social control and the improvement of policies and services, and it is important to advance further in their development.

A comparison of ARIMA Model, BP Neural Network Model and combined model in health policy evaluation:An empirical study of public hospitals pricing reform / 中国卫生政策研究

Objective:To study the effectiveness of different time series models in the prediction of financial data in public hospitals,with the aim of obtaining a more reliable counterfactual in health policy evaluation. Methods:ARI-MA model,BP neural network and their combination were used for the estimation and prediction of drug revenue and medical service revenue based on a dataset for the period from November,2011 to October,2016 for hospital X before and after Nanjing medical pricing reform. Root mean square error (RMSE) was used to estimate the model accuracy. Results:RMSE of drug revenue from the three models were 692.82,501.44 and 380.80,and of medical service were 184.04,215.63 and 168.65. The findings shows that the combination model was proved to be the most efficient one a-mong the three. The combined model was used to calculate the net loss of drug revenue which was estimated to be 120, 440 million,and the net increase of medical service was estimated to be 185,326 million after the reform,which was 1. 539 times of the drug loss. Conclusions:The revenue data of public hospitals are usually complex with a both linear and non-linear trend. The combination model of ARIMA and BP neural network could solve the problem for once with an acceptable accuracy. However,ARIMA model is simpler to operate as compared to other two models, and also more consistent with the forecasting trend,therefore ARIMA is also recommended in the evaluation for health policies.

Políticas de Promoção de Equidade em Saúde para grupos vulneráveis: o papel do Ministério da Saúde / Equity Promotion Policies in Health for vulnerable groups: the role of the Ministry of Health

Resumo Este artigo analisa as Políticas de Promoção de Equidade em Saúde implementadas pelo Ministério da Saúde para grupos vulneráveis, através da Coordenação da Secretaria de Gestão Estratégia e Participativa, em decorrência de marcadores de raça, etnia, gênero e modo de vida. São identificados os três elementos estruturantes destas políticas: gestão participativa, transversalidade e sensibilização/qualificação profissional. Para a realização do trabalho foram consultadas diversas fontes documentais: políticas, vídeos, conferências, e atas de conselhos e comissões de saúde. Os resultados apontam aspectos virtuosos e lacunas no processo de implementação destas políticas. Revelam ainda que as tensões permanentes entre políticas de igualdade e políticas de equidade colocam desafios à garantia dos direitos à saúde destas populações. Por fim, ressalta-se que somente em sociedades democráticas estes direitos podem ser reconhecidos e assegurados.

Abstract This article aims to analyze Equity Promotion Policies in Health implemented by the Ministry of Health for vulnerable groups, through the Department of Strategy and Participative Management based on race, ethnicity, gender and lifestyle markers. The three structural elements of these policies are identified as: participatory management, transversality and awareness / professional qualifications. In carrying out research for this article, different documental sources were used including: policies, videos, conferences and minutes from council meetings as well as information from health committees. The results showed positive aspects and shortcomings in the implementation process of these policies. Also, they revealed that there are permanent tensions between equality policies and equity policies which pose challenges to guaranteeing the right to health of these populations. Finally, it can be reaffirmed that only in democratic societies can these rights be recognized and guaranteed.

A review on drug circulation policy in China: Based on stakeholder game theory / 中国卫生政策研究

The pharmaceutical circulation policy reform is the key link of the three medical linkage reform with a view of deepening medical reform.The policy formulation and implementation will inevitably lead to interest redistribution.Therefore, it is an effective means to comprehensively understand the unexpected results of the reform and the scientific decision-making of the policy direction, while ensuring the smooth progress of the reform.Based on the research literature presented on pharmaceutical circulation reform and policies since the new medical reform, this paper revealed the prevailing problems and limitations of the existing researches, demonstrated that policy evaluation based on the scientific theory framework is a powerful tool to judge whether the reform goals are achieved.With the introduction of the stakeholder theory and the game theory in pharmaceutical circulation policy evaluation, the complex influence factors can be quantified under scientific theoretical framework, so that the causal mechanism of the policy effect can be learnt, which can help to have a clearer interpretation of the pharmaceutical circulation reform policy, and to provide a scientific and reasonable reference for future policy direction.

Evaluation of the sodium intake reduction plan for a local government and evidence-based reestablishment of objectives: Case of the Seoul Metropolitan Government / 한국영양학회지

PURPOSE: To identify the effectiveness of policy evaluation, consistent monitoring is necessary. This study aimed to carry out mid-term evaluation of objectives and programs related to comprehensive plans for sodium intake reduction by 2020 for Seoul city and then reestablish the objectives of the sodium intake reduction plans. METHODS: Literature reviews, data analysis, and reviews of expert focus-groups were performed to evaluate objectives, to develop a new goal, and to identify the priority subjects of the sodium intake reduction programs. In order to examine target populations for the programs, awareness and behaviors related to sodium intakes among Seoul citizens were examined by sex, age, and income level using the 2008~2013 Korea National Health and Nutrition Examination Survey data. RESULTS: Current objectives of the sodium intake reduction plan by 2020 for Seoul city were not appropriate, so objectives were reset to 3,600 mg of sodium intake by 2020 among Seoul citizens with 2% reduction per year. Although sodium intake showed a decreasing trend by year, it was still high, especially in men. The sodium intake reduction programs currently in progress have not been assessed at multiple levels across multiple sectors and have only been assessed fragmentarily. For dietary behavior related to sodium intakes by sex, age, and income level, sodium intake was higher in the group with less than 100 g of fruit intake compared to the group with 100 g or more. Subjects aged 30~59 years and the low household income group showed relatively higher sodium intakes. Based on the data analysis and the expert review, the priority subject of the sodium intake reduction programs was determined to be adult men. In terms of a program strategy for sodium intake reduction, multi-level and setting approaches, including work sites, home, and restaurants, were suggested to reduce sodium intakes of the target subject. CONCLUSION: The suggested objectives should be consistently monitored by data analysis, and the determined programs need to be phased in over 5 years.

Monitoring and evaluation of the PAHO/WHO cooperation project, the Mais Médicos (More Doctors) Program: a mid-term assessment / Monitoramento e avaliação do Projeto de Cooperação da OPAS/OMS com o Programa Mais Médicos: reflexões a meio caminho

As relações de trabalho entre a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) e as instituições de saúde do Brasil têm uma longa história de cooperação com benefícios mútuos que, em muitos casos, foram compartilhados com outras nações sob diversos enfoques de cooperação entre os países para o desenvolvimento da saúde. Um marco nesta relação é a cooperação técnica prestada ao Programa Mais Médicos (PMM). Esta cooperação agrega valor estratégico na redução das lacunas em matéria de igualdade de saúde e capitaliza a natureza única da experiência de cooperação Sul-Sul entre Cuba e Brasil, triangulada através da OPAS/OMS. Este artigo discute o papel da OPAS/OMS na avaliação da sua cooperação técnica com o PMM. Foi desenvolvido um marco de monitoramento e avaliação, visando identificar progressivamente os avanços na cobertura e qualidade dos serviços de atenção básica proporcionados pelo Sistema Único de Saúde (SUS) por meio do PMM. Especial atenção foi dedicada à identificação das melhores práticas nos serviços de saúde, à análise dos resultados e impactos do PMM, e à gestão e divulgação dos conhecimentos produzidos pela sua implementação, através de plataforma de conhecimento. Alguns resultados relevantes do PMM são sinteticamente apresentados e discutidos.

Working relations between the Pan- American Health Organization/World Health Organization (PAHO/WHO) and Brazilian health institutions accumulated a long history of cooperation with mutual benefits, which in many cases were shared with other nations under various cooperation frameworks among countries for health development. A milestone in this relationship is the technical cooperation provided by PAHO/WHO to the More Doctors Program (Programa Mais Médicos - PMM). This cooperation has added both strategic value in reducing gaps in health equality and has capitalized on the unique nature of the Cuba-Brazil South-South cooperation experience, triangulated through PAHO/WHO. This paper discusses PAHO/WHO’s role in the evaluation of its technical cooperation within PMM. A Monitoring and Evaluation (M&E) Framework has been developed in order to progressively identify the advances in coverage and quality of primary health care provided by the Unified Health System (Sistema Único de Saúde - SUS) through the PMM. Special attention was given to identify best practices in health services, to analyze results and impacts of the PMM, and to manage and share knowledge that has been produced by its implementation, through a web-based knowledge platform. Some relevant results of PMM are briefly presented and discussed.

Impact of health research on advances in knowledge, research capacity-building and evidence-informed policies: a case study on maternal mortality and morbidity in Brazil / Impacto da pesquisa em saúde nos avanços de conhecimento, construção de capacidades de pesquisa e políticas informadas por evidências: um estudo de caso sobre a morbimortalidade materna no Brasil

ABSTRACT: CONTEXT AND OBJECTIVE: National health research systems aim to generate high-quality knowledge so as to maintain and promote the population's health. This study aimed to analyze the impact of maternal mortality/morbidity research funded by the Brazilian Ministry of Health and institutional partners, on the dimensions: advancing in knowledge, research capacity-building and informing decision-making, within the framework of the Canadian Academy of Health Sciences. DESIGN AND SETTING: Descriptive study based on secondary data, conducted at a public university. METHODS: The advancing in knowledge dimension was estimated from the principal investigators' publication counts and h-index. Data on research capacity-building were obtained from the Ministry of Health's information system. The informing decision-making dimension was analyzed from citations in Stork Network (Rede Cegonha) documents. RESULTS: Between 2002 and 2010, R$ 21.6 million were invested in 128 maternal mortality/morbidity projects. Over this period, the principal investigators published 174 articles, resulting in an h-index of 35, thus showing progress in the advancing in knowledge dimension. Within the research capacity-building dimension, training of 71 students (undergraduate/postgraduate) was observed. Progress in the informing decision-making dimension was modest: 73.5% of the 117 citations in the Stork Network documents were institutional documents and norms. One of the projects funded, the 2006/7 National Demography and Health Survey, was cited in program documents. CONCLUSION: Impacts were shown in the advancing in knowledge and research capacity-building dimensions. The health research system needs to incorporate research for evidence-informed policies.

RESUMO: CONTEXTO E OBJETIVO: Sistemas nacionais de pesquisa em saúde buscam gerar conhecimentos de qualidade para manter e promover a saúde da população. Este estudo visou analisar o impacto das pesquisas sobre morbimortalidade materna financiadas pelo Ministério de Saúde do Brasil e instituições parceiras, nas dimensões: avanços no conhecimento, construção de capacidade de pesquisa e tomada de decisão informada, da matriz da Canadian Academy of Health Sciences. DESENHO DO ESTUDO E LOCAL: Estudo descritivo baseado em dados secundários, realizado em universidade pública. MÉTODOS: A dimensão avanços no conhecimento foi estimada pelas publicações dos coordenadores de pesquisa e índice h. Dados sobre a capacidade de pesquisa foram obtidos no sistema de informação do Ministério da Saúde. A dimensão tomada de decisão informada foi analisada pelas citações nos documentos da Rede Cegonha. RESULTADOS: Foram investidos R$ 21,6 milhões de reais em 128 pesquisas sobre morbimortalidade materna entre 2002 e 2010. Nesse período, os coordenadores das pesquisas publicaram 174 artigos, resultando no índice h de 35, mostrando progressos na dimensão avanços no conhecimento. Na dimensão capacidade de pesquisa, foi constatado o treinamento de 71 estudantes (graduação e pós-graduação). Na dimensão tomada de decisão informada, o progresso foi modesto: 73,5% das 117 citações nos documentos da Rede Cegonha eram documentos institucionais e normas. Um dos projetos financiados, Pesquisa Nacional de Demografia e Saúde 2006/7, foi citado em documentos programáticos. CONCLUSÃO: Impactos foram demonstrados nas dimensões avanços no conhecimento e capacidade de pesquisa. O sistema de pesquisa em saúde necessita da incorporação de pesquisas para políticas informadas por evidências.

Assessment and rational thinking of “Bidding Group” in Chinese centralized drug procure-ment system / 中国卫生政策研究

In 2015 , policy reforms on centralized drug purchasing system have been released one by one , and the quality of medicines has been highly valued .Centralized drug purchasing system distinguishes different qualities of drugs mainly through bidding grouping , in order to achieve “uality priority”.However , there are yet some existing problems in group bidding policy at present , such as lack of a unified hierarchy , no scientific indicators and so on , which inevitably weaken the leading role of centralized purchasing policy over the quality of medicines .This paper , focuses on the study of group bidding , and the existing main problems are found through the statistical analysis of rel-evant policies introduced in different provinces .Finally, it explores some optimization strategies for “Group Bidding”which is of paramount importance .

Considerações sobre a acessibilidade nos Centros de Atenção Psicossocial no Brasil / Considerations regarding access to Community Psychosocial Centers in Brazil

ResumoO objeto do artigo é a análise da implantação dos serviços comunitários no contexto regional. O artigo descreve o padrão de acesso aos Centros de Atenção Psicossocial (CAPS II) no Estado do Rio de Janeiro na atual década. A partir dos resultados de um inquérito transversal foram identificadas diferentes categoriais de usuários dos serviços comunitários. O artigo recorre ao modelo teórico do isomorfismo organizacional para problematizar a condição de implantação em diferentes contextos municipais. O artigo demonstra que, independente do contexto local, é bastante discrepante a escala de responsabilização dos novos serviços com os usuários, especialmente aqueles saídos de internações de longa permanência ou ainda internados. Conclui que a análise de diferentes categorias de utilização permite problematizar as barreiras de acesso aos serviços comunitários. A identificação destas aos CAPS II pode contribuir para a reflexão crítica sobre a política de saúde mental brasileira atual.

AbstractThe scope of this article is to analyze the implementation of community mental health services in the regional context in Brazil. The article describes the issue of access to community psychosocial centers (CAPS II) in the State of Rio de Janeiro in this decade. By means of a cross-sectional survey, different categories of users of community services were identified. The theoretical models of organizational isomorphism and innovation and diffusion of policies were applied to discuss the adoption and development of community mental health services in different municipal contexts. The article highlights the fact that, irrespective of the local context, there is a considerable discrepancy between the scale of commitment of community mental health to new patient services, especially for those coming out of long-stay hospitalizations or who are still hospitalized. It concludes that the analysis of different categories of users makes it possible to study the problem of barriers of access to community services. The identification of barriers to access CAPS II can contribute to a critical reflection on the current Brazilian mental health policy.

Call for a change in research funding priorities: the example of mental health in Costa Rica / Solicitud de un cambio en las prioridades de financiamiento de la investigación: el ejemplo de la salud mental en Costa Rica

The World Health Organization (WHO) Mental Health Action Plan 2013-2020 urges its Member States to strengthen leadership in mental health, ensure mental and social health interventions in community-based settings, promote mental health and strengthen information systems, and increase evidence and research for mental health. Although Costa Rica has strongly invested in public health and successfully reduced the burden of nutritional and infectious diseases, its transitional epidemiological pattern, population growth, and immigration from unstable neighboring countries has shifted the burden to chronic disorders. Although policies for chronic disorders have been in place for several decades, mental disorders have not been included. Recently, as the Ministry of Health of Costa Rica developed a Mental Health Policy for 2013-2020, it became evident that the country needs epidemiological data to prioritize evidence-based intervention areas. This article stresses the importance of conducting local epidemiological studies on mental health, and calls for changes in research funding priorities by public and private national and international funding agencies in order to follow the WHO Mental Health Action Plan.

El Plan de Acción sobre Salud Mental 2013-2020 de la Organización Mundial de la Salud (OMS) insta a sus Estados Miembros a que fortalezcan el liderazgo en el ámbito de la salud mental, garanticen las intervenciones de salud mental y asistencia social en los entornos comunitarios, promuevan la salud mental y fortalezcan los sistemas de información, e incrementen los datos científicos y las investigaciones sobre salud mental. Aunque Costa Rica ha invertido mucho en salud pública y ha reducido con éxito la carga de enfermedades nutricionales e infecciosas, su modelo epidemiológico transitorio, el crecimiento de la población y la inmigración desde países vecinos inestables han desplazado la carga de morbilidad hacia los trastornos crónicos. Aunque existen políticas en vigor dirigidas a los trastornos crónicos desde hace varios decenios, no se ha incluido en ellas a los trastornos mentales. Recientemente, cuando el Ministerio de Salud de Costa Rica elaboró una Política Nacional de Salud Mental para el periodo del 2013 al 2020, se hizo evidente que el país necesita datos epidemiológicos para priorizar las áreas de intervención con base en pruebas científicas. Este artículo subraya la importancia de llevar a cabo estudios epidemiológicos de ámbito local sobre salud mental, y solicita cambios en las prioridades de financiamiento de la investigación por parte de los organismos de financiamiento públicos y privados, nacionales e internacionales, con objeto de cumplir con lo que establece el Plan de Acción sobre Salud Mental de la OMS.

Progress and bottlenecks of family doctor system in Shanghai / 中国卫生政策研究

Shanghai began to strengthen the community health service system in 1997 , and had officially en-tered the period of “connotation construction” with the core policy of family doctor system in 2011 after the period of“service framework and network establishment” and“operational mechanism reform”. Through summarizing the poli-cy files related the family doctor system and based on 2013 report on monitoring and evaluation of family doctor system in Shanghai, the paper presented the progress of the system from aspects of system coverage, signature relationship, service mode and operational mechanism, and analyzed the development bottlenecks of the system from aspects of the policy itself, service principal, service supervision and service objects. Finally, the paper proposed some suggestions in order to give some references for further development of national general practitioner system.

Avaliação do impacto da política de incentivos fiscais ao setor automotivo sobre a mortalidade por acidente de motocicleta / Evaluation of the impact of the fiscal incentives policy on the automotive sector on motorcycle accident mortality

Este trabalho objetivou avaliar o impacto da política de incentivos fiscais ao setor automotivo sobre a mortalidade por acidentes de motocicleta em Pernambuco, entre 2003 e 2011. Através do método de controle sintético foi obtido um contrafactual para a evolução da taxa de mortalidade por acidente de motocicleta, tendo em vista a impossibilidade de observar as taxas de mortalidade por esses acidentes na presença e ausência da política, lançando-se mão das demais causas de mortalidade por causas externas. Os resultados apontam para um crescimento da taxa de mortalidade por acidente de motocicleta, expressando aumento significativo após a implantação da política no final de 2008. Após a intervenção é evidente a divergência com que a evolução segue entre as taxas de motocicleta e sua causa sintética evidenciando o expressivo crescimento das mortes no estado. As demais causas utilizadas como controle apresentam-se seguindo a tendência que seria esperada caso não tivesse ocorrido a intervenção. Portanto, tal disparidade sugere o efeito negativo da política sobre a mortalidade em Pernambuco. As pessoas mais atingidas foram jovens do sexo masculino, com baixa escolaridade e da cor parda. Políticas econômicas pontuais, que gerem um aumento no número de motocicletas circulantes sem que políticas públicas de melhorias das vias e ações intersetoriais de promoção e prevenção a saúde sejam efetivadas, contribuirão para o aumento das mortes no trânsito causadas por motocicletas.(AU)

This study evaluated the impact of the policy of fiscal incentives to the automotive sector on mortality motorcycle accidents between 2003 and 2011. Through the method of synthetic control was obtained a counterfactual for the evolution of mortality rates by motorcycle accident, having in view the impossibility to observe mortality rates by these accidents, in the presence and absence of politics, launching hand from other causes of mortality from external causes. To construct the synthetic procedures employed the remaining causes of death by external factors, other motorcycle accidents. The results indicate a growth rate of mortality from motorcycle accident, expressing significant increase after the implementation of the policy in late 2008. The other causes used as control are shown following the trend that would be expected if the intervention had not taken place. Therefore, such disparity suggests the negative effect of politics on mortality in Pernambuco. People most affected were young males with low schooling and brown color. Individual economic policies that generate an increase in the number of circulating motorcycles without public policies for improvements of roads and intersectoral health promotion and prevention to take effect, will contribute to the increase in traffic deaths caused by motorcycles.(AU)

Evidences to validate public policies: a review with an international research perspective / Evidencia para validar políticas públicas: una revisión con perspectiva internacional

Nutrition and related health issues are nowadays topics of general interest. The prevalence of overweight and obesity has increased with alarming speed over the past twenty years, being described by the World Health Organization as a global epidemic. An evidence-based approach to public health interventions should be based on the best available information. Given the substantial investment of society in fundamental and applied health research, and the high expectations of society for reducing the burden of illness, attention to these matters should have high priority. There's an urgent need to foster the development of international standards, such as food labeling and profiling. Considering the complex network involved in obesity development, it is necessary to promote multiple-concurrent interventions, taking into account that by focusing on a single intervention in isolation, all other factors being constant, each individual policy change is likely to appear ineffective.

El sobrepeso y la obesidad, hoy definidos por la Organización Mundial de la Salud (OMS) como una epidemia global, son un importante problema de salud pública internacional. Su rápida propagación no sólo afecta a los países desarrollados, sino también a los que están en desarrollo, los cuales enfrentan la doble problemática de la desnutrición y el sobrepeso. Dada la importancia de la investigación sanitaria y las grandes expectativas de la sociedad para reducir el impacto de esta enfermedad, la atención de estos asuntos debe ser prioritaria. Existe una necesidad urgente de fomentar el desarrollo de normas internacionales como el etiquetado de alimentos y la elaboración de perfiles. No obstante, al igual que sucede con la medicina individual, los enfoques para intervenir en la salud pública han de fundamentarse en la mejor evidencia disponible. En el caso específico de la obesidad, puesto que se trata de una red compleja de factores, es indispensable promover intervenciones simultáneas. Lo contrario podría derivar en políticas individuales que no logren resultados eficaces. Este artículo propone, desde un punto de vista basado en las evidencias actuales sobre la obesidad y su desarrollo, una nueva perspectiva internacional para enfrentar esta epidemia.

Perfil dos bolsistas de produtividade em pesquisa do CNPQ em Psicologia / Profile of researchers in Psychology with productivity grants from Brazil's national council of technologiocal and scientific development (CNPQ) / Perfil de los becarios de productividad en investigación del CNPQ en Psicología

Este estudo teve por objetivo analisar o perfil dos bolsistas de produtividade em pesquisa do CNPq da área de Psicologia segundo os dados declarados na Plataforma Lattes. O número de artigos, livros e capítulos de livro, bem como orientações de iniciação científica, mestrado, doutorado e pósdoutorado de 297 pesquisadores bolsistas da área foram coletados no decorrer da última semana de abril de 2011. Também foram coletados dados acerca das instituições às quais os bolsistas estão vinculados. Foram realizadas análises estatísticas descritivas (levantamento de frequências, médias e desvios-padrão) para caracterização da produtividade da amostra, e inferenciais (qui-quadrado e ANOVA) para comparar os bolsistas de cada categoria em relação ao número de publicações e de orientações e de dados demográficos e institucionais. Os resultados mostram que houve predomínio do sexo feminino (63%) e da bolsa tipo 2 (58,6%) entre os bolsistas. A maioria dos bolsistas está vinculada atualmente a instituições públicas (79,1%). A Região Sudeste apresentou o maior número de bolsistas (53,6%), seguida da Região Sul (18,5%). Pesquisadores com bolsas de categorias mais altas (1A e 1B) apresentaram médias significativamente maiores quanto à produção de artigos, livros e capítulos de livro bem como ao número de orientações concluídas. As implicações e as limitações do estudo são discutidas.

The present work aimed to analyze the profile of researchers in psychology with productivity grants from Brazil's National Council of Technological and Scientific Development (CNPq), according to the information collected at the website called Lattes Platform. Numbers of papers, book chapters and books, as well as undergraduate, master and doctoral students' orientations were raised considering 297 researchers with productivity grants. This survey was conducted in the last week of April 2011. Information from the institutions where the researchers work were also collected. Descriptive analyses were held (frequencies, means and standard deviation of the study variables) to characterize the level of productivity of the sample, and inferential analyses were also conducted (Chi-square and ANOVA) to compare the productivity grants researchers of each category in what refers to the number of publications, orientations, social demographical data and institutional characteristics. The results showed the female gender (63%) and the grant type 2 (58,6%) were majority among productivity grants researchers. The majority of researchers works at public institutions (79,1%). The Southeast showed the major number of productivity researchers (53,6%), followed by the South (18,5%). Researchers with grants type 1A e 1B, which means high categories, presented significant higher means of papers, books and book chapters publications, as well as finished students' orientations. The results implications and the study limitations are discussed.

Este estudio tuvo como objetivo analizar el perfil de los becarios de productividad en investigación del CNPq del área de psicología según los datos declarados en la Plataforma Lattes. El número de artículos, libros y capítulos de libro, así como orientaciones de iniciación científica, maestría, doctorado y pos doctorado de 297 investigadores becarios del área fueron recolectados en el transcurso de la última semana de abril de 2011. También fueron recolectados datos acerca de las instituciones a las cuales los becarios están vinculados. Fueron realizados análisis estadísticos descriptivos (relevamiento de frecuencias, promedios y desviación estándar) para caracterización de la productividad de la muestra, e inferenciales (Ji-cuadrado y ANOVA) para comparar los becarios de cada categoría en relación al número de publicaciones y de orientaciones y de datos demográficos e institucionales. Los resultados muestran que hubo predominio del sexo femenino (63%) y de la beca tipo 2 (58,6%) entre los becarios. La mayoría de los becarios están vinculados actualmente a instituciones públicas (79,1%). La Región Sudeste presentó el mayor número de becarios (53,6%), seguida de la Región Sur (18,5%). Investigadores con becas de categorías más altas (1A y 1B) presentaron promedios significativamente mayores en relación a la producción de artículos, libros y capítulos de libro así como al número de orientaciones concluidas. Las implicaciones y las limitaciones del estudio son discutidas.