Educación para la salud y justicia social basada en el enfoque de las capacidades: Una oportunidad para el desarrollo de la salud pública / Education for health and social justice based on the focus on capabilities: An opportunity for public health development

Resumen Se presenta una investigación teórica sobre la educación para la salud, la cual se propone desde una perspectiva emancipadora y constituye una oportunidad para promover la salud en las comunidades porque permite explicitar una concepción de justicia social. La visión de justicia social que se plantea en este artículo está centrada el enfoque de las capacidades que se entienden como un conjunto de oportunidades reales para que las personas tengan la vida que valoran. Este enfoque es pertinente para el trabajo en salud pública porque está centrado en el desarrollo humano, permite incorporar al sujeto en relación dialéctica con la sociedad y se enfoca en las oportunidades reales. Se consideran las diferencias entre las corrientes de salud pública para entender la justicia social y la relevancia de una concepción de salud que permita trascender el abordaje biomédico centrado en la enfermedad. Se reconoce la importancia de avanzar hacia un desarrollo pedagógico de la educación para la salud que supere la perspectiva de educación centrada en los cambios de comportamiento, para entenderla como un proceso social y político con base humanista emancipadora como oportunidad para la construcción de la salud pública.

Abstract Theoretical research on health education is presented, which is proposed from an emancipatory perspective and constitutes an opportunity to promote health in communities because it makes it possible to explain a concept of social justice. The vision of social justice that is put forward in this article is focused on the capabilities that are understood as a set of real opportunities for people to achieve the life they aspire to. This approach is relevant for public health work because it is centered around human development, allows the subject to be incorporated into a dialectical relationship with society and focuses on real opportunities. The differences between public health approaches are considered to understand social justice and the relevance of a health concept that makes it possible to transcend the biomedical approach focused on disease. The importance of advancing towards a pedagogical development of health education that exceeds the perspective of education focused on behavioral changes is acknowledged, in order to understand it as a social and political process with an emancipatory humanist base as an opportunity for the construction of public health.

Sistemas públicos de ensino fundamental e a perpetuação da desigualdade: democracia e qualidade educacional como promotoras de justiça social / Sistemas públicos de enseñanza básica y la perpetuación de la desigualdad: democracia y calidad educacional como promotoras de la justicia social / Public Elementary School Systems and the continuation of inequality: democracy and quality of education as a social justice promoter

A educação restringe/amplia as oportunidades econômicas do indivíduo durante seu ciclo de vida. O sistema educacional de um país ou região tem papel fundamental na geração de igualdade de oportunidades. O artigo investiga os sistemas de ensino público (municipal e estadual) no Brasil e sua relação com a desigualdade. Os entes federados mais desiguais têm sistemas educacionais menos eficazes em prover ensino de qualidade, contudo, um maior nível de democracia aumenta esta eficácia. As desigualdades de riqueza, cor e nível sociocultural da família afetam o desempenho do indivíduo, independentemente da qualidade escolar, o que justifica políticas focalizadas que promovam igualdade de oportunidade por meio da educação.

La educación restringe/amplía las oportunidades económicas del individuo durante su ciclo de vida. El sistema educacional de un país o región tiene un papel fundamental en la generación de igualdad de oportunidades. El artículo investiga los sistemas de enseñanza pública (municipal y estatal) en Brasil y su relación con la desigualdad. Los entes federados más desiguales tienen sistemas educacionales menos eficaces en proveer una enseñanza de calidad, sin embargo, un mayor nivel de democracia aumenta esta eficacia. Las desigualdades de riqueza, color y nivel sociocultural de la familia afectan el desempeño del individuo, independientemente de la calidad escolar, lo que justifica políticas centradas en la promoción de la igualdad de oportunidades mediante la educación.

Education restricts/expands individuals´ economic opportunities during their life cycles. The educational system of a country or region has an essential role in the generation of equal opportunities. The present article investigates the public teaching systems (municipal and state) in Brazil and their relationship with inequality. More unequal states of the federation have less effective educational systems in the provision of quality teaching. However, a higher level of democracy increases efficacy. Inequalities in the health, color and sociocultural level of a family affect an individual´s performance, regardless of the quality of the school, which is the rationale for policies focused on promoting equal opportunities through education.

Through service learning to provide social justice

In Pakistan there are 3.3 Million child laborers without healthcare services and educational opportunities, which affect our social fabric. We report how structured 'Service Experience' helped broaden medical students understanding of social justice. To produce health professionals who are ready to work for a cause without voracity. A Cross sectional survey through a focal group discussion. Do opportunities for structured Service Learning help modify student's perception of their role as doctors in society? Foundation University Medical College, Islamabad. Fifteen months, from January 2008-April 2009. Fifteen students interviewed 700 child laborers using a piloted interview form during a fifteen months period. Focus group discussions were held with these students to discuss their experiences. Qualitative analysis of the discussion is reported. Students empathized that children worked on a contractual basis averaging $1 per 10 hours with no meals. Parents encouraged them to earn money and they felt more satisfied pleasing them. Children didn't attend school because of the school quality and fear of abuse. "Our exposure to child labor had been limited; this has taken us to the core of the issue. We now feel responsible as a physician and a leader to ensure 'security of children in every respect' as part of their health." "We will avoid employing children at our homes and will council parents, trying to be role models for others." "As future leaders we will propose measures including establishment of free quality educational systems with paid vocational tracks." Service learning will inculcate empathy for the oppressed groups of the community and also develop a social and civic responsibility in medical students