ABSTRACT
Resumo Nesta entrevista, Sonia Guajajara, coordenadora executiva da Articulação dos Povos Indígenas do Brasil (APIB), aborda as análises e estratégias desenvolvidas pelo movimento indígena para o enfrentamento da pandemia da COVID-19. Entre os pontos destacados, estão as estratégias de comunicação, vigilância e monitoramento da COVID-19, o apoio aos territórios indígenas, as iniciativas no Legislativo e no Judiciário, a incidência internacional e a articulação com a academia. Torna-se evidente o importante protagonismo do movimento indígena nas ações de contenção da emergência sanitária e na defesa dos direitos dos povos indígenas, em uma conjuntura de embate com o governo federal e de retrocessos nas políticas públicas.
Abstract In this interview, Sonia Guajajara, the executive coordinator of the Brazil's Indigenous Peoples Articulation (APIB), addresses the analyzis and strategies developed by the Indigenous movement to face the COVID-19 pandemic. Among other topics, she highlights some of the movement's strategies concerning communication, surveillance, and the monitoring of COVID-19, as well as its actions to support Indigenous territories, the initiatives carried out in the Legislative and Judiciary realms, the movement's international incidence, and its articulation with academia. Sonia shows the important role played by the Indigenous movement to control the health emergency and to defend the rights of the Indigenous peoples, in the framework of intense conflicts with the federal government and setbacks in public policies.
ABSTRACT
In this interview, Sonia Guajajara, the executive coordinator of the Brazil's Indigenous Peoples Articulation (APIB), addresses the analyzis and strategies developed by the Indigenous movement to face the COVID-19 pandemic. Among other topics, she highlights some of the movement's strategies concerning communication, surveillance, and the monitoring of COVID-19, as well as its actions to support Indigenous territories, the initiatives carried out in the Legislative and Judiciary realms, the movement's international incidence, and its articulation with academia. Sonia shows the important role played by the Indigenous movement to control the health emergency and to defend the rights of the Indigenous peoples, in the framework of intense conflicts with the federal government and setbacks in public policies.
Nesta entrevista, Sonia Guajajara, coordenadora executiva da Articulação dos Povos Indígenas do Brasil (APIB), aborda as análises e estratégias desenvolvidas pelo movimento indígena para o enfrentamento da pandemia da COVID-19. Entre os pontos destacados, estão as estratégias de comunicação, vigilância e monitoramento da COVID-19, o apoio aos territórios indígenas, as iniciativas no Legislativo e no Judiciário, a incidência internacional e a articulação com a academia. Torna-se evidente o importante protagonismo do movimento indígena nas ações de contenção da emergência sanitária e na defesa dos direitos dos povos indígenas, em uma conjuntura de embate com o governo federal e de retrocessos nas políticas públicas.
Subject(s)
COVID-19 , Indigenous Peoples , Female , Humans , Federal Government , Pandemics , Public PolicyABSTRACT
Analisa histórias sobre a saúde indígena por meio de narrativas dos próprios indígenas que apresentam a temática da saúde a partir de seis olhares, memórias e experiências. Traz relatos de conquistas, retrocessos e desafios nas lutas dos movimento e na implementação da saúd einídgena, considerando as realidades específicas e diferenciadas vividas por esses povos.
Subject(s)
Health of Indigenous Peoples , Indigenous Peoples , CultureABSTRACT
Apresenta os contextos e atores no cenário da (in)visibilidade da saúde indígena, as trajetórias e articulações na formulação do subsistema.
Subject(s)
Health of Indigenous Peoples , Indigenous Peoples , Health Services, Indigenous , Health Policy , Indians, South American , BrazilABSTRACT
Given the challenges related to reducing socio-economic and health inequalities, building specific health system approaches for Indigenous peoples is critical. In Brazil, following constitutional reforms that led to the universalization of health care in the late 1980s, a specific health subsystem was created for Indigenous peoples in 1999. In this paper, we use a historical perspective to contextualize the creation of the Indigenous Health Subsystem in Brazil. This study is based on data from interviews with Indigenous and non-Indigenous subjects and document-based analysis. In the 1980s, during the post-dictatorship period in Brazil, the emergence of Indigenous movements in the country and the support for pro-Indigenous organizations helped establish a political agenda that emphasized a broad range of issues, including the right to a specific health policy. Indigenous leaders established alliances with participants of the Brazilian health reform movement, which resulted in broad debates about the specificities of Indigenous peoples, and the need for a specific health subsystem. We highlight three main points in our analysis: (1) the centrality of a holistic health perspective; (2) the emphasis on social participation; (3) the need for the reorganization of health care. These points proved to be convergent with the development of the Brazilian health reform and were expressed in documents of the Indigenist Missionary Council (CIMI) and the Union of Indigenous Nations (UNI). They were also consolidated in the final report of the First National Conference on the Protection of Indigenous Health in 1986, becoming the cornerstone of the national Indigenous health policy declared in 1999. Our analysis reveals that Indigenous people and pro-Indigenous groups were key players in the development of the Indigenous Health Subsystem in Brazil.
Subject(s)
Health Care Reform , Health Policy , Brazil , Delivery of Health Care , Humans , Population GroupsSubject(s)
Coronavirus Infections , Hunger , Indigenous Peoples , Pandemics , Pneumonia, Viral , Betacoronavirus , Brazil , COVID-19 , Food Supply , Humans , Psychometrics , SARS-CoV-2ABSTRACT
This paper analyses the relationship between studies on the health of indigenous people in public health and public policies aimed at reducing ethnic-racial inequalities. This selection assumes that scientific production on the subject is part of the societal effort to confront health inequities and guarantee the rights and public policies of indigenous people. In total, 3,417 papers were found between 1956 and 2018, and 418 were selected for analysis from systematic literature mapping in the PubMed/Medline, Scopus, Lilacs, Sociological Abstract, and Web of Science databases. Initially, the literature is marked by the biomedical benchmark. After 1990, publications and dialogue with the human and social sciences are expanded, including the analysis of the implementation of indigenous health policy. We identified that the knowledge produced is associated with the political, social, and scientific transformations of the health reform and the indigenous agenda. Scientific production increased in 2010. We can conclude that the knowledge guiding the scientific production on indigenous health was established from a horizon politically implicated with the studied populations and improved Indigenous Health Subsystem.
Subject(s)
Health Care Reform , Health Services, Indigenous , Health Policy , Humans , Indigenous Peoples , Population GroupsSubject(s)
Humans , Pneumonia, Viral , Hunger , Coronavirus Infections , Pandemics , Indigenous Peoples , Psychometrics , Brazil , Food Supply , Betacoronavirus , SARS-CoV-2 , COVID-19ABSTRACT
Resumo Embora a Constituição Federal de 1988 assegure aos povos indígenas o direito às políticas sociais, a saúde permanece um campo de tensão no trato desses povos com o Estado. Muito se tem defendido a necessidade de garantir a diretriz de participação no Sistema Único de Saúde e a inserção dos indígenas nos mecanismos de controle social. Dessa forma, este trabalho busca contribuir com o debate sobre os sentidos da participação e refletir sobre os desafios da sua configuração como controle social no âmbito da saúde indígena. A análise foi feita com base nos relatórios das conferências de saúde, na bibliografia afeita ao tema e em entrevistas realizadas com atores-chave. A pesquisa buscou lançar luz sobre a diversidade dos contextos, dos atores e das pautas das cinco conferências de saúde indígena realizadas. Concluímos que houve um deslocamento na participação nas conferências para uma atuação mais burocrática dentro dos estritos limites estabelecidos pela gestão. Ainda assim, é fundamental valorizarmos a potência contida nos mecanismos do controle social, que não à toa são objetos de combate dos grupos mais conservadores da sociedade. Neste sentido, há que se valorizar tais espaços, ocupá-los e transformá-los.
Abstract Even though the Federal Constitution of 1988 guarantees indigenous peoples the right to social policies, health care remains a field of tension in their relationship with the State. The need to ensure a participation guideline for the Brazilian National Health System and the inclusion of indigenous people in mechanisms of social control are widely defended. Thus, this article seeks to discuss the meanings of participation and reflect on the challenges of its configuration as social control within the scope of indigenous health. The analysis was based on health conference reports, bibliography related to the subject, and interviews with key actors. The research sought to shed light on the diversity of contexts, actors, and agendas involved in the five indigenous health conferences. We concluded that there was a shift in the conferences and their participation, which moved towards a more bureaucratic performance within the strict boundaries established by the government. Even so, it is essential to value the power contained in the mechanisms of social control, which not coincidentally are the objects of disputes brought forward by the most conservative groups in society. In this sense, it is necessary to value, occupy, and transform these spaces.
Subject(s)
Humans , Male , Female , Social Control, Formal , Unified Health System , Health Conferences , Health of Indigenous Peoples , Social Participation , Socioeconomic Rights , Right to HealthABSTRACT
Resumo Este artigo analisa as relações entre os estudos sobre a saúde dos povos indígenas na saúde coletiva e as políticas públicas voltadas para redução das desigualdades étnico-raciais. Tal recorte parte do pressuposto de que a produção científica sobre o tema integra o esforço societário de enfrentamento das iniquidades em saúde e garantia dos direitos e políticas públicas em saúde dos povos indígenas. A partir de mapeamento sistemático da literatura nas bases Pubmed/Medline, SCOPUS, Lilacs, Sociological Abstract e Web of Science, foram localizados 3.417 artigos entre 1956 a 2018 e selecionados 418 para análise. Inicialmente a literatura é marcada pelo referencial biomédico, mas após 1990 amplia-se o número de publicações e o diálogo com as ciências humanas e sociais, incluindo a análise da implementação da política de saúde indígena. Identifica-se que o conhecimento produzido está associado às transformações políticas, sociais e científicas da reforma sanitária e da pauta indigenista. A partir de 2010 há um aumento da produção científica. Conclui-se que o conhecimento que baliza a produção científica sobre saúde indígena foi se constituindo a partir de um horizonte politicamente implicado com as populações estudadas e o aprimoramento do Subsistema de Saúde Indígena.
Abstract This paper analyses the relationship between studies on the health of indigenous people in public health and public policies aimed at reducing ethnic-racial inequalities. This selection assumes that scientific production on the subject is part of the societal effort to confront health inequities and guarantee the rights and public policies of indigenous people. In total, 3,417 papers were found between 1956 and 2018, and 418 were selected for analysis from systematic literature mapping in the PubMed/Medline, Scopus, Lilacs, Sociological Abstract, and Web of Science databases. Initially, the literature is marked by the biomedical benchmark. After 1990, publications and dialogue with the human and social sciences are expanded, including the analysis of the implementation of indigenous health policy. We identified that the knowledge produced is associated with the political, social, and scientific transformations of the health reform and the indigenous agenda. Scientific production increased in 2010. We can conclude that the knowledge guiding the scientific production on indigenous health was established from a horizon politically implicated with the studied populations and improved Indigenous Health Subsystem.
Subject(s)
Health Care Reform , Health Services, Indigenous , Population Groups , Indigenous Peoples , Health PolicySubject(s)
Humans , Ethnicity , Health , Communication , Cultural Diversity , Socioeconomic Factors , Public Policy , Social Justice , Women , Black People , Indigenous Peoples , Sexual and Gender MinoritiesABSTRACT
RESUMO Em 23 de setembro de 1999, foi aprovada a criação do subsistema de saúde indígena no âmbito do Sistema Único de Saúde. Neste trabalho, analisamos as bases discursivas de convergência e conflitos entre discursos indigenistas e da Reforma Sanitária, que nos permitem refletir sobre esse processo que consideramos configurar uma 'longa' Reforma Sanitária indígena. Utilizamos como referencial teórico a perspectiva da teoria de Stephen Ball, para analisar documentos produzidos por atores indigenistas (Fundação Nacional do Índio - Funai, Conselho Indigenista Missionário - Cimi e União das Nações Indígenas - UNI) e pelo Movimento da Reforma Sanitária. Apontamos evidências da utilização por indígenas e indigenistas dos argumentos e das propostas da Reforma Sanitária, e, por outro lado, o envolvimento estratégico de Sergio Arouca nos debates da saúde indígena. Os pontos de convergência se localizam principalmente na crítica ao modelo biomédico, à aproximação das propostas da atenção primária e do conceito ampliado de saúde. Os conflitos se relacionaram principalmente quanto à operacionalização do subsistema, mas o discurso indigenista, contrário à municipalização, encontrou na distritalização uma proposta legitimada na Reforma Sanitária.
ABSTRACT On September 23, 1999, the indigenous health subsystem was created within the scope of the Unified Health System. In this work, we analyze the discursive bases of convergence and conflicts between indigenist discourses and the health reform, which allow us to reflect on this process which we consider a 'long' indigenous health reform. We used as reference the perspective of Stephen Ball's theory, to analyze documents produced by indigenist actors (National Indian Foundation - Funai, Indian Missionary Council - Cimi and Union of Indigenous Nations - UNI) and the Health Reform Movement. We point to evidence of indigenous and indigenist use of arguments and proposals for sanitary reform and, on the other hand, the strategic involvement of Sergio Arouca in indigenous health events. The points of convergence are located mainly in the critique of the biomedical model, the approximation of primary care proposals, and the concept of health. Conflicts were mainly related to the operationalization of the subsystem, but the indigenist discourse, contrary to municipalization, found in the district process a proposal legitimized in the Health Reform.
ABSTRACT
Em seus sete capítulos, a obra analisa etapas como o trabalho e a formação dos agentes comunitários e indígenas de saúde, as concepções político-pedagógicas e a organização curricular do Curso Técnico de Agentes Comunitários Indígenas de Saúde (CTACIS), os cuidados da saúde de crianças e mulheres indígenas, vigilância alimentar e nutricional em terra indígena, além de temas transversais, como território, cultura e política
Subject(s)
Humans , Food and Nutritional Surveillance , Health Human Resource Training , Health Services, Indigenous , BrazilABSTRACT
The implementation of the National Policy for Healthcare of Indigenous Peoples (Pnaspi) in the Alto Rio Negro Amazon region was analyzed based on the principles of the differentiated care model. This theme was investigated from three perspectives, namely the formulation of the guidelines, the therapeutic itineraries in indigenous villages, and the work routines of the Indigenous Community Health Agents (AIS). It involved qualitative research based on the anthropological perspective of Eduardo Menéndez. The techniques used were participant observation, interviews, and, document analysis. The formulation of the guidelines of differentiated care emphasizes the adaptation of technologies and professionals, minimizing the coexistence and disputes among healthcare models. Menéndez's perspective focused on the viewpoint of the subjects was crucial for identifying the coexistence and articulation among different forms of care in the villages through the healthcare itineraries. Nevertheless, it was not possible to identify the inclusion of indigenous health practices and representations through the work routines of the Indigenous Community Health Agents (AIS). The focus was on self-care developed and practiced by the subjects and their families.
Subject(s)
Health Policy , Health Services, Indigenous , Self Care , Brazil , Humans , Indians, South AmericanABSTRACT
ResumoAnalisou-se a implementação do modelo de atenção da Política Nacional de Saúde Indígena (Pnaspi) no Distrito Sanitário Especial Indígena do Alto Rio Negro, à luz da diretriz da atenção diferenciada. A temática foi investigada sob três perspectivas: formulação da diretriz; itinerários terapêuticos em aldeias indígenas; atuação dos Agentes Indígenas de Saúde (AIS). Pesquisa qualitativa, apoiada na perspectiva antropológica de Menéndez sobre modelos de atenção. A coleta de dados compreendeu observação participante, entrevistas e análise documental. A formulação da diretriz da atenção diferenciada enfatiza a adequação de tecnologias e profissionais, minimizando a dimensão da coexistência e disputas entre formas de atenção. A perspectiva de análise dos modelos de atenção desde os sujeitos, proposta por Menéndez, mostrou-se fundamental para demonstrar que a partir dos itinerários terapêuticos é possível verificar a coexistência e a articulação de diversas formas de atenção. A começar da análise das rotinas dos AIS não foi possível encontrar a inclusão ou o reconhecimento das representações e práticas indígenas de saúde. Destaca-se a autoatenção, protagonizada por sujeitos e famílias.
AbstractThe implementation of the National Policy for Healthcare of Indigenous Peoples (Pnaspi) in the Alto Rio Negro Amazon region was analyzed based on the principles of the differentiated care model. This theme was investigated from three perspectives, namely the formulation of the guidelines, the therapeutic itineraries in indigenous villages, and the work routines of the Indigenous Community Health Agents (AIS). It involved qualitative research based on the anthropological perspective of Eduardo Menéndez. The techniques used were participant observation, interviews, and, document analysis. The formulation of the guidelines of differentiated care emphasizes the adaptation of technologies and professionals, minimizing the coexistence and disputes among healthcare models. Menéndez's perspective focused on the viewpoint of the subjects was crucial for identifying the coexistence and articulation among different forms of care in the villages through the healthcare itineraries. Nevertheless, it was not possible to identify the inclusion of indigenous health practices and representations through the work routines of the Indigenous Community Health Agents (AIS). The focus was on self-care developed and practiced by the subjects and their families.
Subject(s)
Humans , Self Care , Health Policy , Health Services, Indigenous , Brazil , Indians, South AmericanABSTRACT
O objetivo do estudo foi analisar o perfil demográfico de idosos e sua percepção sobre alimentos funcionais. A pesquisa foi descritiva, com delineamento transversal, e abordagem quantitativa, envolvendo 200 idosos, em João Pessoa PB, em 2011. Na análise, utilizou-se o software SPSS, versão 19, teste de quiquadrado com nível de significância de p<0,05. São resultados: maioria do sexo feminino, faixa etária entre 60 e 69 anos, com um salário mínimo; e maioria viúvos. Quanto aos hábitos alimentares, 90,5% consumiam diariamente frutas e hortaliças, 35,5% referiram não comer frituras e gorduras; 45% bebiam mais de cinco xícaras de líquido e 51,5% atestaram estado de saúde regular. Como conclusão, tem-se que a maioria dos idosos tem um bom conhecimento sobre os alimentos funcionais e os utiliza frequentemente. A percepção dos idosos sobre os alimentos funcionais e seus hábitos alimentares foi de extrema importância para o planejamento de futuras ações, indispensáveis para a promoção da saúde dessa população.
The study analyzed demographic profile and perceptions of functional foods among 200 elderly in João Pessoa, Paraíba, Brazil, in 2011. The design was cross-sectional and the approach, quantitative. The analysis used SPSS software, version 19, chi-square test with a p<0.05 significance level. The results were: mostly female, from 60 and 69 to old, earning one minimum wage; and mostly widowers. Eating habits featured 90.5% consumed fruits and vegetables daily; 35,5% reported not eating fried foods and fats; 45% drank more than five cups of liquid; and 51.5% self-rated their state of health as fair. In conclusion, most of the elderly had good knowledge of functional foods and used them often. Their perceptions of functional foods and their eating habits were extremely important to planning future actions, which are essential to health promotion for this population.
El objetivo del estudio fue analizar el perfil demográfico de los ancianos y su percepción de los alimentos funcionales. La investigación fue descriptiva con diseño transversal y un abordaje cuantitativo, involucrando a 200 ancianos, en João Pessoa Paraíba, Brasil, en 2011. En el análisis, se ha utilizado el software SPSS, versión 19, prueba de chi cuadrado con un nivel designificación de p<0,05. Los resultados son: en su mayoría mujeres, con edades comprendidas entre 60 y 69 años, recibiendo un salario mínimo; y en su mayoría viudas. En cuanto a las costumbres alimentarias, el 90,5% consumía frutas y verduras; el 35,5% informó que no comía alimentos fritos y grasas; un 45% bebía más de cinco tazas de líquido y el 51,5% afirmó que tenía estado de salud regular. En conclusión, la mayoría de los ancianos tiene un buen conocimiento de los alimentos funcionales y los ingieren con frecuencia. La percepción de los ancianos sobre los alimentos funcionales y sus hábitos de alimentación fue sumamente importante para la planificación de acciones futuras, esenciales para la promoción de la salud de esta población.
Subject(s)
Humans , Male , Female , Middle Aged , Functional Food , Aging , Aged , Elderly Nutrition , Health of the Elderly , Evaluation Studies as Topic , Brazil , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
BACKGROUND: The Community Health Workers (CHWs) Programme was launched in Luanda, Angola, in 2007 as an initiative of the provincial government. The aim of this study was to assess its implementation process. METHODS: This is a case study with documental analysis, CHWs reports data, individual interviews and focus groups. RESULTS: Until June 2009, the programme had placed in the community 2,548 trained CHWs, providing potential coverage for 261,357 families. Analysis of qualitative data suggested an association of CHWs with improvements in maternal and child access to health care, as well as an increase in the demand for health services, generating further need to improve service capacity. Nevertheless, critical points for programme sustainability were identified. CONCLUSIONS: For continuity and scaling up, the programme needs medium- and long-term technical, political and financial support. The results of this study may be useful in strengthening and reformulating the planning of the CHWs programme in Luanda and in Angola. Moreover, the lessons learned with this experience can also provide insight for the development of CHWs programmes in other parts of the world. By means of cooperation, Brazil has supported the implementation of this CHWs programme and can potentially contribute to its improvement.
Subject(s)
Community Health Services/organization & administration , Community Health Workers , Health Plan Implementation , Angola , Brazil , Child, Preschool , Community Health Workers/education , Community Health Workers/organization & administration , Community Health Workers/psychology , Evaluation Studies as Topic , Female , Focus Groups , Health Services Accessibility , Humans , Infant , Infant, Newborn , Male , Organizational Case Studies , Pregnancy , Program Evaluation , Resource AllocationABSTRACT
Os sistemas médicos são culturalmente moldados e podem ter impactos negativos naqueles que não compartilham essas bases. Discutimos a perspectiva indígena de questões morais na relação com os serviços de saúde na região do Alto Rio Negro/Amazonas/Brasil. Trata-se de pesquisa qualitativa que utilizou como técnicas a observação participante e entrevistas em duas comunidades na região do Alto Rio Negro. A transferência para serviços de saúde em área urbana foi identificada como a principal questão moral para os indígenas na região. A diversidade de tradições, culturas e valores dos povos indígenas influenciam na sua moralidade e tomada de decisões clínicas, que eram pouco compreendidas pelos profissionais de saúde. Na relação entre profissionais de saúde e usuários indígenas ficou evidente o choque entre habitus distintos e a configuração de uma relação entre estranhos morais. Essas condições dificultam o diálogo para a resolução de conflitos...
Los sistemas médicos son culturalmente moldeados y pueden tener impactos negativos en los que no comparten estas bases. Se discute la perspectiva indígena de cuestiones morales en la relación con los servicios de salud en la región del Alto Rio Negro/Amazonas/Brasil. Fue un estudio cualitativo que utiliza las técnicas de la observación participante y entrevistas en dos comunidades de la región del Alto Rio Negro. La transferencia para servicios de salud en zona urbana fue identificada como la principal cuestión moral para los indios de la región. La diversidad de tradiciones, culturas y valores de los pueblos indígenas tienen influencia en su moralidad y la toma de decisiones clínicas que eran poco comprendidas por los profesionales de salud. En la relación entre los profesionales de salud y los usuarios indígenas se hizo evidente el choque entre los distintos habitus y la configuración de una relación entre extraños morales. Estas condiciones dificultan el diálogo para resolver los conflictos...
Medical systems are culturally adapted and may have negative impacts on those that do not share these bases. We discussed the indigenous perspective on moral issues in the relation with health services in the region of Alto Rio Negro/Amazonas/Brazil. It was a qualitative research that used participant observation and interviews in two communities in the region of Alto Rio Negro as techniques. The transfer to health services in urban areas was identified as the main moral issue for the Indians in the region. The diversity of traditions, cultures and values of the indigenous people influence their morality and clinical decisions to be made, what used to be little understood by health professionals. In the relationship between health professionals and indigenous users it was clear the shock between different habits and the configuration of a relation between moral strangers. These facts hinder the dialogue to solve conflicts...