ABSTRACT
Vulnerability to climate change is a complex and dynamic phenomenon involving both social and physical/environmental aspects. It is presented as a method for the quantification of the vulnerability of all municipalities of Minas Gerais, a state in southeastern Brazil. It is based on the aggregation of different kinds of environmental, climatic, social, institutional, and epidemiological variables, to form a composite index. This was named "Index of Human Vulnerability" and was calculated using a software (SisVuClima®) specifically developed for this purpose. Social, environmental, and health data were combined with the climatic scenarios RCP 4.5 and 8.5, downscaled from ETA-HadGEM2-ES for each municipality. The Index of Human Vulnerability associated with the RCP 8.5 has shown a higher vulnerability for municipalities in the southern and eastern parts of the state of Minas Gerais.
Subject(s)
Climate Change , Environmental Health , Health Status Indicators , Brazil , Environment , Health Status , Humans , Social EnvironmentABSTRACT
O Programa de Qualificação e Desenvolvimento do Agente Comunitário de Saúde (ACS) foi instituído pelo Ministério da Saúde visando investir em sua profissionalização. Este artigo teve por objetivo identificar, analisar e compreender as implicações do Programa de Qualificação e Desenvolvimento concluído em 2009 pela Escola de Saúde Pública do Estado de Minas Gerais na vida pessoal e laboral dos ACS e no processo de atenção à saúde, na visão dos diversos sujeitos envolvidos na Atenção Primária em Saúde (APS): ACS, equipe de Saúde da Família, gestores, docentes e usuários de 4 unidades básicas de saúde em uma capital da região Sudeste. Este estudo tem caráter qualitativo, utilizando como técnicas de coleta de informações a análise documental, entre-vistas, grupo focal e questionários. As informações coletadas foram analisadas por meio da técnica de análise do discurso do sujeito e utilizando o programa SPSS, versão 16. Foram realizados 14 grupos focais com as unidades da Estratégia Saúde da Família, 4 com ACS e 4 com usuários; 7 entrevistas, 4 com gestores e 3 com docentes do curso. No grupo dos ACS, há predomínio do sexo feminino e uma baixa rotatividade. Na análise do discurso, verificou-se que o programa investigado trouxe implicações favoráveis à vida pessoal e profissional do ACS e à APS. Contudo, é necessário estruturar o programa nos parâmetros da educação permanente em saúde, assegurando uma abordagem que propicie a construção permanente de estratégias voltadas à melhoria das condições de vida e saúde e à cidadania plena.
The Development and Qualification Program for the Community Health Worker (CHW) was established by the Ministry of Health in order to invest in the Worker's professionalization. This article aimed to identify analyze, and understand the implications of the Development and Qualification Program concluded in 2009 by the School of Public Health of the State of Minas Gerais in the personal and occupational life of the CHWs and in the health care process. According to the viewpoint of the many subjects involved in Primary Health Care (PHC): CHWs, Family Health team, managers, teachers, and users of four primary health centers in a capital city of Southeastern Brazil. This study has a qualitative nature, using as techniques for information collection and documentary analysis interviews, focus group, and questionnaires. The collected information was analyzed by means of the subject discourse analysis technique and using the software SPSS, version 16. We conducted 14 focus groups with the Family Health Strategy units, 4 with CHWs, and 4 with users; 7 interviews, 4 with managers and 3 with teachers at the course. In the Worker's group, there is a predominance of women and a low turnover. In discourse analysis, it was found that the program under study brought favorable implications to the personal and professional life of CHWs and to APS. However, it needs to start being structured on the parameters of continued health education, in order to assure an approach that provides the permanent construction of strategies aimed to improve life and health conditions and achieve full citizenship.
Subject(s)
Humans , Male , Female , Community Health Workers , Primary Health Care , Professional Training , Credentialing , National Health Strategies , Health Centers , Patient Care Team , Surveys and QuestionnairesABSTRACT
The Amazonian environment is changing rapidly, due to deforestation, in the short term, and, climatic change is projected to alter its forest cover, in the next few decades. These modifications to the, environment have been altering the dynamics of infectious diseases which have natural foci in the, Amazonian biome, especially in its forest. Current land use practices which are changing the, epidemiological profile of the parasitic diseases in the region are road building; logging; mining; expansion of agriculture and cattle ranching and the building of large dams. Malaria and the cutaneous, leishmaniasis are the diseases best known for their rapid changes in response to environmental, modifications. Others such as soil-transmitted helminthiases, filarial infections and toxoplasmosis, which have part of their developmental cycles in the biophysical environment, are also expected to, change rapidly. An interdisciplinary approach and an integrated, international surveillance are needed, to manage the environmentally-driven changes in the Amazonian parasitic diseases in the near future.
