Secretários Municipais de Saúde: o SUS visto pela ponta da corda / Municipal Secretaries of health - SUS seen by the end of the rope

Após vinte e quatro anos, o Sistema Único de Saúde brasileiro consagra-se por uma consolidação na assistência, acesso e na qualidade de serviços para a sociedade, principalmente nas esferas estaduais e municipais. Os modelos organizativos ajudaram a construir uma base, que já se encontra desgastado e carente de uma reestruturação, principalmente no âmbito da organização do Sistema, através de uma revisão das atribuições de cada ente participativo e do repasse de recursos, equilibrados pela necessidade municipal, invertendo o processo verticalização do Sistema. Outro ponto abordado foi a necessidade de incorporar um perfil profissional dos gestores municipais de saúde, peça fundamental do SUS, que assume um cargo político com responsabilidade técnica e administrativa e que hoje segura a ponta da corda em um eterno cabo de guerra contra o Estado e a União. Foi realizada como metodologia uma análise descritiva qualitativa e quantitativa da literatura e do cenário das políticas públicas em saúde, abordando os antecedentes históricos do SUS, o modelo atual das Políticas públicas de Saúde e do Sistema, no âmbito federal, estadual e municipal respectivamente, o perfil dos municípios brasileiros, assim como dos gestores municipais que organizam e controlam o Sistema na ponta mais difícil, a que se defronta com a real necessidade e com o próprio usuário do Sistema, e por fim proposto um novo modelo reestruturante do SUS, com caráter mais municipalista, atingindo uma questão primordial: O equilíbrio organizativo, financeiro e gestor do Sistema Único de saúde.

After twenty and four years the Brazilian health consecrated by a consolidation assistance, access and quality of service to society, especially in state and municipal level. Organizational models helped to build a base, which is already worn out and in need of restructuring, particularly in the organization of the system, through a review of the responsibilities of each participating entity and the transfer of resources, balanced by the need municipal , reversing the process of up righting system . Another point raised was the need to incorporate a professional profile of local health managers , keystone SUS , assuming political office with administrative and technical responsibility and today holds the end of the rope in an eternal tug of war against the state and Union was conducted as a descriptive analysis methodology qualitative and quantitative literature and landscape of public health policies , addressing the historical background of the SUS , the current model of public Policy and Health System , at the federal , state and municipal respectively the profile of municipalities , as well as municipal managers who organize and control the system in tip harder , which faces the real need and the proper user of the system, and finally proposed a new model of restorative SUS with a more municipalist reaching a primary issue : balancing organizational, financial and Manager of the Unified health.

Secretários Municipais de Saúde: o SUS visto pela ponta da corda / Municipal Secretaries of health - SUS seen by the end of the rope

Após vinte e quatro anos, o Sistema Único de Saúde brasileiro consagra-se por uma consolidação na assistência, acesso e na qualidade de serviços para a sociedade, principalmente nas esferas estaduais e municipais. Os modelos organizativos ajudaram a construir uma base, que já se encontra desgastado e carente de uma reestruturação, principalmente no âmbito da organização do Sistema, através de uma revisão das atribuições de cada ente participativo e do repasse de recursos, equilibrados pela necessidade municipal, invertendo o processo verticalização do Sistema. Outro ponto abordado foi a necessidade de incorporar um perfil profissional dos gestores municipais de saúde, peça fundamental do SUS, que assume um cargo político com responsabilidade técnica e administrativa e que hoje segura a ponta da corda em um eterno cabo de guerra contra o Estado e a União. Foi realizada como metodologia uma análise descritiva qualitativa e quantitativa da literatura e do cenário das políticas públicas em saúde, abordando os antecedentes históricos do SUS, o modelo atual das Políticas públicas de Saúde e do Sistema, no âmbito federal, estadual e municipal respectivamente, o perfil dos municípios brasileiros, assim como dos gestores municipais que organizam e controlam o Sistema na ponta mais difícil, a que se defronta com a real necessidade e com o próprio usuário do Sistema, e por fim proposto um novo modelo reestruturante do SUS, com caráter mais municipalista, atingindo uma questão primordial: O equilíbrio organizativo, financeiro e gestor do Sistema Único de saúde...

After twenty and four years the Brazilian health consecrated by a consolidation assistance, access and quality of service to society, especially in state and municipal level. Organizational models helped to build a base, which is already worn out and in need of restructuring, particularly in the organization of the system, through a review of the responsibilities of each participating entity and the transfer of resources, balanced by the need municipal , reversing the process of up righting system . Another point raised was the need to incorporate a professional profile of local health managers , keystone SUS , assuming political office with administrative and technical responsibility and today holds the end of the rope in an eternal tug of war against the state and Union was conducted as a descriptive analysis methodology qualitative and quantitative literature and landscape of public health policies , addressing the historical background of the SUS , the current model of public Policy and Health System , at the federal , state and municipal respectively the profile of municipalities , as well as municipal managers who organize and control the system in tip harder , which faces the real need and the proper user of the system, and finally proposed a new model of restorative SUS with a more municipalist reaching a primary issue : balancing organizational, financial and Manager of the Unified health...

Dental caries profile in Monte Negro, Amazonian state of Rondônia, Brazil, in 2008.

OBJECTIVE: This epidemiological survey assessed the dental caries profile in Monte Negro, a small town in the Amazonian state of Rondônia, Brazil, and its relationship with the northern region, national and global goals for oral health in the years 2000 and 2020. MATERIAL AND METHODS: The groups randomly examined were composed of individuals aged 5, 12, 15 to 19, 35 to 44, 65 to 74 years, living in both rural and urban areas. RESULTS: The means dft (standard deviation) and DMFT (standard deviation) for the groups were, respectively, 3.15 (3.12), 3.41 (2.69), 5.96 (4.19), 16.00 (7.30) and 25.96 (9.82). Caries-free individuals were 34.42%, 14.81% and 8.16% in the preschoolchildren, schoolchildren and adolescent groups, respectively. The Significant Caries Index percentages applied to the two younger groups were 6.65 and 6.70, and they increased to 32.00 in the individuals aged 65 to 74 years. Care Index percentages for adolescents, adults and elderly groups were, respectively, 29.40, 25.00 and 1.41. The dental caries profile in Monte Negro in 2008 shows that, 8 years after the year 2000, no FDI/WHO goal for any age settled in 1982 has been achieved. Dental caries increased with age and the main dental problem of adult and elderly groups was tooth loss. CONCLUSION: Oral health promotion and prevention of oral disease policies are urgent needs. Setting of oral health goals and targets to people living in Monte Negro or Amazonia to be pursuit and achieved in a near future is an important action to do because of the culture, sanitary conditions and socioeconomic aspects of this particular population.

Dental caries profile in Monte Negro, Amazonian state of Rondônia, Brazil, in 2008

OBJECTIVE: This epidemiological survey assessed the dental caries profile in Monte Negro, a small town in the Amazonian state of Rondônia, Brazil, and its relationship with the northern region, national and global goals for oral health in the years 2000 and 2020. MATERIAL AND METHODS: The groups randomly examined were composed of individuals aged 5, 12, 15 to 19, 35 to 44, 65 to 74 years, living in both rural and urban areas. RESULTS: The means dft (standard deviation) and DMFT (standard deviation) for the groups were, respectively, 3.15 (3.12), 3.41 (2.69), 5.96 (4.19), 16.00 (7.30) and 25.96 (9.82). Caries-free individuals were 34.42 percent, 14.81 percent and 8.16 percent in the preschoolchildren, schoolchildren and adolescent groups, respectively. The Significant Caries Index percentages applied to the two younger groups were 6.65 and 6.70, and they increased to 32.00 in the individuals aged 65 to 74 years. Care Index percentages for adolescents, adults and elderly groups were, respectively, 29.40, 25.00 and 1.41. The dental caries profile in Monte Negro in 2008 shows that, 8 years after the year 2000, no FDI/WHO goal for any age settled in 1982 has been achieved. Dental caries increased with age and the main dental problem of adult and elderly groups was tooth loss. CONCLUSION: Oral health promotion and prevention of oral disease policies are urgent needs. Setting of oral health goals and targets to people living in Monte Negro or Amazonia to be pursuit and achieved in a near future is an important action to do because of the culture, sanitary conditions and socioeconomic aspects of this particular population.

Formação de agentes comunitários de saúde na região amazônica: o uso de videoconferência como ferramenta auxiliar na educação em saúde bucal / Training community health workers in the Amazon region: the use of videoconferencing as a tool for dental health education

O objetivo deste estudo é apresentar uma metodologia de ensino à distância, por meio de videoconferência, para capacitar Agentes Comunitários de Saúde em relação à prevenção e educação em saúde bucal. Foram preparados doze módulos a serem desenvolvidos no período de um ano, sendo que cada módulo foi constituído por uma aula presencial e uma não presencial. Os temas adotados nestes módulos permitirão aos Agentes Comunitários de Saúde multiplicar os conhecimentos adquiridos nas micro-áreas em que atuam. O instrumento de medida proposto foi um questionário a ser aplicado antes, durante e após a capacitação, composto por questões relacionadas à saúde bucal. A videoconferência como ferramenta auxiliar de ensino é uma alternativa para a capacitação do ACS, uma vez que os municípios da região amazônica se situam afastados dos grandes centros formadores e dificultam o acesso destes profissionais. O planejamento de aplicação na região amazônica não exclui a possibilidade de aplicação da metodologia aqui apresentada em outras áreas geográficas de difícil acesso.

The objective of this study is to present a methodology for distance learning through videoconferencing to train Community Health Workers for the prevention and oral health education. It were prepared twelve modules to be developed within one year, and each module consisted of a face class and not a face. The themes adopted in these modules will allow the Community Health Agents multiply the acquired knowledge in micro-areas in which they operate. The proposed measuring instrument was a questionnaire to be applied before, during and after the training, consisting of questions related to oral health. Videoconferencing as an auxiliary tool for teaching is an alternative to the training of ACS, as the municipalities of the Amazon region are located far from the large training centers and hinder access to these professionals. The planning application in the Amazon does not exclude the possibility of applying the methodology presented here in other geographical areas of difficult access.