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Políticas públicas saudáveis: estudo de caso português
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| Dissertação de Mestrado | 2.15 MB | Adobe PDF |
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Contexto: As sociedades actuais deparam-se, cada vez mais, com problemas complexo, isto é, problemas altamente resistentes a uma solução, como por exemplo, a toxicodependência, a deficiência, o VIH/sida e a sustentabilidade dos sistemas de saúde. As abordagens utilizadas no século passado não são adequadas à resolução destes problemas, que necessitam de soluções inovadoras, de novas formas de pensar e trabalhar (Kickbusch & Buckett, 2010). Muitos dos factores causais destes fenómenos estão fora do controlo do sector da saúde. Assim, reconhecendo que os determinantes sociais da saúde são influenciados por políticas fora da exclusiva jurisdição do sector da saúde (Wismar, et al. 2006), é necessário desenvolver uma acção coordenada entre todos os sectores da sociedade que possibilite a implementação de estratégias que conduzam à obtenção de ganhos em saúde para a população. A presente investigação reconheceu o termo multidimensional de potenciais ganhos em saúde e identifica este potencial em políticas extra-sector da saúde.
Objectivos: Definiu-se como objectivo geral compreender o que foi feito pelo XVII Governo Constitucional em termos de reforçar estratégias de potenciais ganhos em saúde através de políticas extra-sector da saúde, durante o período de Março de 2005 a Outubro de 2009. Traçou-se como objectivos específicos: identificar estratégias de potenciais ganhos em saúde através de políticas extra-sector da saúde em Portugal, considerando como extra-sector os sectores contemplados nos Ministérios do XVII Governo Constitucional; e descrever o papel do Ministério da Saúde, formal e previsto na legislação, na implementação de estratégias de potenciais ganhos em saúde.
Material e Métodos: Para a concretização deste estudo recorreu-se a uma abordagem qualitativa, com um desenho de estudo de caso único e incorporado, ou seja, com múltiplas unidades de análise (Yin, 2001), sendo os dados recolhidos através de documentos e de informadores chave. As técnicas de recolha de dados utilizadas foram a análise documental e entrevistas de consulta, sendo a técnica de análise de dados a análise de conteúdo.
Resultados: Dos resultados obtidos salienta-se que foram identificadas 267 estratégias de potenciais ganhos em saúde. Relativamente à articulação observou-se que o Ministério da Saúde (MS) tem uma articulação mais evidente com o Ministério da Educação, Ministério do Trabalho e Solidariedade Social, Ministério da Presidência do Conselho de Ministros, Ministério do Ambiente e Ordenamento do Território, Ministério da Justiça e o Ministério da Administração Interna. Não foi verificada uma articulação entre o MS e o Ministério das Finanças e Administração Pública e Ministério da Defesa Nacional. É ainda descrito o papel do MS na implementação de tais estratégias.
Conclusões: Este estudo constitui um ponto de partida para futuras investigações nesta área. Foram realizados esforços no sentido de implementar a saúde em todas as políticas em Portugal, no entanto, é essencial um maior envolvimento de todos os sectores da sociedade para a concretização e sucesso de tal abordagem. Foram enunciadas algumas linhas de acção.
Palavras-chave: política pública saudável, determinantes sociais da saúde, avaliação de impacto em saúde, intersectorialidade e potenciais ganhos em saúde.
Context: Currentsocieties face increasingly complex problems that are highly resistant to resolutions, such as drug addiction, deficiencies, HIV/AIDS and health systems sustainability. The approaches used during the last century are not suitable to resolve these problems that need innovative solutions and new ways of thinking and working (Kickbusch & Buckett, 2010).Many of the factors that cause these phenomena are not controlled by the health sector. Therefore, recognizing that the social health determinants are influenced by policies that are outside the exclusive health sector jurisdiction (Wismar, et al. 2006)makes it’s necessary to develop a coordinated action between all sectors of society that allow the implementation of strategies that lead to the achievement of health benefits for the population. The present investigation recognizes the multidimensional term for potential health gains and identifies this potential in policies outside the health sector. Objectives: We defined as a general objective to comprehend what was done by the 17thConstitutional Government in terms of reinforcing strategies in potential health gains through policies outside the health sector between the period of March 2005 and October 2009. We defined as specific objectives to identify potential health gain strategies through policies outside the health sector in Portugal, considering outside sectors the ones that are contemplated by the 17thConstitutional Government and describe the role of the Health Ministry, formal and predicted in the legislation, in the implementation of potential health gain strategies. Materials and Methods: In order to conduct this study we used a qualitative approach with a single and incorporated case study format with multiple analysis units (Yin, 2001)and the data collected through documents and key informants. The data research techniques used were document analysis and interview consultation while the data analysis technique was the context analysis. Results:Of the obtained results 267 strategies were identified as potential health gains. Concerning the articulation we observed that the Health Ministry (HM) has a more evident articulation with the Ministry of Education, Ministry of Labor and Social Solidarity, Ministry of the Presidency of the Ministers Council, Ministry of Environment and Territorial Planning, Ministry of Justice and the Ministry of the Interior. However, it no articulation was verified between the HM and the Ministry of Finances and Public Administration and the Ministry of National Defense. It also described the role of the HM in the implementation of such strategies. Conclusions:Thisstudy is a starting point for future investigations in this area. Efforts were made to implement health issues in all policies in Portugal. However, the need for a larger involvement of all sectors of society for the achievement and success of this approach is essential. Some guidelines were set out.
Context: Currentsocieties face increasingly complex problems that are highly resistant to resolutions, such as drug addiction, deficiencies, HIV/AIDS and health systems sustainability. The approaches used during the last century are not suitable to resolve these problems that need innovative solutions and new ways of thinking and working (Kickbusch & Buckett, 2010).Many of the factors that cause these phenomena are not controlled by the health sector. Therefore, recognizing that the social health determinants are influenced by policies that are outside the exclusive health sector jurisdiction (Wismar, et al. 2006)makes it’s necessary to develop a coordinated action between all sectors of society that allow the implementation of strategies that lead to the achievement of health benefits for the population. The present investigation recognizes the multidimensional term for potential health gains and identifies this potential in policies outside the health sector. Objectives: We defined as a general objective to comprehend what was done by the 17thConstitutional Government in terms of reinforcing strategies in potential health gains through policies outside the health sector between the period of March 2005 and October 2009. We defined as specific objectives to identify potential health gain strategies through policies outside the health sector in Portugal, considering outside sectors the ones that are contemplated by the 17thConstitutional Government and describe the role of the Health Ministry, formal and predicted in the legislation, in the implementation of potential health gain strategies. Materials and Methods: In order to conduct this study we used a qualitative approach with a single and incorporated case study format with multiple analysis units (Yin, 2001)and the data collected through documents and key informants. The data research techniques used were document analysis and interview consultation while the data analysis technique was the context analysis. Results:Of the obtained results 267 strategies were identified as potential health gains. Concerning the articulation we observed that the Health Ministry (HM) has a more evident articulation with the Ministry of Education, Ministry of Labor and Social Solidarity, Ministry of the Presidency of the Ministers Council, Ministry of Environment and Territorial Planning, Ministry of Justice and the Ministry of the Interior. However, it no articulation was verified between the HM and the Ministry of Finances and Public Administration and the Ministry of National Defense. It also described the role of the HM in the implementation of such strategies. Conclusions:Thisstudy is a starting point for future investigations in this area. Efforts were made to implement health issues in all policies in Portugal. However, the need for a larger involvement of all sectors of society for the achievement and success of this approach is essential. Some guidelines were set out.
Descrição
Palavras-chave
Saúde pública Saúde e desenvolvimento Política de saúde Determinantes sociais da saúde Avaliação de impacto em saúde Intersectorialidade e potenciais ganhos em saúde
Contexto Educativo
Citação
Editora
Instituto de Higiene e Medicina Tropical