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      Escolas Técnicas do SUS (ETSUS) no Brasil: regulação da integração ensino serviço e sustentabilidade administrativa Translated title: Vocational Health Schools (ETSUS) in Brazil: regulation of the integration of teaching-service-administrative sustainability of ETSUS

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          Abstract

          O objetivo deste artigo foi discutir a sustentabilidade administrativa das Escolas Técnicas do SUS (ETSUS) a partir do princípio da integração ensino serviço, que traz uma nova dimensão do trabalho na saúde ainda não regulada pela administração pública brasileira. Trata-se de uma pesquisa qualitativa, por meio de um estudo de caso. A pesquisa foi realizada por meio de questionário semiestruturado junto aos gestores das ETSUS, abordando aspectos institucionais, administrativos e de gestão do trabalho. O universo amostral foi de 6 ETSUS pertencentes à Rede de Escolas Técnicas do SUS (RET-SUS). As ETSUS apresentaram gestão e planejamento centralizados e execução descentralizada de sua atividade fim, em sua maioria sem autonomia administrativa e altamente dependente de financiamento do governo federal. Segundo os gestores das escolas, a falta de regulação da atividade docente por servidor público fragiliza a gestão das ETSUS. Estas instituições apresentam problemas de gestão relacionados à integração ensino serviço, que precisa ser regulamentada para conferir sustentabilidade às escolas e evitar contradições com a legislação brasileira.

          Translated abstract

          The scope of this study was to discuss the administrative sustainability of Brazil's Vocational Health Schools (ETSUS) based on the principle of teaching and service integration, which brings a new dimension to healthcare work as yet unregulated by Brazilian public administration. It was a qualitative study using case study methodology. The research involved a semi-structured questionnaire given to ETSUS managers addressing institutional, administrative, and work management aspects. The sample was composed of 6 ETSUS that belong to the Network of Vocational Health Schools (RET-SUS). The ETSUS showed centralized planning and management, and decentralized implementation of their core activities. The majority did not have administrative autonomy and relied heavily on funding from the federal government. According to ETSUS managers, the lack of regulation of teaching activities by civil servants weakens the management of ETSUS. The ETSUS have managerial problems related to teaching-service integration, which has to be regulated in order to guarantee the sustainability of these schools and avoid conflicts with Brazilian legislation.

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          Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.

          Anthropometry provides the single most portable, universally applicable, inexpensive and non-invasive technique for assessing the size, proportions, and composition of the human body. It reflects both health and nutritional status and predicts performance, health, and survival. As such, it is a valuable, but currently underused, tool for guiding public health policy and clinical decisions. This report presents the conclusions and comprehensive recommendations of a WHO Expert Committee for the present and future uses and interpretation of anthropometry. In a section that sets the technical framework for the report, the significance of anthropometric indicators and indices is explained and the principles of applied biostatistics and epidemiology that underlie their various uses are discussed. Subsequent sections provide detailed guidance on the use and interpretation of anthropometric measurements in pregnant and lactating women, newborn infants, infants and children, adolescents, overweight and thin adults, and adults aged 60 years and over. With a similar format for each section, the report assesses specific applications of anthropometry in individuals and populations for purposes of screening and for targeting and evaluating interventions. Advice on data management and analysis is offered, and methods of taking particular measurements are described. Each section also includes a discussion of the extent, reliability and universal relevance of existing reference data. An extensive series of reference data recommended by the Expert Committee and not widely distributed by WHO hitherto is included in an annex.
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            Quantitativo-qualitativo: oposição ou complementaridade?

            Este trabalho resume um debate metodológico em processo na Escola Nacional de Saúde Pública, Brasil, sobre as duas formas de abordagem mais correntes nas investigações da área de saúde: o método quantitativo e o método qualitativo. Os autores - uma antropóloga sanitarista e um bioestatístico - demonstram, com argumentações teóricas e práticas, que esses métodos são de natureza diferenciada, mas se complementam na compreensão da realidade social. Num mundo onde o que distingue o ser humano é a linguagem comunicativa, o acento deste debate recai sobre a possibilidade, o significado e os limites da linguagem matemática e da linguagem de uso comum na experiência cotidiana.
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              Health conditions and health-policy innovations in Brazil: the way forward.

              Brazil is a large complex country that is undergoing rapid economic, social, and environmental change. In this Series of six articles, we have reported important improvements in health status and life expectancy, which can be ascribed largely to progress in social determinants of health and to implementation of a comprehensive national health system with strong social participation. Many challenges remain, however. Socioeconomic and regional disparities are still unacceptably large, reflecting the fact that much progress is still needed to improve basic living conditions for a large proportion of the population. New health problems arise as a result of urbanisation and social and environmental change, and some old health issues remain unabated. Administration of a complex, decentralised public-health system, in which a large share of services is contracted out to the private sector, together with many private insurance providers, inevitably causes conflict and contradiction. The challenge is ultimately political, and we conclude with a call for action that requires continuous engagement by Brazilian society as a whole in securing the right to health for all Brazilian people. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                csc
                Ciência & Saúde Coletiva
                Ciênc. saúde coletiva
                ABRASCO - Associação Brasileira de Saúde Coletiva (Rio de Janeiro, RJ, Brazil )
                1413-8123
                1678-4561
                April 2012
                : 17
                : 4
                : 977-987
                Affiliations
                [01] Cuiabá MT orgnameEscola de Saúde Pública do Estado de Mato Grosso fabianotonaco@ 123456yahoo.com.br
                [02] São Paulo orgnameUniversidade Estadual Paulista orgdiv1Faculdade de Odontologia de Araçatuba orgdiv2Departamento de Odontologia Infantil e Social Brazil
                [03] orgnameUniversity of Massachusetts at Lowell orgdiv1School Of Health And Environment orgdiv2Department of Community Health and Sustainability
                Article
                S1413-81232012000400020 S1413-8123(12)01700420
                10.1590/S1413-81232012000400020
                46eaa5d3-5f87-4151-9119-3672194aa554

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 30 June 2011
                : 16 May 2011
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 57, Pages: 11
                Product

                SciELO Public Health

                Self URI: Texto completo somente em PDF (PT)
                Categories
                Temas Livres

                Educação profissionalizante,Recursos humanos,Escolas para profissionais de saúde,Políticas,Planejamento e Administração em Saúde,Administração pública,Professional education,Human resources,Schools for public health professionals,Policy, planning and management in health,Public administration

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