No abstract

A implantação dos Centros Viva Vida (CVV) constitui um marco na assistência à saúde no Estado de Minas Gerais, visto que eles ampliam o acesso da população a serviços do Sistema Único de Saúde, contribuindo efetivamente para a redução da mortalidade infantil e materna, consideradas problemas sociais mundiais. O monitoramento permanente desses pontos microrregionais de atenção secundária à saúde é essencial para a execução das ações planejadas pela política estadual de saúde. Esse trabalho apresenta o Sistema Estadual de Monitoramento dos Centros Viva Vida, responsável pelo monitoramento dos CVV no Estado. Esse Sistema, em funcionamento desde 2005, é composto por um conjunto de ferramentas gerenciais que coleta e processa informações assistenciais e contábil-financeiras desses Centros. A metodologia consiste em revisão bibliográfica, coleta e análise dos dados produzidos pelo Sistema de Monitoramento, entre julho de 2008 e junho de 2009, disponibilizados pela Secretaria de Estado da Saúde de Minas Gerais. Dados preliminares desse Sistema apontam um incremento de 42% na produção, no período analisado, além de um superávit financeiro no conjunto dos CVV. Destaca-se que dado o caráter inovador desses Centros, suas ferramentas gerenciais se mantêm em constante aperfeiçoamento. O trabalho conclui ainda que as informações produzidas constituirão base para a implantação dos sistemas de custos dos CVV.

Cet article présente et discute les résultats d’une recherche-intervention réalisée dans la ville brésilienne d’Ouro Preto entre août 2014 et mars 2016. L’objectif principal était de contribuer au développement du réseau intersectoriel et interdisciplinaire pour faire face aux vulnérabilités psychosociales des enfants et des adolescents, spécialement celles liées aux situations de violences sexuelles et à l’usage de drogues. La recherche a identifié les difficultés rencontrées par le Sistema de Garantia de Direitos Humanos da Criança e do Adolescente (SGDHCA), implanté par la municipalité, dans sa mission d’apporter des soins à cette population. Elle a également identifié les facteurs de protection et de promotion déjà mis en place afin de les potentialiser. La méthodologie employée combine la Cartographie de Deleuze et Guattari avec l’Analyse institutionnelle et la Formation croisée. Grâce à des activités pratiques-théoriques co-participatives avec le réseau professionnel d’Ouro Preto, nous avons produit un diagnostic détaillé sur le SGDHCA et un document qui propose des actions stratégiques de court, moyen et long terme. Comme résultat final, la recherche peut aider le collectif local – le Forum Intersetorial da Infância e Juventude – à établir un plan de travail à partir des actions proposées. Cet article se concentre sur le potentiel de la méthodologie utilisée, en présentant les résultats dégagés pendant deux moments importants de la recherche, à savoir : les discussions des cas de réussite et de non-réussite qui élucident le fonctionnement du réseau et la « rotation positionnelle », technique importante de la formation croisée.This paper presents and discusses the results of an intervention research conducted in Ouro Preto, Brazil from August 2014 to March 2016. The main objective was to contribute to the development of an intersectoral and interdisciplinary network to face psychosocial vulnerabilities of children and teenagers, especially related to sexual violence and drug use. To achieve this, we identified the difficulties faced by the Sistema de Garantia de Direitos Humanos da Criança e do Adolescente (SGDHCA) implemented by the municipality which take care of this population. We also identified protective and promotion factors accomplished to empower them. The methodology used combines Deleuze and Guattari Cartography, Institutional Analysis and the Cross Training. This latter methodology was developed by a group of researchers of Douglas Institute, in Montreal, which we met through scientific co-operation with our laboratory. On account of the practical-theoric and co-participative activities with the professional network of Ouro Preto, we produced a detailed diagnosis of the SGDHCA and a document proposing short, medium and long-term strategies. As final r...

In the State of Minas Gerais, the Secondary Reference Viva Vida Centers (CVVRS) are one of the strategies deployed to tackle the problems in child health. This study sought to evaluate pediatric care provided in a CVVRS, using the guidelines defined when it was set up as a benchmark. A quantitative-qualitative approach was adopted, which included a cross-sectional study with stratified random sampling of 385 medical records of children registered with the program between 2007 and 2009, and analysis of focus groups with strategic actors of the initiative. There were divergences between the user profiles and the target audience in terms of age, hometown and clinical characteristics. Access and use of the service differed depending on the town, due to problems of misinformation concerning the proposal, difficulty of transportation and the fragility of the health network. The centers are considered an innovative and important initiative for the expansion and organization of the health network, though the intended logic is not effectively seen in practice. Interventions for articulation between the network services and adaptation of the agreed guidelines to the regional specificities are necessary.