Sanitaristas, Petistas, and the Post-Neoliberal Public Health State in Porto Alegre

2016 ◽  
Vol 43 (2) ◽  
pp. 153-171 ◽  
Author(s):  
Christopher L. Gibson

Scholars of the post-neoliberal state in Latin America commonly trace universal social policies to ruling left parties and deepened democracy. Yet, such accounts often overlook how subnational politics in highly decentralized democracies like Brazil’s can mediate this relationship. Examining such politics in the Brazilian município of Porto Alegre since 1988 suggests that structural constraints and competing programmatic agendas of Partido dos Trabalhadores (Workers’ Party—PT) governments complicated expansion of the public health sector. The município’s surprisingly modest delivery of such services is traceable to enduring deemphasis on critical dimensions of state building in this sector by several PT administrations and the integration of civil society actors into multiple participatory governance institutions with little power over this process. Even in such contexts, far-reaching participatory democratic institutions are no panacea for fulfilling the universal social policy ambitions of local post-neoliberal states that depend heavily upon high-level political appointees for their effectiveness.Estudiosos do Estado pós-neoliberal na América Latina frequentemente associam políticas sociais universais aos partidos governantes de esquerda e à solidificação da democracia. Contudo, tais narrativas ignoram como a política subnacional em democracias muito descentralizadas, como a brasileira, mediam esse relacionamento. Um exame dessa dinâmica política no município de Porto Alegre desde 1988 sugere que restrições estruturais e agendas programáticas competitivas de governos do Partido dos Trabalhadores (PT) ampliou a complexidade de expansão do setor de saúde pública. A modesta oferta de serviços de saúde naquele município pode ser atribuída a um esvaziamento contínuo das dimensões criticas da ingerencia do Estado nesse setor por parte de várias administrações petistas e à integração de atores da sociedade civil em múltiplas instituições de governança participatória com pouco poder de decisão sobre tal processo. Mesmo nesses contextos, instituições democráticas com alcance amplo não constituem uma panacéia que realize as ambições sociais universais de Estados locais pós-neoliberais, os quais dependem muito de políticos do alto escalão em cargos comissionados para serem eficientes.

Author(s):  
M. Prosper Lutala ◽  
Timothée M. Kwalya ◽  
Eric K. Kasagila ◽  
L. Hubert Watongoka ◽  
Bavon W. Mupenda

Background: Health and social services utilisation is seen to be more closely related to age than to other socio-demographic characteristics. Many health problems are known to increase with age and this demographic trend may lead to an increase in the absolute number of health conditions in this population. However, questions are still emerging as to how the elderly seek care in response to their needs in the context of a war-torn region. Objectives: The aim of this study was to determine the behaviour of the elderly in seeking care during a time of conflict.Method: A descriptive cross-sectional study was carried out in the health district Goma, in the Democratic Republic of the Congo (DRC), using a multistage sampling of 500 senior citizens. Eight trained field-workers were deployed in the field where they administered a structured questionnaire.Results: The public health sector was well known and preferred by 186 participants (37.2%), but only used by 16 (3.2%) participants. Financial support received by the elderly came from their own relatives and fellow believers in 33.5% and 20.2% of cases, respectively. Almost 71% of monetary support is the result of begging and unknown sources – there is no government involvement whatsoever. Much of the external support that the elderly receive involves support in the form of food. Disease expenses remain a main concern of the elderly themselves.Conclusion: Government support for the elderly in the DRC is non-existent. There is an overuse of private sector and traditional medicine, despite the preference indicated for the public health sector. As a recommendation, a general increase in income-related activities could contribute to alleviating the health state of the elderly in a war situation. Further studies might explore in future the contribution of those results on the health of elders.


Author(s):  
Sarah Palmeter

In the completion of my practicum at the Public Health Agency of Canada (PHAC) this summer, I worked to develop a surveillance knowledge product to support the national surveillance of developmental disorders. This project used Statistics Canada’s 2017 Canadian Survey on Disability to investigate the burden of developmental disorders in Canada. Developmental disorders are conditions with onset in the developmental period. They are associated with developmental deficits and impairments of personal, social, academic, and occupational function. The project objectives are to estimate the prevalence of developmental disorders in Canadians 15 years of age or older, overall and by age and sex, as well as report on the age of diagnosis, disability severity, and disability co-occurrence in those with developmental disorders. The majority of the analysis has been completed and preliminary results completed, which cannot be released prior to PHAC publication. Although not highly prevalent, developmental disorders are associated with a high level of disability in young Canadians. Early detection and interventions have been shown to improve health and social outcomes among affected individuals. Understanding the burden of developmental disorders in Canada is essential to the development of public health policies and services.


2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.


Author(s):  
Effy Vayena ◽  
Lawrence Madoff

“Big data,” which encompasses massive amounts of information from both within the health sector (such as electronic health records) and outside the health sector (social media, search queries, cell phone metadata, credit card expenditures), is increasingly envisioned as a rich source to inform public health research and practice. This chapter examines the enormous range of sources, the highly varied nature of these data, and the differing motivations for their collection, which together challenge the public health community in ethically mining and exploiting big data. Ethical challenges revolve around the blurring of three previously clearer boundaries: between personal health data and nonhealth data; between the private and the public sphere in the online world; and, finally, between the powers and responsibilities of state and nonstate actors in relation to big data. Considerations include the implications for privacy, control and sharing of data, fair distribution of benefits and burdens, civic empowerment, accountability, and digital disease detection.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Jevtic ◽  
C Bouland

Abstract Public health professionals (PHP) have a dual task in climate change. They should persuade their colleagues in clinical medicine of the importance of all the issues covered by the GD. The fact that the health sector contributes to the overall emissions of 4.4% speaks to the lack of awareness within the health sector itself. The issue of providing adequate infrastructure for the health sector is essential. Strengthening the opportunities and development of the circular economy within healthcare is more than just a current issue. The second task of PHP is targeting the broader population. The public health mission is being implemented, inter alia, through numerous activities related to environmental monitoring and assessment of the impact on health. GD should be a roadmap for priorities and actions in public health, bearing in mind: an ambitious goal of climate neutrality, an insistence on clean, affordable and safe energy, a strategy for a clean and circular economy. GD provides a framework for the development of sustainable and smart transport, the development of green agriculture and policies from field to table. It also insists on biodiversity conservation and protection actions. The pursuit of zero pollution and an environment free of toxic chemicals, as well as incorporating sustainability into all policies, is also an indispensable part of GD. GD represents a leadership step in the global framework towards a healthier future and comprises all the non-EU members as well. The public health sector should consider the GD as an argument for achieving goals at national levels, and align national public health policies with the goals of this document. There is a need for stronger advocacy of health and public-health interests along with incorporating sustainability into all policies. Achieving goals requires the education process for healthcare professionals covering all of topics of climate change, energy and air pollution to a much greater extent than before.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e039242
Author(s):  
Pragashnie Govender

IntroductionEarly childhood is a critical time when the benefits of early interventions are intensified, and the adverse effects of risk can be reduced. For the optimal provision of early intervention, professionals in the field are required to have specialised knowledge and skills in implementing these programmes. In the context of South Africa, there is evidence to suggest that therapists are ill-prepared to handle the unique challenges posed in neonatal intensive care units and wards with at-risk infants in the first few weeks of life. This is attributed to several reasons; however, irrespective of the causative factors, the need to bridge this knowledge-to-practice gap remains essential.Methods and analysisThis study is a multimethod stakeholder-driven study using a scoping review followed by an appreciative inquiry and Delphi process that will aid in the development, implementation and evaluation of a knowledge translation intervention to bridge knowledge-gaps in occupational and physiotherapists working in the field. Therapists currently working in the public health sector will be recruited for participation in the various stages of the study. The analysis will occur via thematic analysis for qualitative data and percentages and frequencies for descriptive quantitative data. Issues around trustworthiness and rigour, and reliability and validity, will be ensured within each of the phases, by use of a content validity index and inter-rater reliability for the Delphi survey; thick descriptions, peer debriefing, member checking and an audit trail for the qualitative data.Ethics and disseminationThe study has received full ethical approval from the Health Research and Knowledge Management Directorate of the Department of Health and a Biomedical Research Ethics Committee. The results will be published in peer-reviewed academic journals and disseminated to the relevant stakeholders within this study.


2021 ◽  
pp. 145507252199570
Author(s):  
Marjut Salokannel ◽  
Eeva Ollila

Background: Use of snus and snus-like nicotine products is increasing, in particular among young people, in several Nordic countries and Estonia, while snus is legally on the market only in Sweden and Norway. Snus is available in a great variety of tastes and packaging particularly catering for young users. Recently, strong snus-resembling nicotine pouches have emerged on the market. This research investigates the regulatory means to counteract this development. Methods: European Union (EU) and national tobacco control legislation, case law of the European Court of Justice (CJEU) and relevant public health studies are analysed. Results: The research finds that the judgement of the CJEU relating to the sale of snus on Finnish ferries has not been enforced. Permitted large traveller imports for personal use have contributed to wide availability of snus in Finland. Even if the legislation in Sweden is in conformity with the exemption it obtained in the Accession Treaty, the public health impact of snus use for young people in its neighbouring countries has become considerable. Nicotine pouches, -which are not regarded as medical products in terms of medicine legislation, lack harmonised EU-wide regulation. Controlling smuggling across open borders is challenging. Conclusions: The legislation at the EU and national levels should be able to protect young people from new tobacco and nicotine products. It is urgent to harmonise regulation relating to new tobacco and nicotine products taking as a base a high level of protection of health as required in the Treaty on the Functioning of the EU.


Author(s):  
Pasquot L ◽  
◽  
Giorgetta S ◽  

Many are the aspects we should ponder on, after 17 months from the burst of the COVID-19 pandemic, especially as nurses. Due to the numerous cuts to the public health sector in the last decades in Italy, the sanitary emergency has been a great sacrifice for health professionals, as public health was completely unprepared to withstand it. The Italian government reacted to this lack of preparation with exceptionally urgent measures. Although, these measures were implemented long after the initial state of confusion and of inappropriate management, they brought about stability and led to a containment strategy for the spread of the virus across the nation [1]. The reduction in the number of COVID-19 diagnoses was mainly achieved through social distancing. At first this was only required to a small number of communities affected by high infection rates, but was eventually extended to the rest of the country from March 2020 [2]. The national lockdown during the first COVID-19 wave (from March to May 2020), was replaced by regional lockdowns in the second wave (from November 2020). As of now, regional lockdowns are integrated by the vaccine campaign and Green Pass enforcement. In November 2020 the Italian Prime Minister at the time, issued legislative measures to enforce regional lockdowns, limiting nonessential movements, cafes, restaurants and other public places opening hours. This legislation established to classify the national territory in different levels of restriction based on the infection rate: red zones - highest risk of infection, orange zones - medium high risk and yellow zones with a minor risk of infection. A later legislation introduced the white zone for territories with the lowest risk of infection (DPCM-14th January 2021). The infection rate has been important to establish a region’s tier status; however, it is not the defining parameter anymore. A new legislation from July 2021 (n.105 - 23rd July 2021), opted to classify a region’s tier status according to the hospital bed’s occupancy rate for COVID-19 patients in intensive care and other medical areas.


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