Políticas Públicas de Saúde Vol 2

Políticas Públicas de Saúde
e Processo de Trabalho
em Saúde da Família
Vol. 2
Organizadores:
Adélia Delfina da Motta S. Correia
Leika Aparecida Ishiyama Geniole
Vera Lúcia Kodjaoglanian
Cristiano Costa Argemon Vieira
Volume 2
Curso de Pós-Graduação
em Atenção Básica
Organizadores:
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Seção 2 - BASES LEGAIS DO SUS: LEIS ORGÂNICAS DA SAÚDE4
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VREUH RV GHWHUPLQDQWHV
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Histórico das Conferências Nacionais de Saúde
CNS Ano TEMA CENTRAL

1ª CNS 1941 6LWXDomRVDQLWiULDHDVVLVWHQFLDOGRVHVWDGRV
2ª CNS 1950 /HJLVODomRUHIHUHQWHjKLJLHQHHjVHJXUDQoDGRWUDEDOKR
3ª CNS 1963 'HVFHQWUDOL]DomRQDiUHDGH6D~GH
4ª CNS 1967 5HFXUVRVKXPDQRVSDUDDVDWLYLGDGHVHPVD~GH
,,PSOHPHQWDomRGR6LVWHPD1DFLRQDOGH6D~GH,,3URJUDPDGH6D~GH
0DWHUQR,QIDQWLO,,,6LVWHPD1DFLRQDOGH9LJLOkQFLD(SLGHPLROyJLFD,9
5ª CNS 1975
3URJUDPDGH&RQWUROHGDV*UDQGHV(QGHPLDVH93URJUDPDGH([WHQVmR
GDV$o}HVGH6D~GHjV3RSXODo}HV5XUDLV
,6LWXDomRDWXDOGRFRQWUROHGDVJUDQGHVHQGHPLDV,,2SHUDFLRQDOL]DomR
GRVQRYRVGLSORPDVOHJDLV EiVLFRVDSURYDGRVSHORJRYHUQRIHGHUDO HP
6ª CNS 1977
PDWpULDGHVD~GH,,,,QWHULRUL]DomRGRVVHUYLoRVGHVD~GHH,93ROtWLFD
1DFLRQDOGH6D~GH
7ª CNS 1980 ([WHQVmRGDVDo}HVGHVD~GHSRUPHLRGRVVHUYLoRVEiVLFRV
,6D~GHFRPR'LUHLWR,,5HIRUPXODomRGR6LVWHPD1DFLRQDOGH6D~GH
8ª CNS 1986
H,,,)LQDQFLDPHQWR6HWRULDO
9ª CNS 1992 0XQLFLSDOL]DomRpRFDPLQKRUHDOL]DGDFRPDQRVGHDWUDVR
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10ª CNS 1996 VHUYLoRVGH VD~GH ,,, &RQWUROH VRFLDO QD VD~GH ,9 )LQDQFLDPHQWR GD
VD~GH95HFXUVRVKXPDQRVSDUDDVD~GHH9,$WHQomRLQWHJUDOjVD~GH
(IHWLYDQGRR686DFHVVRTXDOLGDGHHKXPDQL]DomRQDDWHQomRjVD~GH
11ª CNS 2000
FRPFRQWUROHVRFLDO
6D~GHXPGLUHLWRGHWRGRVHXPGHYHUGR(VWDGR$VD~GHTXHWHPRV
12ª CNS 2003
R686TXHTXHUHPRV
13ª CNS 6D~GHHTXDOLGDGHGHYLGD3ROtWLFDGH(VWDGRHGHVHQYROYLPHQWR
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qual âmbito (local, municipal, estadual ou nacional)? Quais
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Na biblioteca do curso, no ambiente virtual de

aprendizagem, você encontrará os artigos de Ruben
Araújo Mattos: “Os sentidos da Integralidade” (2001) e “A
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Seção 2 - ATENÇÃO PRIMÁRIA À SAÚDE E ESTRATÉGIA DE
SAÚDE DA FAMÍLIA
2.1 - Fundamentos da Atenção Primária à Saúde
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3. Relacione as duas colunas a seguir:
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caminhos...
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SUS - BRASIL
A SAÚDE DA FAMÍLIA
VALORES - UNIVERSALIDADE
- EQUIDADE
Expressam os valores dominantes em uma - INTEGRALIDADE
sociedade. São a âncora moral para as - PARTICIPAÇÃO E CONTROLE SOCIAL
políticas e programas no interesse público.
PRINCÍPIOS - TERRITORIALIZAÇÃO
- INTERSETORIALIDADE
Provêm as bases para a legislação, os critérios - CARÁTER SUBSTITUTIVO (baseado na
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de recursos. - EQUIPES MULTIPROFISSIONAIS
- BASEADO NAS NECESSIDADES E
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ATRIBUTOS Únicos da APS:

(ou elementos ou características da APS)
- PRIMEIRO CONTATO
São a base estrutural e funcional do sistema de - INTEGRALIDADE
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os programas e os serviços. - COORDENAÇÃO
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família
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- Qualidade clínica
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PRIMEIRAS TENTATIVAS DE IMPLEMENTAÇÃO DA APS PREUCUPAÇÕES ATUAIS DAS REFORMAS DA APS

Amplo acesso a um pacote básico de intervenções em Transformação e regulamentação dos sistemas de saúde
saúde e a medicamentos essenciais para os pobres em existentes, com o objetivo de acesso universal e da
áreas rurais. proteção social da saúde.
Concentração na saúde da mãe e da criança. Preocupação com a saúde de todos os membros de uma
comunidade.
Focalização num pequeno número de doenças Resposta integrada às expectativas e necessidades das
selecionadas, primordialmente infecciosas e agudas. pessoas, ampliando o espectro de riscos e de doenças
abrangidas.
Melhorias em higiene, água, saneamento e educação para Promoção de estilos de vida mais saudáveis e mitigação
a saúde ao nível das comunidades. dos efeitos dos riscos sociais e ambientais.
Tecnologias simples para trabalhadores de saúde Equipes de trabalhadores da saúde a facilitar o acesso e o
comunitários, não profissionais e voluntários. uso apropriado das tecnologias e dos medicamentos.
Participação vista como a mobilização de recursos locais e Participação institucionalizada da sociedade civil em
a gestão de centros de saúde através de comitês de saúde diálogos políticos e mecanismos de responsabilização.
locais.
Serviços financiados e prestados pelo Governo com Sistemas de saúde pluralísticos num contexto globalizado.
gestão centralizada de cima para baixo.
Gestão da crescente escassez e redução de postos e Por o aumento dos recursos para a saúde a serviço da
trabalho. cobertura universal.
Ajuda e assistência técnica bilaterais. Solidariedade global e aprendizagem conjunta.
Atenção primária como a antítese do hospital. Atenção primária como coordenadora de uma resposta
integrada a todos os níveis.
APS é barata e requer apenas um modesto investimento. APS não é barata: requer um investimento considerável,
mas mais compensador do que qualquer outra alternativa.
Fonte:2062UJDQL]DomR0XQGLDOGH6D~GHRelatório Mundial 2008

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INTERPRETAÇÕES DE APS DEFINIÇÃO OU CONVEITO DE APS
APS SELETIVA A APS constitui-se em um conjunto de atividades e serviços de alto

impacto para enfrentar alguns dos desafios de saúde mais
Um conjunto específico de prevalentes nos países em desenvolvimento (Gofin; Gofin, 2005).*
atividades e serviços de saúde
voltados à população pobre.
APS refere-se ao ponto de entrada no sistema de saúde quando se

Um nível de Atenção em um apresenta um problema de saúde, assim como o local de cuidados
sistema de serviços de saúde. contínuos da saúde para a maioria das pessoas. Esta é a concepção
mais comum da APS na Europa e em outros países industrializados.
Para que a APS possa ser entendida como uma estratégia para
organizar o sistema de saúde, este sistema deve estar baseado em
Uma estratégia para organizar os alguns princípios estratégicos simples: serviços acessíveis, relevantes
sistema de atenção à saúde.** às necessidades de saúde; funcionalmente integrados (coordenação);
baseados na participação da comunidade, custo-efetivos e
caracterizados por colaboração intersetorial.
Uma concepção de sistema de Um país só pode proclamar que tem um sistema de saúde baseado
saúde, uma “filosofia” que permeia na APS, no sentido mais profundo da expressão, quando seu sistema
todo o sistema de saúde. de saúde se caracteriza por: justiça social e equidade; autor-
responsabilidade; solidariedade internacional e aceitação de um
conceito amplo de saúde. Enfatiza a compreensão da saúde como
um direito humano e a necessidade de abordar os determinantes
sociais e políticos mais amplos da saúde (Ministério da Saúde, 2006).
Não difere nos princípios de Alma-Ata, mas sim na ênfase sobre as
implicações sociais e políticas na saúde. Defende que o enfoque
social e político da APS deixaram para trás aspectos específicos das
doenças e que as políticas de desenvolvimento devem ser mais
inclusivas, dinâmicas, transparentes e apoiadas por compromissos
financeiros e de legislação, se pretenderem alcançar mais equidade
em saúde.
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Parceiros:
SES
Secretaria de Estado de
SESAU
ASMEFAC S e c r e t a r i a
UNIDADE CERRADO PANTANAL
Associação Sul-Mato-Grossense de
Médicos de Família e da Municipal

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Políticas Públicas de Saúde

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Fonte:2062UJDQL]DomR0XQGLDOGH6D~GHRelatório Mundial 2008

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