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12th
NATIONAL HEALTH CONFERENCE
PASTORAL DA CRIANÇA PROPOSALS
Pastoral da Criança participates of the stages
of 12th National Health Conference, that
happens on 2003, with the theme "HEALTH, A RIGHT
OF ALL AND DUTY OF THE STATE – THE HEALTH THAT WE HAVE,
THE SUS THAT WE WANT".
There are twenty years of compromise with the construction
of citizenship, disease prevention, and population’s
education at basic actions and health promotion. Pastoral
da Criança today counts with more than 203 thousand,
that act together with the families of 1 million and
600 thousand poor children and 70 thousand poor pregnant
women, at more than 3,200 municipalities in Brazil.
At the municipal, state and national stages of 12th
National Health Conference, will be discussed the main
theme from 10 axe theme, contemplating each axe the
social control. From its Intersectorial experience Pastoral
da Criança now presents its proposals related
with the axe themes. After quick argument on each axe,
it is present the respective priority proposal. This
is collaboration for the discussion during the stages
of 12th National Health Conference.
- Right to Health
The first right of every human being is life and
the conditions for life quality, with health. There
were historical conquests at the guarantee of this
right with the institution of the Single Health
System – SUS. But many Brazilian children and pregnant
women continue without access to Health. Some because
they are distant, others because they need to stand
in line and there is no place for them. The delay
to access or the risky transportation, they aggravate
the illnesses and until even they are motive of
death for children and pregnant women, especially
at the child first days of life. In the country,
the major cause of Infant Mortality is Perennial
Diseases. And when the people get to arrive to the
Service Public Health, not always are attend in
a welcomed form, with medicine, exams and qualified
and motivated people disposability to offer a quality
treatment.
Proposal: implementation of strategy for
that it happen, at the three government spheres,
the guarantee previewed by the Federal Constitution
the absolute priority at the assistance of pregnant
women and children at the health services, and promotion
of programs like "Secure Birth", "Pregnant
Woman Support’s House", "Birth House",
"Secure Maternity", and "Child Friendly
Hospitals";
- Social Security and Health
Summed to the rights more clearly linked to the
life, health, physical integrity guarantee, our
Constitution defines also as rights of children
at all ages playtime, identity, education his/hers
potentialities development. The guarantee of disposability
of the mother’s physical presence together with
the child at the first months of life contributes
for his/hers development. The formulation of any
policy of social mark for these biologically vulnerable
groups – pregnant women, fosters and children –
must guarantee their development potential. The
consequence of this policy results at a better school
approvement of the child, better self – esteem,
reduction of previewed to weight loss at birth and
of infant and mother child mortality, improve the
production capacity as to the physical point of
view as intellectual and, still, reduction of chronical
diseases not transmittable at the adult age.
Proposal: guarantee disposability of financial
resources for all mothers, at the form of maternity
salary, until the 06 month of the child, independent
the time of contribution together to the National
Social Security Institution – INSS.
- Health Action Intersectority
The articulated actions involving government and
society sectors, at the community level, they contribute
to improve the population’s health. Some actions
have a great impact to prevent human suffering and
illnesses. It is the case of Food Security, Basic
Sanitation, Environment and Education for Health.
A big concept of Food Security, value the traditional
food practices, the local foods, search for more
complete, natural and healthy meals, respecting
the specific food habits of each region and orientate
the take in of food less conventional, rich in nutrients,
as for example: dark-green leaves, peels, and seeds.
At the same way the sanitation respects the environment,
with the use of adequated technology. The Education
for Health involves the population at the construction
of knowledge and of culture change, when needed,
for habits for a healthier life.
Proposal: decentralize Federal Government
resources to develop integrated and self – reliable
actions, focusing in an Intersectorial and prior
way the Food Security, Basic Sanitation, Environment
and Education for Health.
- The three Government Spheres and the SUS Construction
The health actions pacted regionally, the partnerships,
or organization forms according to different country’s
realities, are managing instruments, and a way to
strengthen the attention to populations’ health.
It pleases the union of several disposable resources
at the municipalities for problem solution. It organizes
the reference and non- – reference health services,
for health special assistance. The partnership institution,
and other organizations’ initiatives, are previewed
on Federal Constitution and specific health laws
– n. 8,080/90 and 8,142/90 and can integrate SUS.
The Federal and State government have the mission
to motivate and participate at the regional organization,
respecting the municipal initiatives.
Proposal: financially incentivate and strengthen
the intermunicipal partnerships or associations
at micro regions, and action reference and non –
reference pacted for the attention to health.
- The Attention Organization to Health
The Attention Organization to Health requests instruments
that integrate an information system of evaluation
and monitoring. The SUS Card is one of these instruments.
The basic idea of this Card is that each Brazilian
citizen receives a number, recorded on the card
that will be his/her medical promptuary identification
at the national level. Beyond to attend the System’s
register and organization exigencies, the card permits
to realize with the assistance ability for all the
population and its posterior charge, in a total
integrated form. Its implementation involves at
the attention services organization between the
three government levels. Many municipalities already
have registered their population and are in processing
final processor the use of the Card system.
Proposal: incentive and mobilization for
the registration of all Brazilians at the SUS Card
until the end of 2,005, and permanent processing
and maintenance of assistance system with the SUS
Card at all levels of health service, specially
in relation to organization of health actions, with
disposability if basic services, appointments, exams,
medicines, workers, material and financial resources
at adequated quantity.
- Participative Managing
The 1,988 Federal Constitution, at its article
204, assures that the people participate directly
at the elaboration and social control of public
policies at all levels national, state and municipal.
The Laws 8,080/90 and 8,142/90 rule this participation
channel at health and define the Health Councils
with maximum instance for the formulation of policies
and fiscalization of execution of health resources.
The participation on the decisions on health includes
all the actions designated to promote and improve
the condition of Brazilian lives, and happen as
at councils as also through conferences.
Proposal: promote the participation of organized
society at Health Councils and strengthen the counselors’
action, promoting the counselors and managers capacitation,
democratizing the information on Social Control,
the communities participation at the Council’s activities
and decisions and collaborating to accomplish that
is previewed at the legislation on Health Council’s
attributions.
- Work on Health
The investment on work’s Managing and capacitating
at the health area, influences in a direct way at
the health service’s improvement given to the population.
To assure that the health workers be satisfied with
their work process and with the result of their
work, it’s a practical and right way to advance
at the system’s implementation, as it is described
at the document "principles and directions
to the Basic Operational Norm on Human Resources",
approved by the National Health Council on 2002.
Investments on managing a capacitation improves
the assistance quality and diminishes the lack of
professional motivation, the function switch, and
conceive the dialogue spaces between workers, managers
and employers.
Proposal: implant with the health, continued
education processes and Health service humanization
strategies workers and managers, with the responsibility
of many government levels, from the social reality
of each region, with the guarantee of resources
to form and disponibilize of adequated educative
material.
- Science and Technology and Health
The application of technologies, scientific discoveries,
quality teaching and scientific information to prevent
and heal the human suffering must integrate the
health planning, at the three government spheres.
The researches and technology development can bring
concrete answers to SUS, with new products and modernized
ways to struggle with health and illness. Brazil
needs to improve the researches related with endemic,
infectious and parasitarian diseases. We have a
natural wealth little used, especially at phytotherapic
medications and new formulas for medicines. Respecting
the regional diversity, the Science and Technology
can contribute for strategic and low cost solutions
for problems related to health, diminishing the
social inequalities.
Proposal: implement a science and technology
policy, integrating research centers, official laboratories
and universities, aiming the pharmaceutics input
for development and research, specially phytotherapic,
to gradually diminish the external dependence and
create reference in terms of medicine cost.
- Health Financing
The minimum financial resource application for
Health have the Constitutional guarantee, according
to Constitutional Emendation 29 – EC 29, approved
on September 2000. According to this Emendation,
the municipalities must invest 15% and the states
12% of their budget resources with health. The Federal
Government must correct every year its budget for
Health according to Gross Domestic Product – PIB.
Between 2004 and 2005, will be discussed a Complementary
Law for EC – 29. One of this Complementary Law will
be the definition on which are the expenses with
health that lacks at the Emendation, and which the
budget sources to compose the health percentage.
This Emendation and Health uncentralization process,
and resources from fund to fund for States and Municipalities,
represent a Social Control great achievement. The
investments get nearer where the health actions
are executed. However, besides the last years’ budget
growth it lacks resources for Health at the three
government spheres. Allied to the low financial
disposability, many times the disposable money is
used without adequated planning and without priorities
for health promoting and disease prevention actions;
and without the population qualified participation
through councils, conferences and non – governmental
entities that act at communities. Besides this,
there are many managers little prepared for management,
and lack of workers’ capacitation, and until even
the Health money evasion to its areas.
Proposal: promote ample public discussion
with the community participation, for the Complementary
Law elaboration that will discipline the dispositives
of Constitutional Emendation n. 29, as it is previewed
on Federal Constitution’s 198th article
3rd §; and establish as parameter for
the discussion the resolution number 322, of May
08th 2003, from the National Health Council,
that presents the directions about the Constitution
Emendation n. 29 application, and that counts with
government sectors and civil society ample participation,
during its formulation.
- Communication and information in health
The initiative related with policies and strategies
of communication and information at health for Brazilian
citizens, they need to be democratic. The language
must be adequated, with content of interests for
the local society and the modern media usage, like
the Internet, and the popular ones – like radio
and printed material, that make possible the ample
access. Besides this, initiatives of communication
and information uncentralized and network organized
can divulge local experiences and strengthen the
social control.
Proposal: Communication and Information
strategies and policies definition that aim to give
visibility of Health Service and Social Control
offers, orientation for the population on healthy
habits, disease prevention, information on resources
applied on health, besides motivating the citizens
to exert their duties and charge their rights and
the responsibilities of health managers and renders
of services.
The National Conference stages happen at the municipalities,
at the states and at Brasília, from December
07th to 11th 2003. The municipal
conference will discuss the local questions related
to the theme and the tem thematic axles, and elect
the delegates to the state step. At the state conferences
will be elaborated a report with proposals from
the state level and it will be related for the national
meeting.
The Health Conference accomplishment is defined
at the law n. 8,142, from December 28th
1990. It must join the social segment representation
that act on the health area. Our orientation for
Pastoral da Criança, as an organized health
popular movement at more than 3,500 municipalities,
it is active participate and health municipal conferences
and being possible, to candidate someone to a chair
at the State Conference, that will elect the delegates
to the national stage. We inform that the travel
expenses to these conferences are responsibility
of state and municipal governments.
Respectfully
Dr. Zilda Arns Neumann
Pastoral da Criança National Coordinator
CNBB Chair Representative at the National Health
Council
More information with Clóvis Boufleur, Juliana
Kuwano and Annalice Del Vecchio,
telephone: (+55041) 336-0250 or
E-mail: juliana@pastoraldacrianca.org.br,
annalice@pastoraldacrianca.org.br
e lilian@pastoraldacrianca.org.br
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