执行土著保健政策:对Solimões河上游保健做法的民族志分析。

IF 1.1 4区 医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Ciencia & saude coletiva Pub Date : 2024-12-01 Epub Date: 2024-05-15 DOI:10.1590/1413-812320242912.08202024
Roberta Aguiar Cerri, Luiza Garnelo
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引用次数: 0

摘要

本研究分析原住民健康政策的执行情况,重点关注亚马逊河上游Solimões河原住民医疗保健子系统卫生团队的护理实践。利用民族志作为方法论资源,研究了政策实施过程中参与者、话语和权力之间的动态关系,揭示了实践与其他情境现实之间的复杂联系。有三种现象对护理实践产生了关键影响:医疗模式、卫生模式和绩效文化。医疗保健和卫生模式得以延续。绩效文化引入了一种基于定量指标和预定义目标的控制范式,影响职业认同、社会互动和行动的有效性。在制度的边缘,其他日常实践是由时间需求、主观感受和地方权力网络引起的,从而挑战社会结构和习俗。受旧政策影响的做法重新制定了土著保健政策,并通过官僚机构诱导的技术进行了改造,使其与意识形态议程保持距离。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementation of the Indigenous Health Policy: an ethnographic analysis of healthcare practices in the Upper Solimões River.

This study analyzes the implementation of the Indigenous Health Policy, focusing on the care practices of health teams of the Indigenous Health Care Subsystem in the Upper Solimões River in the Amazon region. Using ethnography as a methodological resource, the dynamics among participants, discourses, and power in the implementation of the policy are investigated, revealing a complex interconnection between practices and other contextual realities. Three phenomena emerge as critical influences on care practices: the medical-care model, the sanitation model, and the culture of performance. The medical-care and sanitation models are perpetuated. The culture of performance introduces a control paradigm based on quantitative indicators and pre-defined goals, affecting professional identity, social interactions, and the effectiveness of actions. On the margins of the institution, other daily practices are induced by temporal needs, subjective feelings, and local networks of power, thus challenging social structures and conventions. The Indigenous Health Policy was reformulated by practices influenced by old policies and was remodeled by techniques induced by bureaucracy, distancing itself from its ideological agenda.

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来源期刊
Ciencia & saude coletiva
Ciencia & saude coletiva PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
3.60
自引率
11.80%
发文量
533
审稿时长
12 weeks
期刊介绍: Ciência & Saúde Coletiva publishes debates, analyses, and results of research on a Specific Theme considered current and relevant to the field of Collective Health. Its abbreviated title is Ciênc. saúde coletiva, which should be used in bibliographies, footnotes and bibliographical references and strips.
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