Análise do programa saúde na escola como estratégia de promoção da saúde
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Data
2023-12-12
Autores
Wagmacker, André dos Santos
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Universidade Federal do Espírito Santo
Resumo
Introduction: The School Health Program (Programa Saúde na Escola - PSE) was established in 2007 through a partnership between the Ministries of Health and Education of Brazil, aiming to promote the comprehensive health of public school students. Although the PSE has proven to be an important health strategy, its implementation has not yet reached its full potential, with one of the most notable weaknesses being intersectorality.Objectives: This dissertation aimed to analyze the PSE as a health promotion strategy and had the following specific objectives: to describe the implementation and results of the PSE in Brazil through a scoping literature review; to analyze the correlation between social inequalities, organization of health services, epidemiological indicators, and PSE outcomes in the municipalities of the state of Espírito Santo (ES) between 2019 and 2022; and to develop a manual to support the execution and monitoring of PSE results by Brazilian municipalities.Methods: This is a qualitative-quantitative study divided into three stages. In the first stage, a scoping review of the literature on the implementation and results of the PSE in Brazil between 2007 and 2022 was conducted. In the second stage, an ecological study was performed using public secondary data. The dependent variable considered the set of goals agreed upon in the adherence to the PSE in each cycle and was constructed with data from SISAB. The result was correlated with social variables, organization of health services, and epidemiological indicators. In the third stage, an e-book containing information on the execution and monitoring of PSE results for Brazilian municipalities was developed. Results: The scoping review revealed weaknesses in the implementation of the PSE across the country, namely: in the structure, there is insufficient training on the program's objectives, a shortage of professionals, and work overload; in the process, there is an absence of situational diagnosis and intersectoral planning, fragmented activities, and the health sector's leading role; and in the results, there were improvements in access to health services, increased adherence to the program, and perceived improvements in students' habits and learning. The ecological study showed that municipalities in ES had difficulties meeting the program's goals, especially in 2020, the peak of the COVID-19 pandemic. The Metropolitan Health Region achieved better results in the four years evaluated; a correlation was observed between social variables (HDI, CadÚnico, IDEB, and illiteracy rate), health system variables (Basic Care Coverage and Previne Brasil ISF), and epidemiological variables (Poliomyelitis Vaccination Coverage) with better PSE outcomes. The health sector was noted as the main participant in activities compared to the education sector. In the third stage, an e-book was developed containing information about the PSE, proposed methodologies to be employed in activities, and tools for monitoring its results. Conclusions: Both the literature review and the ecological study showed that municipalities face difficulties in developing the activities agreed upon in the cycles. These findings highlight the need for improvements in the program's implementation, addressing its structural and procedural weaknesses to enhance its desired outcomes and impacts. It is hoped that the developed manual will contribute to this process
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Programa saúde na escola , Serviços de saúde escolar , Promoção da saúde , Educação em saúde , Desigualdades sociais