Viana Ana Luiza d'Avila, Machado Cristiani Vieira, Baptista Tatiana Wargas de Faria, Lima Luciana Dias de, Mendonça Maria Helena Magalhães de, Heimann Luiza S, Albuquerque Mariana Vercesi, Iozzi Fabíola Lana, David Virna Carvalho, Ibañez Pablo, Frederico Samuel
Faculdade de Medicina, Universidade de São Paulo, Avenida Dr. Arnaldo 455, São Paulo, SP 01246-903, Brazil.
Cad Saude Publica. 2007;23 Suppl 2:S117-31. doi: 10.1590/s0102-311x2007001400002.
This article presents the results of a study on Federal health policy in the Brazilian Legal Amazon (BLA) from 2003 to 2005, aimed at backing the development of regional health policies. The region has peculiar dynamics, an extensive border area, and adverse social indicators. The methodology included documental and financial analysis, participatory observation, interviews with heads of various Federal Ministries and State and Municipal health secretaries from the BLA; characterization of geographic situations in the BLA; and field studies in 15 municipalities. Institutional consolidation of health policy proved to be low in the Amazon during the study period, due to structural, institutional, and political difficulties. The identification of six geographic situations was useful for systematizing land use differences with repercussions on health, and which should be considered when implementing public policies. There is a certain gap between Federal actions and territorial dynamics, expressed as a mismatch between the current policy and its recognition by local administrators. In addition to establishing a regional policy for the Amazon, there is an evident need for differentiated policies within the region.
本文介绍了一项关于2003年至2005年巴西合法亚马逊地区（BLA）联邦卫生政策的研究结果，旨在支持区域卫生政策的发展。该地区有着独特的动态、广阔的边境地区以及不利的社会指标。研究方法包括文献和财务分析、参与式观察、对联邦各部委负责人以及BLA地区州和市卫生秘书的访谈；对BLA地区地理情况的描述；以及在15个市进行的实地研究。在研究期间，由于结构、体制和政治方面的困难，亚马逊地区卫生政策的机构整合程度较低。确定六种地理情况有助于将对健康有影响的土地利用差异系统化，并且在实施公共政策时应予以考虑。联邦行动与地域动态之间存在一定差距，表现为当前政策与地方管理者对其认可度之间的不匹配。除了制定亚马逊地区的区域政策外，该地区显然还需要差异化政策。
