Minayo Maria Cecília de Souza, Deslandes Suely Ferreira
Centro Latino-Americano de Estudos sobre Violência e Saúde, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública, Rio de Janeiro.
Cien Saude Colet. 2009 Sep-Oct;14(5):1641-9. doi: 10.1590/s1413-81232009000500002.
In this article we problematize the results of an investigation entitled 'Diagnostic Analysis of the National Policy for Reduction of Morbidity and Mortality from Accidents and Violence (PNRMVA)' and present some thoughts for discussion. Based on a quantitative and qualitative analysis of the implantation of this policy in five Brazilian state capitals--Recife, Rio de Janeiro, Manaus, Curitiba and Brasília and vicinities--along with the participation of local academic institutions we performed a diagnosis of the situation. The article presents evaluative information regarding: the profile of morbidity and mortality from accidents and violence; the adequacy of mobile and fixed pre-hospital emergency services, hospital services and rehabilitation services to preventing the described epidemiological profile; the training of the professionals dealing with these traumas; surveillance and monitoring of violence and accidents as well as support for studies and investigations into the issue. Aimed at proposing a debate, the article concludes raising questions about the advances made in the implementation of the policy, about the fragilities of the system and about the possibilities for an efficient implementation of the PNRMVA guidelines.
在本文中，我们对一项名为“国家减少事故和暴力所致发病率和死亡率政策（PNRMVA）的诊断分析”的调查结果提出质疑，并提出一些供讨论的想法。基于对该政策在巴西五个州首府——累西腓、里约热内卢、马瑙斯、库里蒂巴和巴西利亚及其周边地区实施情况的定量和定性分析，以及当地学术机构的参与，我们对形势进行了诊断。本文提供了有关以下方面的评估信息：事故和暴力所致发病率和死亡率的概况；流动和固定院前急救服务、医院服务及康复服务对于预防上述流行病学概况的充足性；处理这些创伤的专业人员的培训情况；暴力和事故的监测以及对该问题研究和调查的支持。旨在引发一场辩论，本文最后对该政策实施过程中取得的进展、系统的脆弱性以及有效实施PNRMVA指南的可能性提出了疑问。
