Minayo Maria Cecilia de Souza, Souza Edinilsa Ramos de, Silva Marta Maria Alves da, Assis Simone Gonçalves de
Departamento de Estudos sobre Violência e Saúde Jorge Careli, Escola Nacional de Saúde Pública Sergio Arouca, Fiocruz. Rio de Janeiro RJ Brasil.
Hospital das Clínicas, Universidade Federal de Goiás. Goiânia GO Brasil.
Cien Saude Colet. 2018 Jun;23(6):2007-2016. doi: 10.1590/1413-81232018236.04962018.
This article reflects on the evolution of the theme of violence within the field of public health. It provides an overview of the strategies and actions developed within Brazil's Unified Health System developed in response to the country's main guiding policy on violence, the National Policy for the Reduction of Morbidity and Mortality due to Accidents and Violence, drawing on baseline documents, national and international research, data from the country's main violence information systems, and the firsthand experiences of the authors from their participation in the abovementioned actions. Violence against children and adolescents, women, and older persons have assumed a prominent position on the health agenda, while other forms of violence, such as child labor, human trafficking, homophobic and racial violence, and violence against street dwellers and people with disabilities, who are deprived of their liberty, are gradually finding their way onto the agenda. Despite undeniable progress in institutionalizing the theme, there is a need for greater investment in various areas including out-of-hospital emergency, rehabilitation, and mental health services. It is also necessary to incorporate the theme into the training and development of all of healthcare professionals and intensify continuing training to enhance capacity for detecting and reporting violence and delivering adequate care to victims.
本文反思了公共卫生领域内暴力主题的演变。它概述了巴西统一卫生系统针对该国关于暴力的主要指导政策——《减少事故和暴力导致的发病率和死亡率国家政策》所制定的战略和行动,参考了基础文件、国内外研究、该国主要暴力信息系统的数据,以及作者参与上述行动的第一手经验。针对儿童和青少年、妇女及老年人的暴力行为在卫生议程中占据了显著位置,而其他形式的暴力,如童工、人口贩运、恐同和种族暴力,以及针对街头流浪人员和被剥夺自由的残疾人的暴力行为,也逐渐被纳入议程。尽管在将该主题制度化方面取得了不可否认的进展,但仍需要在包括院外急救、康复和心理健康服务等多个领域加大投资。还必须将该主题纳入所有医疗保健专业人员的培训和发展中,并加强持续培训,以提高发现和报告暴力行为以及为受害者提供适当护理的能力。