Batista Karina Barros Calife, Schraiber Lilia Blima, D'Oliveira Ana Flávia Pires Lucas
Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brasil.
Cad Saude Publica. 2018 Aug 20;34(8):e00140017. doi: 10.1590/0102-311X00140017.
The study focuses on policies to deal with violence against women in the city of São Paulo, Brazil. The objectives were to map the public policies and the proposals for institutional organization of a network of comprehensive care, in addition to analyzing the implementation of these policies, highlighting the health sector, with reports by administrators and policymakers. The study addresses the relationship between management practice and the public policy provisions, the weight of administrators' personal values and perspectives, and the weight of the socially dominant discourse in decision-making for implementation of these policies. Data were produced through semi-structured interviews with 32 administrators working at different levels in the institutional organization of the Municipal Health Department, including some policymakers in the state and national scenarios. The body of data were submitted to thematic content analysis, examining each of the interviews and relating them to the literature and conceptual framework. The study concludes that health administrators, as agents of practices, are influenced by the prevailing structures and beliefs and reference to their social and historical context for decision-making. However, when they relate to such structures, they are also capable of intervening in the ways care is produced and provided for women in situations of violence, especially by addressing the training and awareness-raising processes and new references concerning recognition of women's rights as human rights.
该研究聚焦于巴西圣保罗市应对暴力侵害妇女行为的政策。其目标是绘制公共政策以及综合照护网络的机构组织提案，此外还分析这些政策的实施情况，重点突出卫生部门，并参考管理人员和政策制定者的报告。该研究探讨了管理实践与公共政策规定之间的关系、管理人员个人价值观和观点的影响，以及社会主导话语在这些政策实施决策中的影响。数据通过对在市卫生部门机构组织中不同层级工作的32名管理人员进行半结构化访谈收集而来，其中包括一些州和国家层面的政策制定者。对这些数据进行了主题内容分析，审视每一次访谈，并将其与文献和概念框架相关联。该研究得出结论，卫生管理人员作为实践主体，受到主流结构和信念的影响，并在决策时参考其社会和历史背景。然而，当他们与这些结构相关联时，他们也有能力干预针对暴力情况下妇女的照护提供方式，特别是通过开展培训和提高认识的过程，以及关于将妇女权利视为人权的新参考内容。
