Suchergebnisse

The Zika virus was first isolated in 1947 in Uganda. If the disease has existed since then, why is it only now that there is attention from the media, science, funding agencies and national and international bodies? From the standpoint of critical global health that considers the social, political and ideological contexts which Zika is framed, we aim to analyse the Zika epidemic in four aspects: (1) investigation of the social, cultural and political processes; (2) analysis of signification practices; (3) study of neglected/silenced zones; and (4) attention to the diversity of individual experiences related to health and disease. The political tensions here identified and discussed - related to the control of neglected diseases, social, class and gender determinants - fall into dynamics that go beyond national borders. In this sense, processes of signification and responses to the epidemic show the current limits of global health.

ObjectivesThis research seeks to understand viewpoints on the use of data containing personally identifiable information by a range of organizations for divergent purposes, focusing on the sharing and linkage of administrative data for the purposes of conducting research and evaluating public policies in Brazil.
ApproachAn exploratory approach was employed to perceive how the concepts relevant to this subject are understood, experienced and expressed by our interlocutors. A semi-structured interview technique was chosen to establish a base of scripted questions capable of building on and adapting to discussions with the participants, as well as addressing the questions that emerged during interviews. The interviewees were divided into three groups: data subjects (patients and beneficiaries of social welfare programs), researchers, and managers with experience in public policy in the areas of health and social protection. Specific scripts were elaborated for each group of respondents.
ResultsGroups and individuals are constantly balancing risks and benefits with regard to exposing and sharing their data; risks weigh more heavily depending on the individual's socioeconomic context, which is permeated by intersectionality. The processing of personal data by the government raises more fears than actions taken by large technology companies. Individuals and social groups want to receive feedback on research carried out in their communities, and also desire to participate in the design of scientific research and the analysis of evidence used to guide public policies which directly affect them. Data governance is indispensable, requiring not only data management but also specific conditions on data sharing and linkage, principally regarding the sharing of administrative data aligned with legitimate public interests.
ConclusionRaising awareness and providing information on individual and collective rights on personal and sensitive data collection, as well as informing the public about the purposes of data sharing and linkage, is of utmost importance for responsible data management. Administrative data governance should be planned and implemented to foster trust and transparency among all involved and interested parties.

RESUMO A publicação do 'Dossiê Abrasco: um alerta sobre os impactos dos agrotóxicos na saúde', a partir de 2012, movimentou um amplo debate público sobre o enquadramento dos agrotóxicos como problema de saúde pública. Este artigo teve por objetivo analisar o papel dessa publicação como um ponto de inflexão ao promover uma arena de debate que reposiciona diversos atuantes que pactuam um consenso, ainda que instável e profundamente combatido por setores dominantes, sobre os efeitos dos agrotóxicos na saúde. Argumenta-se que o documento hibridizou seus sentidos ao visibilizar pesquisas e dados sobre o assunto e, também, ao se constituir como um documento-manifesto. Tal efeito é problematizado a partir do papel que a agroecologia assumiu no texto, apropriada como um lugar de reunião de forças diante da disputa travada com os arranjos vitais da formação econômica, agroexportadora e dependente do Brasil. Assim, por meio da abordagem dos estudos de Ciência, Tecnologia e Sociedade (CTS), discute-se o tortuoso e complexo processo de construção histórica e sociológica de um problema de saúde pública e como o 'Dossiê' contribuiu para reconfigurar um campo de batalha que tem na agroecologia um espaço próprio que congrega cientistas e movimentos sociais para transformarem a realidade juntos.

ObjectivesPublic engagement is an important pilar to add new perspectives as take into consideration participants' interests in research. We aim to share the potential of Cidacs experience with data administrative linkage for creating the Social Disparities Index for Covid-19 (SDI-Covid-19).
ApproachDialogue is the core of our work. We invited policy makers, community groups and researchers based on their interest with the key themes of the project. Webinars, technical meetings, discussion groups, and individual conversations were the main methods explored to allow participants to know each other and to change experiences about social inequalities in Covid-19 pandemic. We used digital technologies to enable these interactions because of social distance measures. Website, posts on social media, guides, and minibiographies of participants were produced to share information periodically. Our engagement framework includes the following steps: inform, collect, consult, share, revise, disseminate, and evaluate.
ResultsWe added new perspectives to SDI-Covid-19 suggested by the research participants during our events and individual conversations. Policy makers indicated a new level of information to make SDI-Covid-19 more useful for them in their daily work. We also discussed and interpreted some results with representatives of community groups from black movement, and slums. Besides that, they suggested some strategies to produce more accessible messages to support the scientific dissemination of research findings to civil society. Participants validated some information from SDI-Covid-19 and shared their impressions about how it can be used to design social policies. We connected 279 researchers, policy makers and representatives of community groups on two webinars; 29 policy makers on a technical meeting; 8 representatives of community groups on a discussion group.
ConclusionsA more equitable and ethical research was possible with our engagement experience with SDI-Covid-19. The ideas added improved the quality of research, validated results, and supported dissemination. The use of linked administrative data has been recognized as useful resource for managers, community groups and researchers.

IntroductionHealth inequalities in Brazil have deepened on Covid-19 pandemic, and the most vulnerable people were the more affected. A multidisciplinary team from Cidacs/Fiocruz Bahia developed a Social Disparities Index for Covid-19 (IDS-COVID-19) to support the evaluation of effects of health inequalities on the pandemic in Brazil. Public Involvement and Engagement were the pillars of this research because they allowed us to access first hand experiences about the social context in our country.
ObjectivesThis paper aims to describe our Public Involvement and Engagement experience by analysing our challenges, strategies, activities, results, and lessons learned during the construction of IDS-COVID-19.
MethodsThe basis of the IDS-Covid-19 public engagement model was the participation of different social groups through methods and techniques that allow dialogue. Several activities and communication products supported the continuous interactions. Another guideline was the inclusion and the welcoming of participants from the beginning of the project to ensure that the participant's contributions could drive decision-making about the research.
ResultsParticipants made several contributions to the research as a new layer of information to the Index, and improvements were made to the interactive panel. They also compromised to support the dissemination and use of the product. Eight representatives of community groups and 29 policymakers participated in our engagement activities during the project. More than 500 people were in our open webinars. In addition, more than 140 news items about IDS-Covid-19 were published in national and international media.
ConclusionsWe highlight as lessons learned the adaptation of some dissemination formats to the public, and the necessity of being flexible and accessible to participants. We strengthened the relationship with relevant stakeholders by exploring individual conversations by phone, WhatsApp, email, and interviews to produce a documentary that registered this whole experience. Cidacs/Fiocruz Bahia has also embedded public engagement and involvement in the study agenda.

Background: Based on a feminist approach, we analyzed the experiences of workplace bullying suffered by women front-line healthcare professionals dealing with the Covid-19 pandemic. We start from studies that show that women make up 70% of the global health workforce, 85% in the area of nursing, and 90% in the case of social care workers. An unequivocal need thus exists to address gender issues regarding the composition of the labor force in the health area. The pandemic has aggravated recurring problems involving healthcare professionals at the various caregiving levels, such as mental harassment (bullying) and its effects on mental health.
Methods: Data were gathered from an online survey of a convenience (non-probability) sample composed of 1,430 volunteer respondents, all women that work in the public health system in Brazil. The analyses and discussions involved the responses to a questionnaire containing 12 closed-ended questions and one open-ended question.
Results: The results revealed a context of workplace bullying aggravated by precarious material, institutional and organizational conditions in the area of health services against the backdrop of the Covid-19 pandemic in Brazil. This context has variously led to aggression, isolation, heavy workloads, and invasion of privacy, humiliation, persecution and fear as it was possible to see, mainly, in the answers to the study's open-ended question. This situation degrades both work relations and the integrity of the healthcare professionals who work on the front line to treat Covid-19 cases.
Conclusion: We conclude that bullying is a psychosocial phenomenon that heightens the oppression and subordination still experienced by women in the contemporary context, but with new hues in a scenario of frontline response to Covid-19.

Community health workers (CHWs) are framed as the link between communities and the formal health system. CHWs must establish trusting relationships with the community and with the broader health service. How to find the optimal balance between the various strands of work for CHWs, and how to formalise this, has been the focus of different studies. We performed an extensive documentary analysis of federal legislation in Brazil to understand the institutionalisation of the CHW workforce in Brazil over the last 3 decades. The paper offers three contributions to the literature: the development and application of an analytical framework to consider the institutionalisation process of CHWs; a historical analysis of the professional institutionalisation of CHW in Brazil; and the identification of the paradoxes that such institutionalisation faces: firstly, institutionalisation focused on improving CHW remuneration created difficulties in hiring and paying these professionals; when CHW are incorporated within state bureaucracy they start to lose their autonomy as community agents; and that the effectiveness of CHW programmes depends on the improvement of clinical services in the most deprived areas.