Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_SP |
Texto Completo: | https://tede2.pucsp.br/handle/handle/21771 |
Resumo: | The aim of this study is to analyze how Vulnerability emerged as a problem and an intervention object for Public Health policies in Brazil, and the ways it has been used by professionals of Primary Health Care in the city of São Paulo - SP. The notion of Vulnerability was adopted in Brazil by the Ministry of Health as one of the fundamental intervention objects of the National Health Promotion Policy (NHPP), producing profound changes in the way of defining, identifying, intervening and prioritizing the population to be served, producing changes in the practices of public health professionals and users in the country. As a research method, we start with the genealogy developed by Michel Foucault. As an analytical of the modes of subjectivity, the genealogy allowed us to glimpse the historical conditions of the production of knowledge, sets of rules and ways in which health professionals recognize situations of vulnerability and use this notion in their practices. The research was developed from the analysis of archives and documents of the field of Public Health policies, participant observation of activities by professionals carried out in Primary Health Care units, as well as interviews with such professionals. It was verified that the notion of vulnerability was not used to give meaning to a complex reality, but to a concrete action on the problems that it names and proposes. Historically different uses and strategic functions have been produced for the notion of vulnerability in Brazil amidst disputes, confrontations, transformations and resistances. If, on the one hand, the emergence of such a notion in the field of HIV/AIDS care in Brazil constituted resistance and problematization of the concept of health risk, on the other hand, its spread and its use in other public health fields suffered appropriations that acted out different strategic functions and moved away from the initial critical stance. The process of constitution of the notion of vulnerability as a problem and object of intervention in public health historically involved control strategies and resistance practices. In the quotidian of the practices of the professionals of the Primary Attention to Health of São Paulo articulate, on the one hand, strategies of governmentality through institutions, procedures, analyzes, calculations and tactics that allow establishing relations of power over the population, with the intention to make it useful and participative, through a neoliberal rationality, interested in increasing capacities and security strategies, controlling and avoiding risks. On the other hand, in this same context, the practices of recalcitrance move these strategies with resistances, oppositions, elusive, inversions of positions. Each actor seeks to affirm ways of living that are often inconsistent with preestablished performance guidelines. In agreement with Judith Butler, we understand that attention to the situation of violence and precariousness to which many people are exposed is fundamental, but it is also necessary to refuse policies that victimize or stigmatize these people with the argument of protection or salvation, so that they offer resources for their strengthening and empowering their ways of living |
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Vicentin, Maria Cristina G.http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4518337D9Mota, Saulo Tavares da2018-12-17T11:53:45Z2018-11-27Mota, Saulo Tavares da. Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil. 2018. 235 f. Tese (Doutorado em Psicologia: Psicologia Social) - Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social, Pontifícia Universidade Católica de São Paulo, São Paulo, 2018.https://tede2.pucsp.br/handle/handle/21771The aim of this study is to analyze how Vulnerability emerged as a problem and an intervention object for Public Health policies in Brazil, and the ways it has been used by professionals of Primary Health Care in the city of São Paulo - SP. The notion of Vulnerability was adopted in Brazil by the Ministry of Health as one of the fundamental intervention objects of the National Health Promotion Policy (NHPP), producing profound changes in the way of defining, identifying, intervening and prioritizing the population to be served, producing changes in the practices of public health professionals and users in the country. As a research method, we start with the genealogy developed by Michel Foucault. As an analytical of the modes of subjectivity, the genealogy allowed us to glimpse the historical conditions of the production of knowledge, sets of rules and ways in which health professionals recognize situations of vulnerability and use this notion in their practices. The research was developed from the analysis of archives and documents of the field of Public Health policies, participant observation of activities by professionals carried out in Primary Health Care units, as well as interviews with such professionals. It was verified that the notion of vulnerability was not used to give meaning to a complex reality, but to a concrete action on the problems that it names and proposes. Historically different uses and strategic functions have been produced for the notion of vulnerability in Brazil amidst disputes, confrontations, transformations and resistances. If, on the one hand, the emergence of such a notion in the field of HIV/AIDS care in Brazil constituted resistance and problematization of the concept of health risk, on the other hand, its spread and its use in other public health fields suffered appropriations that acted out different strategic functions and moved away from the initial critical stance. The process of constitution of the notion of vulnerability as a problem and object of intervention in public health historically involved control strategies and resistance practices. In the quotidian of the practices of the professionals of the Primary Attention to Health of São Paulo articulate, on the one hand, strategies of governmentality through institutions, procedures, analyzes, calculations and tactics that allow establishing relations of power over the population, with the intention to make it useful and participative, through a neoliberal rationality, interested in increasing capacities and security strategies, controlling and avoiding risks. On the other hand, in this same context, the practices of recalcitrance move these strategies with resistances, oppositions, elusive, inversions of positions. Each actor seeks to affirm ways of living that are often inconsistent with preestablished performance guidelines. In agreement with Judith Butler, we understand that attention to the situation of violence and precariousness to which many people are exposed is fundamental, but it is also necessary to refuse policies that victimize or stigmatize these people with the argument of protection or salvation, so that they offer resources for their strengthening and empowering their ways of livingO objetivo deste estudo é analisar o modo como a Vulnerabilidade se tornou um problema e um objeto de intervenção para as políticas de Saúde Pública no Brasil, e os modos como vem sendo usada por profissionais da Atenção Básica à Saúde no município de São Paulo - SP. A noção de Vulnerabilidade foi adotada no Brasil pelo Ministério da Saúde como um dos objetos de intervenção fundamentais da Política Nacional de Promoção da Saúde (PNPS), produzindo mudanças profundas no modo de definir, identificar, intervir e priorizar a população a ser atendida, produzindo alterações nas práticas dos funcionários e dos usuários de serviços de Saúde Pública no país. Como método de pesquisa, partimos da genealogia desenvolvida por Michel Foucault. Enquanto analítica dos modos de subjetivação, a genealogia permitiu entrever as condições históricas da produção de saberes, conjuntos de regras e modos pelos quais profissionais de saúde reconhecem situações de vulnerabilidade e usam essa noção em suas práticas. A pesquisa foi desenvolvida a partir da análise de arquivos e documentos do campo das políticas de Saúde Pública, observação participante de atividades por profissionais realizadas em unidades de Atenção Básica à Saúde, além de entrevistas com tais profissionais. Verificou-se que a noção de vulnerabilidade é usada não somente para dar sentido a realidades complexas, mas para a ação concreta sobre os problemas que ela nomeia e propõe. Historicamente produziram-se usos e funções estratégicas diferentes para a noção de vulnerabilidade no Brasil, em meio a disputas, confrontos, transformações e resistências. Se, por um lado, a emergência de tal noção no campo da atenção ao HIV/AIDS no Brasil se constituiu como resistência e problematização do conceito de risco em saúde, por outro lado, sua propagação e seu uso em outros campos da saúde pública sofreram apropriações que agenciaram funções estratégicas diferentes e que se afastaram da inicial postura crítica. O processo de constituição da noção de vulnerabilidade como problema e objeto de intervenção na saúde pública historicamente envolveu estratégias de controle e práticas de resistência. No cotidiano das práticas dos profissionais da Atenção Básica à Saúde de São Paulo articulam-se, por um lado, estratégias de governamentalidade por meio de instituições, procedimentos, análises, cálculos e táticas que permitem estabelecer relações de poder sobre a população, com o intuito de torná-la útil e participativa, por meio de uma racionalidade neoliberal, interessada no incremento das capacidades e de estratégias de segurança, controlando e evitando riscos. Por outro lado, nesse mesmo contexto, as práticas de recalcitrância deslocam essas estratégias com resistências, contraposições, esquivas, inversões de posicionamentos e afirmam de modos de viver muitas vezes inconformes às diretrizes de atuação preestabelecidas. Em consonância com Judith Butler entendemos que é fundamental a atenção à situação de violência e precariedade a que muitas pessoas estão expostas, porém também é necessário a recusa de políticas que vitimizem ou estigmatizem essas pessoas com o argumento da proteção ou salvação, de modo que ofereçam recursos para seu fortalecimento e potencializando seus modos de viverConselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPqapplication/pdfhttp://tede2.pucsp.br/tede/retrieve/47769/Saulo%20Tavares%20da%20Mota.pdf.jpgporPontifícia Universidade Católica de São PauloPrograma de Estudos Pós-Graduados em Psicologia: Psicologia SocialPUC-SPBrasilFaculdade de Ciências Humanas e da SaúdeSaúde públicaPromoção da saúdeAtenção primária à saúdePolítica de saúdePublic healthHealth promotionPrimary health careMedical policyCNPQ::CIENCIAS HUMANAS::PSICOLOGIAUsos e desusos da noção de vulnerabilidade na saúde pública no BrasilUses and disuse of the notion of vulnerability in public health in Brazilinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_SPinstname:Pontifícia Universidade Católica de São Paulo (PUC-SP)instacron:PUC_SPTEXTSaulo Tavares da Mota.pdf.txtSaulo Tavares da Mota.pdf.txtExtracted texttext/plain571100https://repositorio.pucsp.br/xmlui/bitstream/handle/21771/5/Saulo%20Tavares%20da%20Mota.pdf.txta3a6a7e9eb66b9611e3d7b4c42688f2eMD55ORIGINALSaulo Tavares da Mota.pdfSaulo Tavares da Mota.pdfapplication/pdf1743608https://repositorio.pucsp.br/xmlui/bitstream/handle/21771/2/Saulo%20Tavares%20da%20Mota.pdff423cfc2c3563cada41f4825b99efc94MD52LICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
dc.title.alternative.eng.fl_str_mv |
Uses and disuse of the notion of vulnerability in public health in Brazil |
title |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
spellingShingle |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil Mota, Saulo Tavares da Saúde pública Promoção da saúde Atenção primária à saúde Política de saúde Public health Health promotion Primary health care Medical policy CNPQ::CIENCIAS HUMANAS::PSICOLOGIA |
title_short |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
title_full |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
title_fullStr |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
title_full_unstemmed |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
title_sort |
Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil |
author |
Mota, Saulo Tavares da |
author_facet |
Mota, Saulo Tavares da |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Vicentin, Maria Cristina G. |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4518337D9 |
dc.contributor.author.fl_str_mv |
Mota, Saulo Tavares da |
contributor_str_mv |
Vicentin, Maria Cristina G. |
dc.subject.por.fl_str_mv |
Saúde pública Promoção da saúde Atenção primária à saúde Política de saúde |
topic |
Saúde pública Promoção da saúde Atenção primária à saúde Política de saúde Public health Health promotion Primary health care Medical policy CNPQ::CIENCIAS HUMANAS::PSICOLOGIA |
dc.subject.eng.fl_str_mv |
Public health Health promotion Primary health care Medical policy |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS HUMANAS::PSICOLOGIA |
description |
The aim of this study is to analyze how Vulnerability emerged as a problem and an intervention object for Public Health policies in Brazil, and the ways it has been used by professionals of Primary Health Care in the city of São Paulo - SP. The notion of Vulnerability was adopted in Brazil by the Ministry of Health as one of the fundamental intervention objects of the National Health Promotion Policy (NHPP), producing profound changes in the way of defining, identifying, intervening and prioritizing the population to be served, producing changes in the practices of public health professionals and users in the country. As a research method, we start with the genealogy developed by Michel Foucault. As an analytical of the modes of subjectivity, the genealogy allowed us to glimpse the historical conditions of the production of knowledge, sets of rules and ways in which health professionals recognize situations of vulnerability and use this notion in their practices. The research was developed from the analysis of archives and documents of the field of Public Health policies, participant observation of activities by professionals carried out in Primary Health Care units, as well as interviews with such professionals. It was verified that the notion of vulnerability was not used to give meaning to a complex reality, but to a concrete action on the problems that it names and proposes. Historically different uses and strategic functions have been produced for the notion of vulnerability in Brazil amidst disputes, confrontations, transformations and resistances. If, on the one hand, the emergence of such a notion in the field of HIV/AIDS care in Brazil constituted resistance and problematization of the concept of health risk, on the other hand, its spread and its use in other public health fields suffered appropriations that acted out different strategic functions and moved away from the initial critical stance. The process of constitution of the notion of vulnerability as a problem and object of intervention in public health historically involved control strategies and resistance practices. In the quotidian of the practices of the professionals of the Primary Attention to Health of São Paulo articulate, on the one hand, strategies of governmentality through institutions, procedures, analyzes, calculations and tactics that allow establishing relations of power over the population, with the intention to make it useful and participative, through a neoliberal rationality, interested in increasing capacities and security strategies, controlling and avoiding risks. On the other hand, in this same context, the practices of recalcitrance move these strategies with resistances, oppositions, elusive, inversions of positions. Each actor seeks to affirm ways of living that are often inconsistent with preestablished performance guidelines. In agreement with Judith Butler, we understand that attention to the situation of violence and precariousness to which many people are exposed is fundamental, but it is also necessary to refuse policies that victimize or stigmatize these people with the argument of protection or salvation, so that they offer resources for their strengthening and empowering their ways of living |
publishDate |
2018 |
dc.date.accessioned.fl_str_mv |
2018-12-17T11:53:45Z |
dc.date.issued.fl_str_mv |
2018-11-27 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
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doctoralThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Mota, Saulo Tavares da. Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil. 2018. 235 f. Tese (Doutorado em Psicologia: Psicologia Social) - Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social, Pontifícia Universidade Católica de São Paulo, São Paulo, 2018. |
dc.identifier.uri.fl_str_mv |
https://tede2.pucsp.br/handle/handle/21771 |
identifier_str_mv |
Mota, Saulo Tavares da. Usos e desusos da noção de vulnerabilidade na saúde pública no Brasil. 2018. 235 f. Tese (Doutorado em Psicologia: Psicologia Social) - Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social, Pontifícia Universidade Católica de São Paulo, São Paulo, 2018. |
url |
https://tede2.pucsp.br/handle/handle/21771 |
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Pontifícia Universidade Católica de São Paulo |
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Programa de Estudos Pós-Graduados em Psicologia: Psicologia Social |
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PUC-SP |
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Brasil |
dc.publisher.department.fl_str_mv |
Faculdade de Ciências Humanas e da Saúde |
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Pontifícia Universidade Católica de São Paulo |
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