Imagem-objetivo para a descentralização da vigilância sanitária em nível municipal

The use of the Delphi Method adjusted to evaluate the Stork Network: from Image-objective to Reality

Abstract This study aims to evaluate the Stork Network (SN), a new pattern of intergovernmental program. The method was applied through the adjusted Delphi Method, with 13 specialists. It was constituted in 3 moments. A Logical Model (LM) was elaborated, with the purpose of showing the design of the actions of the program and its main components. By consensus the Delphi Matrix of Concordance with the proposal of the Goal Image was elaborated and validated. Finally, this Matrix was used as an instrument to evaluate the degree of implementation of the program. The results show that SN is classified in the Unsatisfactory Level, in the III Macro-regional Health in Pernambuco, corroborating the irrelevance of initiatives developed to strengthen the program. It is concluded that the application of this Delphi Method was consistent with the complexity of the object, given the lack of specific models for this purpose based on new institutional relations in the regionalization of the Unified Health System (SUS, acronym in Portuguese). This study showed its implications for nursing practice in the search for solutions for patient safety in maternal and child health care, pointing out the indispensability of these professionals to make SN more effective, especially in the face of a vulnerable and disadvantaged population in the interior of the semi-arid region, in an adverse political-economic scenario.

[Local contexts of drinking-water quality surveillance: Brazil and Colombia]

Objective This article aims to analyze comparatively the national surveillance systems of water quality for human consumption (DWQS) of Brazil and Colombia, seeking to understand how practices are organized in these countries, along with their limits and possibilities. Methods The National Cross Comparison methodology was used with document analysis of secondary sources, with the purpose of discussing the similarities and differences between the two systems using the WHO’s Guidelines for Drinking Water Quality. Results The legal framework on DWQS in Brazil and Colombia was defined in the 70s and 80s, coinciding with the international visibility of this issue. Thereafter, DWQS practices in Brazil have been defined and organized in a national program, which has only recently started in Colombia. The current Brazilian and Colombian legislations show progress in technical elements that guide surveillance practices, such as the incorporation of risk assessment methodologies. The Colombian legislation defines the regulation of water supply services provision, which is not contemplated in Brazilian legislation. Elements such as decentralization, intersectionality, universality and right to information are included in the legislations of both countries, although further action on DWQS is needed. Conclusions Brazil and Colombia have similarities in the implementation of DWQS, despite being at different points in the implementation timeline. Actions on drinking-water quality surveillance are necessary to guarantee human rights related to the protection of the environment, such as universal access to drinking water, contributing to the promotion of health.