[Social research in health: why read Norbert Elias?]

This essay aims to reflect on the theoretical-methodological challenges of social research in health and, especially, to explore the conceptual matrix present in the work of Norbert Elias, a sociologist and historian whose approach to the civilizing process greatly contributes to understanding the singularities that shape individual and collective existence. By investigating long chains of interdependence throughout history, Elias challenged deterministic interpretations of social processes and built a vigorous analysis of a plurality of objects from an interdisciplinary, constructivist, and relational perspective. By illuminating the dynamics of interaction and the mutual constitution of individuals and society, the author redefines the nature of the reciprocal relations among social structures, the psychic economy, and the body. In this sense, the appropriation of this reflexive perspective can fertilize studies and research processes. Considering the complexity of Public Health, we propose to stimulate possible articulations, dialogues, and uses of the Eliasian theoretical framework in the problematization and construction of strategies and research paths.

Cesarean childbirth: an institutional socio-clinical study of the professional practices and discourses

OBJECTIVE

to analyze how the social, historical, economic and professional elements influence the institutionalization process of cesarean childbirth in Brazil and France.

METHOD

a qualitative study grounded on the theoretical framework of the institutional socioclinic. The data were produced through focus groups and individual interviews, supported by semi-structured scripts, with health professionals, mothers and fathers and a research diary. The study had 83 participants. The analysis was based on the theoretical framework and thematic analysis. Cross analysis was developed between the different types of data, services and groups, as well as between countries.

RESULTS

the participants were characterized in terms of schooling, employment, level of training and workplace. The countries researched have their own peculiar health and educational structure and are marked by a social-historical-economic construction outlined by patriarchy. The New Public Management influences both contexts and makes health care precarious. The technical and organizational dimensions reinforce an intellectual and social division of work and knowledge in health.

CONCLUSION

the institutionalization process of childbirth in the countries is marked by social, economic and professional aspects. Practices and speeches of the professionals in their work process influence the occurrence, or not, of cesarean sections.