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This publication gives an overview of the Ministry of Health and Wellness for the year 2020-2021. It details vision, mission, strategic goals and objectives, results-based management framework, Executive direction and administration programme, health sector regulation programme. It also gives a special report on COVID-19 management response and financial report for the period
Asunto(s)
Organización y Administración , Salud Pública , Políticas, Planificación y Administración en Salud , Atención a la SaludRESUMEN
Performance-based funding and calls for public-funded science to demonstrate societal impact are encouraging public research organisations to evaluate impact, the so-called impact agenda. This paper explores evaluation methods of four fully or partially public-funded agricultural research organisations and how they are building evaluative capacity to respond to the impact agenda. Drawing on cross-organisational comparison of the readiness of each organisation to implement evaluation, the implications for improving evaluative capacity building (ECB) are discussed. This study extends the current literature on ECB, as very little has focussed on research organisations in general, and particularly agricultural research. Driven by the impact agenda, the organisations are beginning to emphasise summative evaluation. Organisational leaders valuing the demonstration of impact and commitment to building evaluation capacity are important precursors to other aspects of organisational readiness to implement evaluation. However, organisational emphasis remains on using evaluation for accountability and to improve efficiency and allocation of funding. The organisations have yet to systematically embed evaluation processes and capabilities for learning at programme and organisation-levels. There is, therefore, an opportunity to develop organisation and programme-level evaluation processes that inform each other and the pathways to impact from science. To realise this opportunity, organisations could strengthen internal and external networks of evaluation practitioners and academics to bridge the gap between the theory and practice of monitoring and evaluation for learning (MEL) and to begin to reshape organisational culture by using evaluation methods that are grounded in co-production and integrated scientific and societal values.
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Creación de Capacidad , Humanos , Irlanda , Nueva Zelanda , Evaluación de Programas y Proyectos de Salud , España , UruguayRESUMEN
Resumo As sistemáticas de monitoramento de políticas públicas ganharam relevância no âmbito governamental a partir das reformas gerenciais da administração pública. A despeito disso, a utilização das informações pelos gestores persiste como desafio iminente. O objetivo do artigo é identificar e categorizar, à luz da literatura de referência, o uso dado às informações geradas pelas estratégias de monitoramento da Política de Prevenção Social à Criminalidade (PPSC) do Estado de Minas Gerais. São utilizados dados qualitativos coletados em pesquisa realizada com atores que atuam em diferentes áreas de execução da política. Constatou-se que os gestores fazem uso direto e político das informações, de tipo instrumental, processual, persuasiva e imposta. Apesar disso, observou-se que a PPSC não dispõe de um sistema de monitoramento estruturado. Assim, a produção de registros e dados fica concentrada nas unidades locais de implementação dos programas que compõem a política. Notou-se ainda que a publicização destes dados é insuficiente e que as atividades de monitoramento são percebidas como instrumentos de controle e fiscalização.
Resumen Las sistemáticas de monitoreo de políticas públicas adquirieron relevancia en el ámbito gubernamental a partir de las reformas gerenciales de la administración pública. Sin embargo, la utilización de la información por los gestores persiste como un desafío inminente. El artículo identifica y categoriza, a la luz de la literatura de referencia, el uso de las informaciones generadas por las estrategias de monitoreo de la Política de Prevención Social a la Criminalidad (PPSC) del estado de Minas Gerais. Se utilizan dados cualitativos de investigación realizada con actores involucrados en la gestión de la política. Se notó que los gestores hacen uso directo y político de la información, en la forma instrumental, procesual, persuasiva e impuesta. Sin embargo, la política no tiene un sistema de monitoreo estructurado, la producción de información se concentra en las unidades locales de implementación de los programas que componen la política, la divulgación de estos datos es insuficiente y las actividades de monitoreo se ven como instrumentos de control y fiscalización.
Abstract Methods of public policy monitoring have gained relevance with the emergence of managerial reforms of the public administration. However, the use of information by managers persists as an imminent challenge. The objective of this study is to identify and categorize, based on the literature, the use of the information collected from the monitoring strategies adopted in the Crime Prevention Policy in the Brazilian state of Minas Gerais, based on qualitative research. The study observed that managers make direct and political use of information in an instrumental, procedural, persuasive, and imposed form. However, the policy does not have a structured monitoring system. The production of information is concentrated in the local units of implementation, the publicity of the data is insufficient, and the activities are seen as instruments of control and inspection.
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Política , Política Pública , Administración Pública , CrimenRESUMEN
Small-scale fisheries are an important livelihood and primary protein source for coastal communities in many of the poorest regions in the world, yet many are overfished and thus require effective and scalable management solutions. Positive ecological and socioeconomic responses to management typically lag behind immediate costs borne by fishers from fishing pressure reductions necessary for fisheries recovery. These short-term costs challenge the long-term success of these interventions. However, social marketing may increase perceptions of management benefits before ecological and socioeconomic benefits are fully realized, driving new social norms and ultimately long-term sustainable behavior change. By conducting underwater visual surveys to quantify ecological conditions and by conducting household surveys with community members to quantify their perceptions of management support and socioeconomic conditions, we assessed the impact of a standardized small-scale fisheries management intervention that was implemented across 41 sites in Brazil, Indonesia, and the Philippines. The intervention combines TURF reserves (community-based territorial use rights for fishing coupled with no-take marine reserves) with locally tailored social-marketing behavior change campaigns. Leveraging data across 22 indicators and 4 survey types, along with data from 3 control sites, we found that ecological and socioeconomic impacts varied and that communities supported the intervention and were already changing their fishing practices. These results suggest that communities were developing new social norms and fishing more sustainably before long-term ecological and socioeconomic benefits of fisheries management materialized.
Catalización del Manejo de Pesquerías Sustentables por medio de Intervenciones de Cambio de Comportamiento Resumen Las pesquerías a pequeña escala son un sustento importante y la principal fuente de proteína para las comunidades costeras en muchas de las regiones más pobres del mundo, sin embargo, muchas sufren de sobrepesca y por lo tanto requieren soluciones de manejo efectivas y escalables. Las respuestas ecológicas y socioeconómicas positivas al manejo generalmente se retrasan con respecto a los costos inmediatos asumidos por los pescadores a partir de las reducciones de la presión ocasionada por la pesca necesarias para la recuperación de la pesquería. Estos costos a corto plazo son un reto para el éxito a largo plazo de las intervenciones. Sin embargo, la mercadotecnia social puede incrementar las percepciones de los beneficios del manejo antes de que se conozcan por completo los beneficios ecológicos y socioeconómicos, lo que genera nuevas normas sociales y finalmente un cambio en el comportamiento a largo plazo. Realizamos censos submarinos visuales para cuantificar las condiciones ecológicas y censos domésticos a los miembros de la comunidad para cuantificar sus percepciones del apoyo al manejo y de las condiciones socioeconómicas. Con esto, evaluamos el impacto de la intervención de manejo para pesquerías estandarizadas a pequeña escala que fue implementada en 41 sitios de Brasil, Indonesia y las Filipinas. La intervención combina las reservas TURF (derechos de uso de pesca territorial basados en la comunidad acoplados con reservas marinas con restricción de pesca) con campañas de mercadotecnia social para el cambio de comportamiento ajustadas al contexto local. Con la movilización de datos a lo largo de 22 indicadores y cuatro tipos de censos, junto con los datos de tres sitios de control, encontramos que los impactos ecológicos y socioeconómicos variaron y que las comunidades apoyaban la intervención y ya se encontraban cambiando sus prácticas de pesca. Estos resultados sugieren que las comunidades ya estaban desarrollando nuevas normas sociales y pescando de manera más sustentable antes de que los beneficios ecológicos y socioeconómicos a largo plazo del manejo de las pesquerías se materializaran.
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Conservación de los Recursos Naturales , Explotaciones Pesqueras , Animales , Brasil , Peces , Indonesia , FilipinasRESUMEN
Resumen: El desarrollo infantil temprano (DIT) es la base del desarrollo económico y social de los países y de su capacidad de cumplir con los Objetivos de Desarrollo Sostenible (ODS). La gestación y los primeros 3 años de vida son fundamentales para que los niños tengan un desarrollo físico, psicosocial, emocional y cognitivo adecuado para el resto de sus vidas. La crianza y el cuidado cariñoso y sensible a las necesidades de los niños durante la gestación y la primera infancia son esenciales para el desarrollo de los billones de neuronas y trillones de sinapsis necesarias. El DIT requiere de acceso a buena nutrición y servicios de salud desde la gestación, crianza sensible de acuerdo a la etapa de desarrollo del niño, protección social y del bienestar del niño, y oportunidades de estimulación y aprendizaje temprano. Para mejorar el DIT a nivel nacional se recomiendan seis acciones con fuerte participación de la sociedad civil: expandir la voluntad política y financiamiento, crear un entorno de políticas favorables basadas en evidencia, construir capacidad con coordinación intersectorial, asegurar una gobernanza justa y transparente de los programas y servicios, aumentar apoyo a la investigación multidisciplinaria y promover el desarrollo de líderes. México ha logrado avances importantes en DIT bajo el liderazgo del Sector Salud, pero enfrenta retos significativos para implementar estas recomendaciones. La reciente creación de un marco nacional intersectorial favorable al DIT con apoyo de los organismos internacionales y la participación de la sociedad civil pueden ayudar a sobreponer estos retos.
Abstract: Early childhood development (ECD) is the basis of countries' economic and social development and their ability to meet the Sustainable Development Goals (SDGs). Gestation and the first three years of life are critical for children to have adequate physical, psychosocial, emotional and cognitive development for the rest of their lives. Nurturing care and protection of children during gestation and early childhood are necessary for the development of trillions of neurons and trillions of synapses necessary for development. ECD requires access to good nutrition and health services from gestation, responsive caregiving according to the child's developmental stage, social protection and child welfare, and early stimulation and learning opportunities. Six actions are recommended to improve national ECD programs: expand political will and funding; create a supportive, evidence-based policy environment; build capacity through intersectoral coordination; ensure fair and transparent governance of programs and services; increase support for multidisciplinary research; and promote the development of leaders. Mexico has made significant progress under the leadership of the Health Ministry, but still faces significant challenges. The recent creation of a national intersectoral framework to enable ECD with support of international organizations and the participation of civil society organizations can help overcome these challenges.
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Preescolar , Humanos , Lactante , Recién Nacido , Desarrollo Infantil/fisiología , Desarrollo Sostenible/tendencias , Neuronas/fisiología , Política Pública/tendencias , Cambio Social , Cognición/fisiología , Accesibilidad a los Servicios de SaludRESUMEN
Early childhood development (ECD) is the basis of countries' economic and social development and their ability to meet the Sustainable Development Goals (SDGs). Gestation and the first three years of life are critical for children to have adequate physical, psychosocial, emotional and cognitive development for the rest of their lives. Nurturing care and protection of children during gestation and early childhood are necessary for the development of trillions of neurons and trillions of synapses necessary for development. ECD requires access to good nutrition and health services from gestation, responsive caregiving according to the child's developmental stage, social protection and child welfare, and early stimulation and learning opportunities. Six actions are recommended to improve national ECD programs: expand political will and funding; create a supportive, evidence-based policy environment; build capacity through inter-sectoral coordination; ensure fair and transparent governance of programs and services; increase support for multidisciplinary research; and promote the development of leaders. Mexico has made significant progress under the leadership of the Health Ministry, but still faces significant challenges. The recent creation of a national inter-sectoral framework to enable ECD with support of international organizations and the participation of civil society organizations can help overcome these challenges.
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Desarrollo Infantil/fisiología , Neuronas/fisiología , Desarrollo Sostenible/tendencias , Preescolar , Cognición/fisiología , Accesibilidad a los Servicios de Salud , Humanos , Lactante , Recién Nacido , Política Pública/tendencias , Cambio SocialRESUMEN
Water, sanitation, and hygiene (WaSH) in schools contributes to better health and educational outcomes among school-aged children. In 2012, UNICEF Nicaragua and partners conducted a cross-sectional survey of WaSH in 526 schools in 12 low socio-economic status municipalities in Nicaragua. The survey gathered information on: school characteristics; teacher and community participation; water and sanitation infrastructure; and hygiene education and habits. Survey results were analyzed for associations between variables. WaSH coverage was significantly higher in urban than rural areas. Presence of drinking water infrastructure (43%) was lower than sanitation infrastructure (64%). Eighty-one percent of schools had no hand washing stations and 74% of schools lacked soap. Sanitation facilities were not in use at 28% of schools with sanitation infrastructure and 26% of schools with water infrastructure had non-functional systems. Only 8% of schools had budgets to purchase toilet-cleaning supplies and 75% obtained supplies from students' families. This study generates transferable WaSH sector learnings and new insights from monitoring data. Results can be used by donors, service providers, and policy makers to better target resources in Nicaraguan schools.
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Higiene , Instituciones Académicas , Estudios Transversales , Agua Potable , Higiene de las Manos , Humanos , Nicaragua , Factores Socioeconómicos , Encuestas y Cuestionarios , Cuartos de BañoRESUMEN
A descentralização do SUS exige que as secretarias estaduais de saúde assumam novas competências como o monitoramento e avaliação da Atenção Básica. Este artigo busca avaliar a "capacidade de governo" de uma secretaria estadual de saúde do Nordeste brasileiro para o monitoramento e avaliação da Atenção Básica. A partir da colaboração técnica realizada via componente III do Programa de Expansão e Consolidação da Saúde da Família (Proesf), foram entrevistados gestores estratégicos, analisados documentos de gestão e realizada observação participativa das atividades do centro formador junto à secretaria, com "análise de conteúdo" do material disponível. Como resultados, destacam-se: ausência de "projeto de governo"; problemas de estrutura física, recursos humanos e materiais; profissionais com baixa qualificação no uso de sistemas de informação, monitoramento e avaliação, e planejamento estratégico, promovendo trabalhos burocráticos e frágil uso de dados epidemiológicos. Em 2006, a secretaria usou recursos federais para fortalecer o monitoramento e avaliação da Atenção Básica, ampliando sua estrutura física, adquirindo equipamentos e capacitando pessoal, sem investir recurso próprio. Conclui-se que esta secretaria tem dificuldades em se adequar à descentralização, com a institucionalização de novos processos de trabalho.
The decentralization of the SUS requires state health departments to assume new powers as the monitoring and evaluation of Basic Care. This article aims to evaluate the "capacity for governance" of a State Health Northeastern Brazilian Department in monitoring and evaluation of Basic Care. From the technical cooperation held via component III of Proesf, key health care managers were interviewed, strategical documents were analyzed, and participatory observation of activities was carried out at a training centre, with a "contend analysis" procedure. Among the results, are: absence of "government project", problems of physical infrastructure, human resources and material, with low professional qualification in the use of information systems, monitoring and evaluation, and strategic planning, promoting and fragile bureaucratic work use of epidemiological data. In 2006, the Department used federal resources to strengthen the monitoring and evaluation of primary care by expanding its physical infrastructure, acquiring equipment and training for staff, without investing its own resource. To conclude, the Health Department has experienced difficulties in adjusting to decentralization, with the introduction of new working procedures into the institution.
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Humanos , Atención a la Salud/organización & administración , Atención Primaria de Salud/organización & administración , BrasilRESUMEN
O processo de contratualização na gestão pública nasce da perspectiva de que o Estado, por meio de instrumentos contratuais, repassa às entidades não-estatais a execução de determinados serviços. No entanto, o Estado permanece como responsável pelas políticas públicas, exercendo o papel de financiador, indutor e regulador, para que os serviços sejam prestados adequadamente,com qualidade e eficiência. Visando prestar assistência à população, a Secretaria de Estado de Saúde de Minas Gerais (SES/MG) caracteriza-se como grande compradora de serviços e ações de saúde, fazendo uso de uma variedade excessiva de instrumentos contratuais, sem padronização, para a formalização dessas transações. Nesse contexto, viu-se a necessidade de reformular os contratos dos programas estaduais, como adotar instrumento jurídico único que centralize a formalização do conteúdo. O objetivo deste trabalho foi apresentar o Contrato Único como uma proposta de inovação e qualidade na gestão pública, visando desenvolver no Sistema Único de Saúde em Minas Gerais (SUS/MG) a cultura de resultados. Essa mudança da lógica contratual torna o processo mais objetivo, organizado e transparente, propiciando uma gestão mais eficiente e que efetiva uma relação de parceria. O modelo proposto contribuirá para o aprimoramento da gestão dos contratos assistenciais no Estado de Minas Gerais, além de viabilizar a existência de um processo de acompanhamento e avaliação, até então não-efetivo nos processos de contratação da SES/MG.
The contracting process in public management derives from the perspective that the State, bycontractual arrangements, passes to non-state entities the implementation of certain services. However, the State remains responsible for the public policies, playing the role of financier, regulator and inductor, so the services are rendered with proper quality and efficiency. Aiming to assistthe population, the Secretaria de Estado de Saúde of Minas Gerais (SES/MG) is characterized as a large buyer of health services and actions, using a variety of contractual arrangements, withoutstandardization, for the transactional formalization. In this context, it is necessary to restructure thecontracts of the State programs, with the adoption of a single legal instrument, which centralizes the formalization of the content. The aim of this paper was to present Contrato Único as a proposal for innovation and quality in public administration, in order to develop results-oriented culture inthe National Health System of Minas Gerais (SUS/MG). This change in contractual logic makes the process more objective, organized and transparent, and provides a more efficient management which effects a partnership. The proposed model will contribute to the improvement of assistance contract management in Minas Gerais and will provide the existence of a monitoring and evaluationprocess which is not effective yet in SES/MG hiring procedures.
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Contratos , Administración de los Servicios de Salud , Salud PúblicaRESUMEN
This paper reviews the concepts and methodological strategies that have shaped the monitoring of the AIDS pandemic, today in its third decade. A deliberate effort was made to highlight aspects usually forgotten by the canon. The paper aims to track the footsteps of the evolving strategies in the field of surveillance & monitoring, with the help of disciplines such as epidemiology, molecular biology, social, and behavioral sciences. The deep divide that opposes societies severely affected by the epidemic and affluent societies much less affected by the epidemic is contrasted with the scarce human and financial resources of the societies facing harshest epidemic vis-à-vis the comprehensiveness of the response to the epidemic in their affluent counterparts in terms of the scope and high standards of their initiatives on monitoring, prevention, management & care. The pressing need to implement feasible alternatives to the current sophisticated and expensive ones is briefly discussed. Beyond the renewed challenge posed to the creativity of scientists and health professionals, the AIDS pandemic is described as a major public health crisis, compromising the social fabric in some contexts, and as a never fulfilled calling for an ethics of solidarity between different societies and different social strata of each given society.
O artigo procede a uma retrospectiva histórica dos conceitos e estratégias metodológicas que informaram e informam o monitoramento da pandemia de aids, hoje na sua terceira década. Procurou-se iluminar aspectos raramente abordados pela história canônica da epidemia, buscando traçar as raízes e desdobramentos das atuais alternativas de vigilância e monitoramento, no campo da epidemiologia, da biologia molecular e das ciências sociais e comportamentais. O profundo cisma que opõe sociedades duramente afetadas pela epidemia e que contam com recursos humanos e financeiros escassos a serem empregados tanto no monitoramento, como na implementação ampla e adequada de estratégias de prevenção e tratamento às pessoas vivendo com HIV/aids nas sociedades afluentes e substancialmente menos afetadas pela epidemia é criticamente revisado, em prol de soluções factíveis e prementes, dado o alto custo e a complexidade de boa parte das alternativas-padrão em curso nos países mais ricos. Mais do que um desafio à engenhosidade de cientistas e profissionais de saúde, a pandemia de aids é revista como uma crise de grandes proporções da saúde pública, da vida social e um chamamento renovado à frustrada ética solidária entre as diferentes sociedades e segmentos sociais.
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Humanos , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Brotes de Enfermedades , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Síndrome de Inmunodeficiencia Adquirida/virología , Métodos Epidemiológicos , Vigilancia de la PoblaciónRESUMEN
A avaliação formal é poderosa ferramenta de transparência da ação pública e de gestão de políticas e programas, apontando as medidas necessárias para sua sustentabilidade, otimização dos recursos e controle social. Este artigo trabalha a avaliação além da simples abstração teórica, agregando o foco no Programa de Erradicação do Trabalho Escravo, que visa eliminar essa grave violação aos direitos humanos que ainda persiste no Brasil. Com o intuito de investigar quais as características da sistemática de monitoramento e avaliação atualmente adotada pelos gestores do programa, partiu-se de pesquisa aplicada exploratória, utilizando-se dados secundários. Verificou-se que a sistemática adotada pelos gestores do programa possui características que se aproximam mais de um acompanhamento do que de um monitoramento e uma avaliação do programa. Os dados disponíveis, abundantes, necessitam de tratamento prático para se transformarem em instrumentos de monitoramento e avaliação. Com esse objetivo, o artigo utiliza-se da metodologia de avaliação formal constante nas referências teóricas, com vistas a propor uma sistemática de monitoramento e avaliação que possa ser utilizada para a melhoria da gestão do programa.
Formal evaluation is a powerful tool for ensuring the transparency of public action and in the management of policies and programs, pinpointing necessary measures for a policy's sustainability, for resource optimization and social control. This paper utilizes evaluation far beyond simple theoretical abstraction, applying it to the Program for the Eradication of Slave Labor, which functions to eliminate this grave violation of human rights, still being practiced in Brazil. In order to investigate the characteristics of the present monitoring and evaluation system adopted at by the program's managers, an applied-exploratory research approach was instigated using secondary data. It was verified that the characteristics of the monitoring system adopted by the program managers are closer to a performance follow-up than to a de facto monitoring or evaluation of the program as pointed out in the literature. Although abundant, the available data needs practical handling to be transformed into a tool of monitoring and evaluation. With that objective, this study uses the methodology of formal evaluation from various theoretical references aimed at the development of a system of monitoring and evaluation that can be used to improve the program's management.