Participatory construction of the State Health Promotion Policy: a case from Minas Gerais, Brazil

Campos, Daniela Souzalima; Turci, Maria Aparecida; Melo, Elza Machado de; Guerra, Vanessa de Almeida; Nascimento, Carolina Guimarães Marra; Moreira, Conceição Aparecida; Paschoal, Ellen Mendes; Beltrão, Nathalia Ribeiro Mota; Silva, Kleber Rangel

doi:10.1590/1413-812320172212.25062017

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Article • Ciênc. saúde colet. 22 (12) • Dec 2017 • https://doi.org/10.1590/1413-812320172212.25062017 copy

Participatory construction of the State Health Promotion Policy: a case from Minas Gerais, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Minas Gerais started the development of the Minas Gerais Health Promotion Policy (POEPS-MG) based on the review of the National Health Promotion Policy (PNPS). This is a case report based on the documentary analysis of the material produced in the 38 workshops with a participation of 1.157 members across the State. The first workshop was intrasectoral and took place at the State Health Secretariat (SDH-MG). The second was an intersectoral workshop with the participation of several State Health Secretariats of Minas Gerais. The final workshop counted on the participation of State Regional Technical References. Another 35 workshops were developed in the 28 State Regional Administrations. Results were systematized and consolidated from the Analytical Matrix used in the PNPS, generating the base document of the POEPS-MG. It is important to highlight that, the specific regional requirements identified during the Policy's construction process reinforce the enriching moments of developing in an innovative, democratic and participative way actions that may provide some meanings to Health Promotion in the State of Minas Gerais. The State Policy seeks to bring life to the PNPS, adapting it to the reality of the territory and strengthening it - with the assurance of budgetary resources.

Key words
Health promotion; Public policy; Social participation; Funding

WORKSHOPS	PARTICIPANTS	OBJECTIVE
Intrasectoral Workshop	44 participants	To show the National Health Promotion Policy and survey of specificities and priorities for the construction of the State Health Promotion Policy involving intrasectoral representatives.
Intersectoral Workshop	66 participants	To show the National Health Promotion Policy and survey of specificities and priorities for the construction of the State Health Promotion Policy involving intersectoral representatives.
Workshop with representatives of the Regional Health Administrations	28 State Regional Health Administrations with 55 participants	To show the proposal and implement the methodology to build the State Health Promotion Policy with the representatives of the Regional Health Administrations and train them to replicate the methodology at the regional level for the municipalities under their jurisdiction.
Workshops at the Regional Health Administrations	966 participants	To show the National Health Promotion Policy and survey of specificities and priorities for the construction of the State Health Promotion Policy involving municipal representatives.
Systematization Workshops	26 participants	To systematize the products obtained in the workshops to build the State Health Promotion Policy and to elaborate jointly elaborate its draft.

PNPS	POEPS-MG
– Values: solidarity, happiness, ethics, respect for diversity, humanization, co-responsibility, justice and social inclusion. – Principles: equity, social participation, autonomy, empowerment, intersectoriality, intrasectoriality, sustainability, integrality and territoriality.	- Values and principles: solidarity, happiness, ethics, respect for diversity, humanization, coresponsibility, justice and social inclusion, equity, social participation, autonomy, empowerment, intersectoriality, intrasectoriality, sustainability, integrality and territoriality, perseverance, belonging, lovingness, creativity, respect, environmental justice, horizontality.
- Cross-sectional themes: Social Determinants of Health (SDH), equity and respect for diversity, sustainable development, health and care production, healthy environments and territories, life at work, peace culture and human rights.	- Cross-sectional strategies: Social Determinants of Health (SDH), health care, sustainable development promotion, life at work, equity in health promotion.
- Operational axes: territorialization; intrasectoral and intersectoral coordination and cooperation; healthcare network; social participation and control; Management; education and training; surveillance, monitoring and evaluation; Production and dissemination of knowledge; Social communication and media.	- Operational strategies: territorialization; intrasectoral, intersectoral and interagency coordination and cooperation; healthcare networks; social participation and control; management; education and training; surveillance, monitoring and evaluation; production and dissemination of knowledge; Mobilization and Social Communication.
- Priority themes: continuing training and education, appropriate and healthy food, bodily practice and physical activities, coping with tobacco use and derivatives, coping with alcohol and other drugs abuse, safe mobility promotion, peace culture and human rights promotion, sustainable development promotion.	- Themes: coping with alcohol and other drugs abuse, appropriate and healthy food, bodily practice and physical activities, peace culture and human rights promotion, worker's health promotion, continuing training and education, and popular education in health.

Theme	N° votes	Recurrence in Workshops
Continuing training and education	269	23
Health and care production	85	11
Bodily practice and physical activities	78	8
Appropriate and healthy food	74	11
Coping with alcohol and other drugs abuse	58	9
Healthy environments and territories	35	5
Peace culture and human rights promotion	27	5
SDH, equity and respect for diversity	24	6
Professional appreciation	15	1
Quality culture	14	2
Physical activity	13	2
Quality of life	9	1
Professionalization of extended and responsible management with the obligation of an exclusive primary care coordinator	9	1
Physical practices and physical activity associated with healthy eating	9	1
Participatory management	8	1
Health promotion in child education	7	1
Health promotion and care	6	1
Healthy food	6	1
Coping with tobacco use and derivatives	5	1
Health professionals’ health promotion	5	1
Healthy food and bodily practices	5	1
Encouraging self-care	5	1
Sustainable development promotion	4	1
Coping with legal and illegal drugs’ abuse	2	1

ABRASCO - Associação Brasileira de Saúde Coletiva Av. Brasil, 4036 - sala 700 Manguinhos, 21040-361 Rio de Janeiro RJ - Brazil, Tel.: +55 21 3882-9153 / 3882-9151 - Rio de Janeiro - RJ - Brazil
E-mail: cienciasaudecoletiva@fiocruz.br

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[1] Collaborators

DS Campos, MA Turci, EM Melo, VA Guerra, CGM Nascimento, CA Moreira, EM Paschoal, NRM Beltrão and KR Silva contributed to the construction of the manuscript.

1-Continuing training and education and Popular education in health	Continuing training and education: promoting training for managers, health workers and other sectors. Popular education in health: theoretical perspective oriented to the educational practice and social work intentionally directed to the promotion of people's autonomy.
2- Adequate, Healthy and Sustainable Food	Actions aiming at an environment that generates practices and customs that favor healthy choices and that are environmentally, culturally and socially sustainable.
3-Bodily practice and physical activities	Body practices: human beings in movement, assigning senses and meanings to content and intervention; Physical activity: any form of bodily movement, with energy expenditure above resting levels; Leisure activities: to practice pleasant activities, for rest, fun, recreation and entertainment.
4- Peace culture and human rights promotion	Includes promoting, articulating and mobilizing actions that foster coexistence, respect for diversity and differences in gender, sexual orientation and gender identity, between generations, ethnic-racial, cultural, territorial, social class and related to people with disabilities.
5-Álcool, Tobacco and Other Drugs	Actions to reduce the consumption of alcohol, tobacco and other drugs, with the co-responsibility and autonomy of the population, including educational, legislative, economic, environmental, cultural and social actions.
6- Worker's Health Promotion	The promotion and protection of formal and informal workers’ health, as well as surveillance of work environments and processes and stimulating workers’ role.
7- Equity in health promotion	Respect for sexual and gender diversity, ethnic-racial, cultural and territorial diversity, as well as breaking down institutional barriers that hinder access to health.