Revista Gaúcha de Enfermagem: a contribution to the Universal Access to Health and Universal Health Coverage

The Revista Gaúcha de Enfermagem has been instrumental for 40 years in the socialization of the knowledge produced in nursing. This fact expresses a clear commitment with the agendas of international organizations whose goals are characterized by identifying the impact of social, political, economic, and environmental transformations in health and determine joint actions to prevent, promote, treat, and recover damages done to vulnerable populations.

At the helm of this context is the World Health Organization (WHO), which at its meeting held in 2005 with the participation of member states, took on as a presupposition that health services should meet people’s needs without this implying in financial costs or impoverishment. It being therefore possible to promote human development based on well-being from enjoying a healthy life, this depends on strategies and actions aimed at universal health coverage ¹ .

This commitment was reaffirmed in the WHO resolution in 2012 that highlighted the value of universal health coverage in order to reach the Millennium Development Goals for mitigating poverty and achieving sustainable development. Recognizing that health is beyond a dependence on medical services and the consequent inherent costs, inasmuch as the influence of social, environmental, and disaster factors are also considered as determinants ¹ .

In this context, the international commitment to the development of research was highlighted in Research for Universal Health Coverage on August 15, 2013. This report focuses the need for a multiplicity of appropriately designed studies ranging from clinical research to analyses of health policies and systems, as well as demonstrating how to provide services of prevention, treatment, and health care to the population ² .

Following this pact, a new agenda is identified to be developed after achieving the Millennium Development Goals in 2015, which was defined as still having two main challenges whose elements are “high quality health services” and “protection against financial risk” to be offered to all individuals in different scenarios, reaffirming the principle of universal access.

Thus decided, the Pan American Health Organization, World Health Organization (PAHO/WHO) and its Member States in 2014 in Resolution CD53/5, Rev.2 ³ - ⁴ conceptualize Universal Access to Health and Universal Health Coverage from two perspectives: as the lack of socio-cultural, organizational, economic, geographic, and gender-associated barriers with regard to health care; and as the ability of the health systems to meet the needs of people at any level of health care, providing infrastructure, adequate human resource capacity, and health technologies without causing financial losses.

To do this it becomes necessary to train professionals for identifying health needs in different scenarios of care and apply an evidence-based practice based on their studies whose results could be consumed critically to assess the relevance of its application in other contexts.

In this regard, it becomes evident that nurses are in an environment of care that is characterized by the diversity of individuals with unique and complex needs. This condition determines applying a care process based on empirical science contextualized in ethical, aesthetic, social, and cultural aspects of the subjects that give concreteness to nursing as a humanistic and social profession and the way of caring by the nurses should be guided by the principles of Universal Health.

In consideration of the strategy of Universal Health, a study was conducted that resulted in a list of research priorities in nursing on health systems and services in the Americas. After a complex analysis of documents, six main categories and 14 subcategories came to the surface ⁴ .

The categories listed include Policies and education of human resources in nursing; Structures, organization, and dynamics of the health care systems; Science, technology, innovation, and information systems in public health; Financing of health systems and services; Health policies, governance, and social control; and Social studies in health ⁴ .

This editorial considered this context that analyzed the 100 articles that were accessed the most in the Revista Gaúcha de Enfermagem according to metrics of SciELO from 2013 to 2016 ⁵ in relation to these categories and subcategories.

In the analysis, it was found that among the articles published in the Revista Gaúcha de Enfermagem in this period, 55% were related to themes that fell under the category Structures, organization, and dynamics of the health care systems, the most prevalent in this study, in its subcategory Health care models and structure, predominant in this analysis. These manuscripts focused studies on nursing interventions in individual and collective health care, scientific basis for comprehensive nursing care, organization and management of health systems and services and of public and nursing policies, and health systems. Results that showed different dimensions of nursing were directly related to the care environment as related to the different individuals, forms of care in compliance with public policies determined by national and international government agencies, as well as the genuine commitment of nursing to care with professional and expressive quality.

A search for offering quality health services expressed by its efficiency, efficacy, and effectiveness, giving credibility to the institutions and consequently visibility for what they offer to different populations, was evident in the analysis sampled by SciELO, in which 23% of the articles written by nurses were also part of the category Structures, organization, and dynamics of the health care systems, but belonged to the subcategory Improvement in the quality of services, accreditation, and patient safety. Prominent among these are aspects related to the assessment of the patient’s humanization in nursing care, interventions to reduce or mitigate errors and adverse events occurring in health care, organizational climate and culture, and accreditation of health services.

In this context, the international organization Joint Commission International can be highlighted, which is considered the gold standard in global health care, legislating on patient safety and best practices in health care systems and services ⁶ . This entity, upon assessing several requirements, gives hospitals worldwide a seal as being a certified hospital, which sets them apart from others for the quality of the services they provide for the population in these areas. These conditions have been a target of various hospitals in Latin America and in particular in Brazil, which have required them to comply with health care targets focused on the rights of patients and their families. These include the development of health care protocols structured from meta-analysis studies and other research designs for the improvement of health care indicators such as falls, errors in medication administration, pressure ulcers, among other strategies for patient safety.

The category of Policies and Education of Human Resources in Nursing related to the subcategory of Distribution, education, and professional skills reached 14% among the 100 most visited in the last four years, according to SciELO. This category and its respective subcategories refer to the distribution of human resources in Nursing in accordance with social and health needs, the impact and shortage of nursing professionals, evaluation and monitoring of the professional skills for high school and college, curricular transformation and educational and technological innovations for training human resources in nursing, educational models for preparing human resources in nursing.

The changes in the epidemiological profile of the population and consequent morbidity and comorbidities are notorious, as well as the development and application of health technologies in the different care processes, which requires that the nurse constantly be making accurate clinical decisions due to the complex and diverse health problems of individuals. These factors indicate the need for preparing critical professionals on ways for providing culturally determined care. This context makes it necessary to have teaching and learning models that promote logical reasoning and clinical judgment through technologies that promote interaction and develop the technical-scientific, ethical, aesthetic, and cultural competencies of the future nursing professional.

The category Health policies, governance, and social control and Social studies in health contained 8% of the articles analyzed. These were characterized respectively by the impact of the production of nursing knowledge on establishing health, nursing, and social control policies and on the historical analysis of the professional practice of nursing, marketing, and nursing consumers. This index, identified in the categories over a period of four years of production, expresses a moment of trends and perspectives in nursing as a social profession. The carrying out of researches by nurses in the areas of nursing history, policies, social, entrepreneurship, and marketing are just beginning. Research groups have emerged with an interest in these subjects, which is believed to boost the production of articles in these areas as a result of studies that will support organizational and/or practical initiatives in this subject.

The analysis of scientific production object of this presentation, when comparing it to the study of the research priorities in nursing in Latin America related to the Universal Health objectives, pointed out that there are gaps in the production of knowledge in nursing in different categories, but the second major dimension in the new agenda of PAHO/WHO and Affiliated Members in 2015 highlights that the need is for studies on the financing of health systems and services, thus making it possible for the population to have full access to quality health care at no extra cost at any order.

In this sample, the Revista Gaúcha de Enfermagem gives explicit witness to its scientific, social, ethical, and humanistic commitment to the community and especially to the quality of the health of individuals as it promotes the knowledge produced, gives it visibility, and allows strategies, models, methods, among other instruments to be used by other professionals in different national and international contexts, making them able to implement actions towards Universal Access to Health.

REFERÊNCIAS

• ¹
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• ²
  Chan M. Message from the director-general. In: World Health Organization (CH). The World health report 2013: research for universal health coverage. Geneva: WHO; 2013 [cited 2016 Nov 14]. p. iv-v. Available from: http://apps.who.int/iris/bitstream/10665/85761/2/9789240690837_eng.pdf?ua=1
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• ³
  Pan American Health Organization (US). Strategy for universal access to health and universal health coverage. Washington: PAHO; 2014 [cited 2016 Nov 14]. (53rd Direct Council, CD53/5, Rev. 2, 2 Oct 2014. 66th Session of the Regional Committee of the WHO for the Americas). Available from: http://www.paho.org/uhexchange/index.php/en/uhexchange-documents/technical-information/26-strategy-for-universal-access-to-health-and-universal-health-coverage/file
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• ⁴
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• ⁵
  SciELO Analytics [Internet]. São Paulo; 2016- . Revista Gaúcha de Enfermagem (1983-1447) Top 100 articles by number of accesses 2013-2016 [cited 2016 Nov 14] [about 9 screens]. Available from: http://analytics.scielo.org/w/accesses/list/articles?range_end=2016-12-15&range_start=2013-12-16&py_range=2013-2016&journal=1983-1447&collection=scl&sa_scope=Health%20Sciences
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  Consórcio Brasileiro de Acreditação. Coordenação de Educação. Nova edição do manual internacional de acreditação hospitalar. 5. ed. [Rio de Janeiro], 2014 [citado 2016 nov 14]. 132 slides. Disponível em: https://intranet.hcpa.ufrgs.br/downloads/Comunicacao/apresentacao_manual_hospitalar.pdf
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Publication Dates

• Publication in this collection
  2016