Título :	Reiventando o corpo e a tradição na prática da circuncisão masculina : um estudo sobre Vamakonde do sul de Moçambique
Autor :	Mabutana, Carlos
metadata.dc.contributor.email:	carlosmabuta@gmail.com
metadata.dc.identifier.orcid:	Coorientador: Prof. Dr. Edgar Merchan-Hamann
Orientador(es)::	Díaz Bermúdez, Ximena Pamela Claudia
Coorientador(es)::	Merchan-Hamann, Edgar
Assunto::	Circuncisão masculina Moçambique Infecções por HIV - prevenção - vida e costumes sociais
Fecha de publicación :	14-ago-2024
Data de defesa::	23-feb-2023
Citación :	MABUTANA, Carlos. Reiventando o corpo e a tradição na prática da circuncisão masculina: um estudo sobre Vamakonde do sul de Moçambique. 2023. 240 f., il. Tese (Doutorado em Saúde Coletiva) — Universidade de Brasília, Brasília, 2023.
Abstract:	Introduction: Cow's Milk Protein Allergy - CMPA represents an important public health problem that affects mainly children. In 2017, after extensive discussion, the incorporation of three infant formulas (amino acids, extensively hydrolyzed and soy) was approved for children with this allergy and should be offered by the Unified Health System - SUS. Objective: To map the challenges for the implementation and maintenance of state and municipal programs for the supply of formulas for special purposes, aiming at the care of children with allergies to cow's milk proteins, in the context of incorporation by the SUS. Methodology: an exploratory study, also purposeful with a cross-sectional approach and a quantitative-qualitative approach, the study population was formed by the main actors involved in the discussions regarding the incorporation of this new technology, the participants were grouped into six interest groups that responded to semi-structured interviews and collecting secondary data via email. Results: The information collected was organized into three chapters. In Chapter 1, an excerpt was made of the discussions on translational research bringing to the Brazilian scenario, which culminated in the article, Translational research in Brazil: research topics and their adherence to the SUS Agenda that identified 64 programs/groups, being 8 graduate programs, 12 research programs and 44 groups in the area of translational health research. In 2019, the data showed that there was no adherence between the research topics of these 64 programs/groups and the SUS Priority Agenda, including the theme of this work, although more recently research notices were induced by the DCIT/MS/FINEP/CNPq with adherence to national needs. In Chapter 2, municipal and state programs that dispense infant formula to children with cow's milk protein allergy were characterized. 21 programs/services participated in the study, 15 municipal and 6 states in the 5 regions of the country, whose main inducer of creation was judicialization. Most (18/21) provide formulas for up to 2 years of age and perform multidisciplinary follow-ups. All programs use their resources, whether state or municipal, with no counterpart from the Union. The lack of specialized human and financial resources, according to local managers, was and still are the main obstacles to the creation and execution of these programs. In Chapter 3, we sought to map the challenges involved in this incorporation and list proposals for more cost effective solutions, based on translational research, based on the discussion with the main stakeholders in this process, Government, Productive Sector, Academy, Civil Society and Breastfeeding Protection Nets. 17 key professionals participated in the study and the challenges involving macro management, technical issues, multidisciplinary training, imprecision in diagnosis and lack of prevalence studies need to be considered to promote the rational use of public resources and better assistance to users who need this input. The correct guidance for breastfeeding, including maternal restriction of milk and dairy products, would strongly contribute to the lower use of infant formula. At an international level, among the countries evaluated, there is a positive example on this topic in Finland, which provides for a clear definition of goals and evaluation and monitoring tools, standardized and certified diagnostic process, continuous training for health professionals, elaboration of educational campaigns for the lay public, involvement of patients and associations in discussions and long-term planning, in addition to the partial reimbursement program. Financial support from the Federal sphere would help a lot in the Brazilian context for the case of the APLV Program. Final Considerations: Translational research needs the effort to achieve its goals on this topic in Brazil, even though it has already reached Stage 4. Investing in multidisciplinary training to improve the diagnosis, management and education of laypeople of APLV as well as "looking" at international examples already functioning properly and efficiently are relevant factors to effect this incorporation in a more beneficial way to the population and SUS.
metadata.dc.description.unidade:	Faculdade de Ciências da Saúde (FS)
Descripción :	Tese (doutorado) — Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, 2023.
metadata.dc.description.ppg:	Programa de Pós-Graduação em Saúde Coletiva
Aparece en las colecciones:	Teses, dissertações e produtos pós-doutorado

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