Participatory methodology as an instrument for the territorialization of Environmental Surveillance actions.

Jan Bitoun,Anselmo César Vasconcelos Bezerra

doi:10.1590/1413-812320172210.17722017

Abstract

This paper aims to show a health territorialization methodology built from the experiences of endemic control and environmental health agents in the Metropolitan Region of Recife (RMR). Ten workshops were held with the participation of three hundred Health Surveillance agents and supervisors working in four municipalities of the RMR. Techniques such as the application of questionnaires, interviews and directed discussions were used. Results indicate that the incorporation of geographical concepts to consolidate Health Surveillance field actions is incipient. The territory is predominantly adopted from an administrative perspective, and territorialization is used as a simple territorial division for the development of actions. However, there is an understanding and consensus of the need to understand the geographic knowledge, a fact that was expressed by the rich collective construction of a participatory territorialization model that should involve a range of social stakeholders. We concluded that, in practice, surveillance agents have significant abilities to participate in the territorial management and territorialization process, not only collecting data, but also mainly intervening for the collective well-being.

Highlights

Environmental Surveillance has a strong geographic component in the scope of Health Surveillance
It is believed that there are great operational challenges between these two spheres of planning and operationalization of Health Surveillance actions, often due to the lack of communicative interaction between program managers and executors, which results in ineffective actions in the territory
The health territorialization process advocated by Monken and Barcellos[12], Bezerra[15], Gondim et al.[16] only makes sense if conceived through the discussion with stakeholders about what does the territory represent, why territorialize and the role of health agents in this process

Summary

Introduction

Environmental Surveillance has a strong geographic component in the scope of Health Surveillance. This work is conceived and performed by health professionals who work from the operational scales closest to the population, vulnerabilities and risks, such as health agents, to management spheres that think, organize and distribute actions, such as municipal, state and federal managers. Coordination between these different scales in the operational practice has shown some difficulties in the scope of territorial management, since the performance rationale of surveillance policy field operators, namely, health agents, is based on a relation of proximity and coexistence with communities. The knowledge of geographic space and the planning of actions based on a given territorial organization can be a contribution to bring operative and management spheres closer

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Results