Caminhos para a equidade em saúde: avaliação do Programa de Combate ao Racismo Institucional (PCRI)

Abstract

This dissertation evaluates the Program to Combat Institutional Racism (PCRI) in the field of health in Salvador/Bahia from a counter-hegemonic, non-positivist perspective, based on the in-depth evaluation of Léa Rodrigues. In order to respond to the proposed objective, in the period from 2006 to 2021, methodologies were used that allowed an in-depth evaluation of the PCRI, based on the data source triangulation strategy. The work is organized in the format of articles, in order to meet the specific objectives and present the results of the experiences lived during the social residency. In addition to the introduction, it is discussed theoretically-politically, in the first moment, health, racism as a social determinant of health, equity, public policies to combat racism in health, social management and the evaluation of public policies. In the second moment, the first article is presented as a result of interviews with key informants and bibliographic research; and the second article, which presents the analysis of interviews with health workers and management documents of the Municipal Health Department (SMS). In the next section there is the third article that shows the result of the social residence. The fourth moment of the dissertation makes an exposition of the Social Management Technology (TGS) and, finally, there are the Final Considerations. When analyzing the results, in the first article, with the support of IRAMUTEQ, it is noted that the implementation of the PCRI in the field of health in the municipality of Salvador is a challenge that demands coordinated and articulated efforts among the various social actors. The road taken in the implementation linked to the conduct of the health policy of the black population presents moments of confluence of elements favorable to its implementation and others of stagnation. Also, in the results of the second article, it is clear that the challenges to the full implementation of policies for the promotion of racial equity in health are still significant: : i) by the lack of knowledge and/or denial of racism; ii) the lack of acceptance of the impacts of racism on the health of the black population; iii) by denying the existence of racist practices, whether in the political-programmatic sphere or in the field of relations; and, iv) because the underfunding of health policies has been a barrier to the effectiveness of actions to combat racism. To deepen the reflection, a literature review was developed that addresses the role of black women in the struggle for the right to health, which will be presented in the third article. As for the TGS, it is based on the combination of two important elements for the implementation of policies to promote racial equity in health: social control and racial literacy. In this perspective, an educational immersion project is proposed for training in Monitoring and Evaluation of Social Control in the SUS aiming at combating racism in health and promoting the health of the black population, as well as the development of actions and political strategies that allow the strengthening of the program and the deconstruction of institutional racism within the system itself, in a transversal way, in the intersectoral perspective. As racial inequalities in health are products of a broad process of social exclusion, it is concluded that the PCRI is an important tool for the promotion of racial equity, with possibilities for improving the health of the black population.