http://www.bdtd.uerj.br/handle/1/3918 2026-04-16T17:42:49Z http://www.bdtd.uerj.br/handle/1/25554 Título: Pelo direito de ter e ser: um estudo sobre as evidências acerca do cuidado na saúde sexual e reprodutiva na centralidade da mulher Autor: Sodré, Carolina Passos Primeiro orientador: Pinheiro, Roseni Abstract: Reproductive planning has emerged as a central theme on the international public agenda, gradually consolidating itself as a fundamental right. It originates both from a capitalist instrument of population control and from social movements and international conferences on population and women, eventually approaching a rights-based perspective. Among its functions, two distinct dimensions stand out: a conservative one aimed at demographic control, especially directed at people living in poverty, and another linked to reproductive rights, grounded in population needs and demands. Although these rights have been recognized as part of human rights, several barriers may still hinder their full realization, directly affecting women’s autonomy and the care practices directed toward them. Reproductive care, therefore, unfolds as a political practice, involving ethical and moral dimensions and aligning with the ideas of being and having health. This study aimed to analyze scientific evidence on reproductive planning within the comprehensiveness of women's health care, considering public policies, knowledge systems, and practices of sexual and reproductive health care between 2015 and 2025. An Integrative Literature Review was conducted using searches in the Virtual Health Library (VHL), including the Latin American and Caribbean Health Sciences Literature (LILACS Plus); the Scientific Electronic Library Online (SciELO); the Brazilian Open Access Publications and Scientific Data Portal (Oasisbr); the Brazilian Digital Library of Theses and Dissertations (BDTD/CAPES); and the Sirius/ UERJ. A total of 33 publications were selected, and the results were organized into three categories. Category 1, Reproductive Profiles and Contraceptive Practices of Women, gathered the sociodemographic characteristics of women, including inequalities in access to reproductive planning. Category 2, Between Barriers and Resistance: Power, Autonomy, and Reproductive Care Strategies, sought to express the limitations and emerging collective strategies aimed at advancing reproductive autonomy. Category 3, Beyond Contraception: Reproductive Care as a Proposal for Comprehensiveness, incorporated notions of care to support practices centered on comprehensive care and the strengthening of women's autonomy. The analysis showed that most studies focused on describing women’s profiles or adopting a normative perspective, while giving little attention to the symbolic and subjective dimensions embedded in reproductive care. The findings demonstrate persistent unequal access to contraceptive methods, which limits the realization of sexual and reproductive rights. They also reveal that women’s choices are influenced by factors such as race, social class, education, and culture, and that care actions remain predominantly centered on biomedical approaches, with limited emphasis on women’s subjectivities Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação 2025-12-15T00:00:00Z http://www.bdtd.uerj.br/handle/1/25455 Título: "Protocolando condutas, etiquetando pessoas": as políticas prescritivas da sexualidade em um protocolo clínico do Ministério da Saúde Autor: Guimarães, Marina Soares Primeiro orientador: Carrara, Sérgio Luiz Abstract: The current research can be understood as an exploratory work about the policies of standardization and management of sexuality by brazilian's health ministery in the first half of the 21st century. Through an ethnographic analysis of documents published by the referred institution, specifically the "Caderno da Atenção Básica número 26 – Saúde Sexual e Saúde Reprodutiva (Primary Care Brochure number 26 - Sexual and Reproductive Health)" from 2010, and interviews conducted in 2017 with some participants of the creation of this publication, the document is the basis for a case study that analyzes different aspects of the sexual and reproductive policies conducted by the brazilian's ministery of health. The referred institution is mentioned as an example of clinical governance, creating protocols for medical conducts, and defining the medical and ethical etiquette of health practitioners.The document studied is perceived as a pedagogic apparatus that rules professional practices related to the bodies, the sexual behaviors, and the reproductive choices. This research discusses which elements of rationality, morality, and political view, that coexist in the document are used to establish and define the boundaries of the permissions and obligations related to different sexuality regimens Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação 2018-05-25T00:00:00Z http://www.bdtd.uerj.br/handle/1/25357 Título: A desinstitucionalização dos sujeitos com transtornos mentais: uma análise da situação em Petrópolis Autor: Martins, Viviane dos Santos Primeiro orientador: Correa, Marilena Cordeiro Dias Villela Abstract: This study constitutes a monographic investigation focused on the deinstitutionalization of individuals with mental disorders in the municipality of Petrópolis/Rio de Janeiro. The city's last psychiatric hospital, Casa de Saúde Santa Mônica, is only ceasing operations in 2024, 23 years after the enactment of the Psychiatric Reform Law. Petrópolis was compelled to strengthen its Psychosocial Care Network, particularly through the establishment of Therapeutic Residential Services, in order to accommodate the last patients from the hospital psychiatric hospital. Concrete challenges persist in implementing deinstitutionalization, manifesting in the following aspects: a) the institutionalizing nature of state actions in social policies in general, and in mental health policy in particular; b) the necessary infrastructure therapeutic residences, the number and types of Centers for Psychosocial Care (CAPS) available; c) the acceptance of patient reintegration by families, which encompasses issues related to the Continuous Cash Benefit (BPC), guardianship, and, primarily, the estrangement between families and patients due to the prolonged duration of hospitalization. In this context, the research question is as follows: What are the structural and institutional limits and possibilities that emerge in the deinstitutionalization process for individuals with mental disorders in Petrópolis? The general objective is to analyze the structural and institutional limits and possibilities associated with the deinstitutionalization of individuals with mental disorders in Petrópolis, considering structural aspects, institutional factors, and the relationships between these individuals and their families, as perceived through the municipal deinstitutionalization team over the past five years. The specific objectives are: to identify and analyze the main characteristics of the municipal mental health policy and the key actors involved; to describe and analyze the development of the infrastructure required for deinstitutionalization, including its limits and possibilities; and to examine the deinstitutionalization team's reports on interactions with families to identify the challenges encountered in facilitating family reintegration for service users. Regarding the methodology, the study was supported by documentary analysis of the judicial process that oversaw the hospital's closure in the municipality, as well as by the analysis of two focus groups with members of the deinstitutionalization team. Data analysis was conducted using Bardin's Content Analysis approach, which enabled the identification of eight thematic categories permeated by affects, contradictions, and multiple meanings that traverse the experiences of the subjects involved in the everyday execution of the Municipal Mental Health Policy. The research results demonstrate that, although the deinstitutionalization process was catalyzed by both the actions of the Public Prosecutor's Office of the State of Rio de Janeiro (MPRJ) and the municipal team responsible for its implementation, historical, cultural, and institutional barriers remain that hinder progress in the local mental health policy. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação 2025-12-12T00:00:00Z http://www.bdtd.uerj.br/handle/1/25217 Título: Modelos de cofinanciamento federal e a função política na indução do desenho assistencial da Atenção Primária à Saúde do Sistema Único de Saúde Autor: Scavazza, Maíra Andrade Primeiro orientador: Santos, Ronaldo Teodoro dos Abstract: The study aims to analyze the federal co-financing models of Primary Health Care of the Unified Health System as a political tool to induce the care model, focusing on the analysis of the interfederative relationship. The chosen methodology was documentary analysis, and the SUS PHC regulations published by the Ministry of Health between 2016 and 2024 were selected from the point of view of the relationship between the care design and the federal co-financing model. Historically, the financing of public health policies and financial transfers from the Union to subnational spheres have been an important mechanism to induce, shape and regulate the policies implemented by state and municipal governments, ensuring federal coordination of health policies. The Brazilian process of decentralization in health has a political-administrative character and produced important effects in increasing the coverage of the Family Health Strategy in the territories. However, federal coordination maintained the concentration of power to induce public health policies through conditionalities linked to fund-to-fund financial transfer mechanisms. This model, over the more than three decades of SUS, has had repercussions on interfederative relations. While the decentralization guideline for the progressive health field is related to democratization, for the conservative field it is related to greater power for municipalities and decision-making autonomy for local managers, reconcentrating power in the local political elites. The scenario of interfederative relations was the basis for analyzing the three models of federal co-financing and the care model induced in each period, considering: Basic Care Floor - PAB (1996-2019), Previne Brasil Program (2019-2024) and new federal co-financing methodology for SUS PHC (2024-current). Thus, it is understood that the first model was essential for the expansion of Family Health teams in the country and was composed of several rules to be followed so that municipalities could access resources, generating criticism about the centralization of federal management. The Previne Brasil Program model subverted principles that guaranteed comprehensive PHC and comprehensive care, to the detriment of fostering managerial autonomy at the municipal level, altering the pillars of federal coordination present in co-financing, in order to induce a focused care model that diverges from the principles of universality and comprehensiveness. The third model revisits the principles of the SUS and the Constitution and advances some debates based on a movement to recentralize care induction through federal financial induction. Thus, the constant tension between local and central power reverberates in the effects of the policy and in the paths of PHC induced. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Dissertação 2024-11-08T00:00:00Z