Plano Nacional de Saúde no Sistema Penitenciário: o desenvolvimento da política e os reflexos no déficit de acesso aos serviços de saúde

Abstract

The right to health care for the prison population has been established in Brazil from the Criminal Sentencing Act, and reaffirmed constitutionally through the institutionalization of the universal right to health. Thus, considering the challenge of promoting access of the prison population to the actions and health services SUS was created the National Health Plan in Prisons (PNSSP). This paper aims to analyze the PNSSP order to investigate the factors involved in the existence of deficit in this population to access health services in the SUS. The research methodology was based on the case study, in which we studied the implementation experiences of Operational Plans State Prison Health of Minas Gerais, Rio Grande do Sul and Mato Grosso do Sul, using for both desk research and interviews with staff and managers state and municipal governments as well as representatives of health advice. It was used as the basis analytical the literature dealing with the formation of the government agenda, design and implementation of public policies, with specialattention to the contributions of Schneider and Ingram (1997). The main results of the study can cite the existence of strong evidence that health policy at the national penitentiary arose from the issue of human rights violations and pressure suffered by the state bureaucracy to provide answers to this problem. The theme of the prison health care has failed to unite interests and political actors, which makes difficult the recognition of the problems involved in this context. The design of the policy was not able to provide answers to the needs of intergovernmental and intersectoral coordination and, on the other hand, the federal government has shown a low capacity for policy coordination in the course of itsimplementation. However, ultimately, the institution of PNSSP is understood as a breakthrough regarding the reassertion of the right to health of the prison population and the state responsibility to ensure means for its exercise.