Avaliação do Programa Saúde na Escola com foco na integração entre Unidade Básica de Saúde e Escola de Ensino Fundamental: um estudo de caso em Belo Horizonte, Brasil

Abstract

The School Health Program (SHP), an intersectoral health and education policy, aims to build healthy schools. The aim of this study was to carry out an evaluation of the School Health Program. The case study was carried out in Belo Horizonte in two Elementery Schools (ES) and Basic Unit Health (BUH), and was developed in five stages: 1. Strategic analysis through a SHP Evaluatability Study, based on the six guidelines on the process in which this type of study should be guided and using the quality parameters of the Joint Committee on Standards for Educational Evaluation (JCEE). The SHP in Belo Horizonte was considered an evaluable program; 2. Mapping of the literature on economic evaluations of school health programs, carried out in PubMed / Medline for studies published in the last decade, using as search strategy the terms "cost", "economic evaluation", "school health services", "school. The results, after the analysis of 35 articles, showed a positive relationship between school health programs, costs and benefits for schoolchildren and communities; 3. Normative considering secondary data, evaluating the frequency with which the activities were carried out. The analysis presented average performance in health assessments (visual, 54.78%, oral health, 53.20%, vaccine situation, 55%, anthropometric evaluation, 83.32%). Actions to prevent more serious diseases in schools have been to combat dengue and vaccination against human papillomavirus, as well as health promotion actions related to food safety and promotion of healthy eating. No education records were found for health and education professionals. Some actions to prevent injuries that appear to be in the hands of the executors were made more frequently. The actions of health promotion presented the worst results despite their importance. Monitoring systems lack proper regularity of food and capacity to fulfilneut; 4. Evaluation of the context through the analysis focusing on the integration between health and education in the SHP, a case study with a qualitative approach, which used a matrix of indicators, based on the theoretical and logical model developed in the study of assessability, which was agreed by experts using the Delphi Technique, enabling the construction of a semi-structured interview script. As a result, the SHP in Belo Horizonte presented a multisectoral characteristic, in which most of the actions and services provided were planned by a single sector and applied to others, with low or no link between the teams, being the punctual actions not very effective and without sustainability; 5. Evaluation of effectiveness through the student perceptions about the SHP, qualitative study, with data collection carried out with schoolchildren from eleven to fourteen years old and as instrument of data collection was used written narrative. From the analysis of written narratives, three themes were identified: Ease of care and care; Learning and care; and Kindness, gratuity and help?. The schoolchildren perceived the assistance activities developed by the program, but the same did not occur with preventive and health promotion activities. The program is perceived as help and favor, subject to gratitude. The schoolchildren were passive and receptive without, however, the protagonism necessary to the production of their own health. Co-responsibility seems to be a seed still germinating.