Morte materna: uma expressão da "questão social" Maternal death: an expression of the "social issue"
Author(s)Luzia Magalhães Cardoso
Mirian Moura Costantin Félix de Souza
Roberto Ubirajara Cavalcante Guimarães
Social sciences (General)
Social pathology. Social and public welfare. Criminology
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AbstractEste trabalho é resultado do estudo acerca dos determinantes sociais, econômicos e culturais da morte materna, realizado no período de julho de 2007 a dezembro de 2008. A metodologia utilizada foi a pesquisa-ação, por meio de análise documental, em prontuários da unidade de saúde, e de entrevista estruturada, com os familiares de mulheres que foram a óbito. Para a análise dos dados, utilizou-se a associação dos métodos quantitativo e qualitativo, e como método geral, a dialética. O resultado aponta para a relação da morte materna com as condições materiais de existência, resultantes de múltiplos fatores, entre os quais estão a falta de acesso ao SUS, o misticismo, a prática do aborto e o isolamento social.<br>This article is the result of the study about the social, economic and cultural aspects related to maternal death, conducted from July 2007 to December 2008. The methodology used was action-research, through analysis of documents, records of the health unit, and a structured interview with relatives of the women who have died. For the analysis of the data, the association of quantitative and qualitative methods was used, and as a general method, dialectics was employed. The result points to the relationship between maternal death and the material conditions of existence, the result of several factors, among which are lack of access to SUS, mysticism, the practice of abortion and social isolation.
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Social Protection in Low Income Countries and Fragile Situations : Challenges and Future DirectionsOvadiya, Mirey; Zampaglione, Giuseppe; Das, Maitreyi; Andrews, Colin; Elder, John (World Bank, Washington, DC, 2013-05-28)Demand for social protection is growing in low income countries and fragile situations. In recent years, the success of social protection (SP) interventions in middle income countries (MICs) like Brazil and Mexico, along with the series of food, fuel, and financial crises, has prompted policymakers in low income countries (LICs) and fragile situations (FSs) to examine the possibility of introducing such programs in their own countries. Flagship programs in countries as diverse as Ethiopia, India, Pakistan, and Rwanda have shown the adaptability of social protection interventions to the LIC context. Yet, despite growing levels of support for these initiatives, many challenges remain. In LICs and FSs, governments are confronted with a nexus of mutually reinforcing deficits that increase the need for SP programs and simultaneously reduce their ability to successfully respond. Governments face hard choices about the type, affordability, and sustainability of SP interventions. The paper reviews how these factors affect SP programs in these countries and identifies ways to address the deficits. It supports the establishment of resilient SP systems to address specific needs and vulnerabilities and to respond flexibly to both slow and sudden onset crises. To achieve this, both innovation and pragmatism are required in three strategic areas: (i) building the basic blocks of SP systems (e.g., targeting, payments, and monitoring and evaluation); (ii) ensuring financial sustainability; and (iii) promoting good governance and transparency. These issues suggest the possibility of a different trajectory in the development of social protection in LICs than in MICs. The implications for World Bank support include the need to focus on increasing knowledge and operational effectiveness of SP programs, fostering institutional links between multiple SP programs, and using community capacity and technological innovations to overcome bottlenecks in operations.
Managing Risk, Promoting GrowthWorld Bank (World Bank, Washington, DC, 2016-02-08)A growing body of evidence demonstrates
that individuals and households experience a range of
positive outcomes from social protection. Social protection
increases productivity and growth. Countries can realize
significant benefits by creating an integrated social
protection system. Social protection is affordable in
low-income countries despite tight budgets. While overall
spending on social protection in Africa remains low by
international standards, experience suggests that social
protection programs can achieve national coverage at the
cost of only 1 to 2 percent of gross domestic product (GDP).
While this is only a portion of the financing required to
operate a social protection system, it draws attention to
what countries can achieve in the short-term. Indeed, one
way in which existing social protection spending can be made
significantly more efficient would be by reallocating
existing financing for inefficient subsidies and ad hoc
emergency food aid to predictable safety nets. At the same
time, pursuing reforms to social security systems will
ensure their fiscal sustainability, while expanding
coverage. Notably, the costs of not protecting poor families
are very high, are borne disproportionately by women and
children, and undermine the productivity of future
generations. The Strategy will be implemented by leveraging
partnerships, knowledge, and the World Bank's financing
instruments. The World Bank will continue to invest in
analytical work to fill knowledge gaps and promote an
evidence-based dialogue for social protection systems in
Africa and further innovation. It will work with governments
to build country-owned national social protection systems
with the aim of reducing fragmentation in the sector. The
Bank also will pay particular attention to institutional
development and capacity building by using its lending to
increase the coverage of successful social protection
interventions. Throughout this work, the Bank will work in
coordination with governments, development partners, the
private sector, academics, civil society, and beneficiaries.