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Revista de Saúde Pública

On-line version ISSN 1518-8787Print version ISSN 0034-8910


PILON, André Francisco. O problema metodológico em educação sanitária. Rev. Saúde Pública [online]. 1968, vol.2, n.2, pp.216-225. ISSN 1518-8787.

In any public or private social-addressed programme arises the question of how to coordinate agency-client relationships, in order to obtain the best results, in terms of agency's policy and aims and people's interests and needs. Two american sociologists, Litwak and Meyer, of Michigan University, postulate that this coordination is a function of the degree of social distance between agency and clientele. Thus "maximum social control is most likely to occur when coordinating mechanisms develop between bureaucratic organizations and external primary groups that balance their relationships at a middle position of social distance where they are not too intimate and not isolated from one another". These mechanisms are 1) the detached expert approach; 2) the opinion leader approach; 3) the settlement house approach; 4) the voluntary association approach; 5) the common messenger approach; 6) the mass media approach; 7) the formal authority approach and 8) the delegated function approach, all of them with differential power of initiative, intensity, focused expertise and coverage. All the different mechanisms of coordination should be used according to the degree of social distance between agency and clientele, which means that in dealing with external groups the agency must decide whether they are supporting ones (same values of the agency, informed and organized), resistent ones (deviant values and organized), or a mixture tipe (some deviant, some conforming or with the desired values, but not organized or lacks knowledge). The agencies which are to deal with groups must not just select the appropriate mechanisms, but ought to have themselves the desired structure to facilitate the coordination, according to the cases. Besides that, the objectives of their programmes shall be analised, whether they are pure informative-content objectives or culture change-content objectives. We believe that the "balance theory of coordination between bureaucratic organizations and external primary groups", as the authors call it, is an important contribution to the intended integration of the Social Sciences with the Educational and Administrative ones. In the field of Health Education methodology, it gives a more sound criterium to choose the appropriate methods in dealing with people, according to the content of our message and the characteristics of the clientele concerned, without forgeting the bureaucratic structures of our own agencies.

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