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Ciência & Saúde Coletiva

On-line version ISSN 1678-4561Print version ISSN 1413-8123

Ciênc. saúde coletiva vol.4 n.2 Rio de Janeiro Jan. 1999 




The present edition of the Ciência & Saúde Coletiva, is dedicated to the topic Management of the Integrated Health System: problems, challenges and advances. It reflects one of the concerns of the historical moment we are living, witnessing deep changes in production modes and relationships, in the division of work on international level and also in the role of the state in this process. All over the world, a reorganization of production and communication systems, evidenced by a different notion of space and time is being discussed ant put into practice. As Max Weber reminds us, the notion of space and time represents one of the most relevant bases of culture and changes in its perception foreshadows great transformations in the symbolic organization of society.

This number of Ciência & Saúde Coletiva assesses many of the socio political and organizational problems of this end of the century, reflected in the way healthcare institutions are organized and managed, understanding them as a synthesis of past and present problems and the movements towards transformation. A great part of the questions here discussed by experts in this field are part of the implementation process of the Integrated Health System, guided by the constitutional precepts of 1988. It is thus important to follow not only the analysis of impasses and difficulties but also to observe the advances the reform of the health system permitted on the basis of macropolitical and local processes. Decentralization, for instance, allowed to bring the greater part of health care, health promotion and prevention activities closer to the population and at the same time, to construct a sophisticated system integrating health management, social control and intercommunication between the different spheres of power.

This number deals with problems related to concepts, methodologies theories, articulation of theory and practice, evaluation and improvement of quality and demonstrates the extense increase of knowledge created in this sector with respect to the topics in question.

It also presents an excellent reflection about the theoretical and practical interrelations of epidemiology and planning - today an interdisciplinary field - as well as a broad review of science and technology management with emphasis to the problems of the health sector. This thematic number still deals with the relevance of the ongoing transformations in the world of work and with the reform of the State and of the health sector. It analyses the international trends and compares them with the Latin American and Brazilian situation where a certain precipitation and radicalism in carrying out the changes provoked a series of problems, among others, the unstableness of work, lack of social protection and related legislation, showing the fragility of the system against the power of the antisocial ideas and practices which mark the history of globalization.

Certainly this new number of Ciência & Saúde Coletiva will contribute essentially to the discussion of the ongoing health reform, which always had in Abrasco one of its main leaders.


Maria Cecília de Souza Minayo