Health and Nursing Systems: the national and international context

Maria Helena Machado Mirna Albuquerque Frota Mônica Carvalho de Mesquita Werner Wermelinger Francisco Rosemiro Guimarães Ximenes Neto Neyson Pinheiro Freire About the authors

The fast pace of evolution, in the labor market at the end of the twentieth century, saw the emergence of a new world order translated into rapid and constant changes in society and in labor, the introduction of different practices of production, marketing and consumption of goods and services, greater competition and interdependence between individuals, institutions and nations. These changes influenced the Health Systems and the professions by technological determinism and the acquisition of new practices and know-how demanded by the labor market, especially due to the inversion of the age pyramid and epidemiology as a whole.

In the field of labor relations occur severe repercussions on the profile of the professions. It is effectively a new form of social labor performance. The power structure of the institutions changed, and a new modus operandi was instituted. In this context, the health system and its workers have been experiencing changes in their archetype. In addition to the adjustments arising from technological changes, this scenario has applied changes that define what a profession represents and its social importance. Nursing as a core health profession has experienced this phenomenon in daily work, imposing changes in its archetype and in the sociological construct of its essentiality in providing assistance and care to the population.

Brazil, with a Health System based on the principles of universality, comprehensiveness and equity, which seeks to enhance and ensure the access of the population to health actions and services, this scenario of social, economic, political, geographical and cultural transformations, in which the professions are empowered or reveal their failings, reinforces the relevance and strategic character of research aimed at identifying and monitoring the sociological processes that occur within them.

In this complex socio-political-economic scenario, Fiocruz, in partnership with Cofen, conducted the Nursing Profile Survey in Brazil. The study set out to analyze and characterize their professional profile, seeking to comprehend the dynamics, working, employment and training conditions, from the economic and social through to the ethical and political aspects of the organization11 Machado MH, coordenadora. Pesquisa Perfil da Enfermagem no Brasil: Relatório Final. Rio de Janeiro: Nerhus-Daps-Ensp/Fiocruz; 2017.,22 Freire NP. Trajetória: Fatos e fotos da Pesquisa Perfil da Enfermagem. Enfermagem em Foco 2016; 7(n. esp.):81-86.. The results show, for example, workers widespread burnout, illness, low wages and saturation of the labor market. Besides providing input for the discussion of public policies and interventions to improve nursing care, these results motivated the compilation of this special issue: Health and Labor Systems – The Nursing challenges.

The featured article introduces the journal by presenting the challenges and importance of profession in the SUS. In the thematic context, Training and Management of Education, fundamental themes of Health Education are addressed, in addition to their challenges for new labor contexts, focusing on universal health systems. Approaching contemporary themes of the world of labor, the Labor Market and Labor Relations article presents a thought-provoking discussion of the current reality of Nursing. To close this special issue, the article Health Systems: international panorama presents the scenario of health systems and Nursing practices around the world.

We would like to thank all the authors who contributed to this publication with previously unpublished articles of excellent quality. Our special thanks go to the Federal Council of Nursing for making this pu­blication a reality.

We dedicate this issue to all Nursing professionals in Brazil.


  • 1
    Machado MH, coordenadora. Pesquisa Perfil da Enfermagem no Brasil: Relatório Final Rio de Janeiro: Nerhus-Daps-Ensp/Fiocruz; 2017.
  • 2
    Freire NP. Trajetória: Fatos e fotos da Pesquisa Perfil da Enfermagem. Enfermagem em Foco 2016; 7(n. esp.):81-86.

Publication Dates

  • Publication in this collection
    20 Dec 2019
  • Date of issue
    Jan 2020
ABRASCO - Associação Brasileira de Saúde Coletiva Rio de Janeiro - RJ - Brazil