Autor/es
Descripción
ver mas
Colaborador
Di Leo, Pablo Francisco
Materias
Spatial Coverage
Idioma
spa
Extent
156 p.
Derechos
info:eu-repo/semantics/openAccess
Atribución-NoComercial-SinDerivadas 2.0 Genérica (CC BY-NC-ND 2.0)
Formato
application/pdf
Identificador
Cobertura
1005838
Villa Lugano (neighborhood)
Abstract
This thesis purpose is to contribute to the knowledge on implementation processes of health policies aimed at young people. It’s considered substantive to address to the implementation levels, as well as the design and planning ones, in order to analyze social policies in its complexity, and its socio-historical and relational character.
The overall objective of this work is to know and analyze the process of implementing health policies aimed at young people, especially those who are pregnant, that live in impoverished neighborhoods of Buenos Aires (CABA) and are attended in public institutions of primary health care.
The methodological approach proposed to account for the objectives of this tesis was the case study strategy. Particularly, it was selected the case of a Health Center and Communal Action (CESAC) situated near the Villa 15 which is located in the district of Lugano in CABA. The choice of this methodological strategy was based on the possibility of integrate both singulars and generals processes in the analysis, which allow us to attend to the relation among several dimensions involved in the implementation of social policies.
For the construction of empirical data, depth interviews were applied to professionals of the CESAC team. To analize that, we followed the general guidelines of grounded theory, using Atlas.ti software as a technical auxiliary. In order to articulate and combine the emergent in the testimonies and the proposed conceptual framework, three main categories were constructed. The construction of such categories enabled the expression of tensions and conflicts present in the testimonies, as well as the points in common and connections between them.
Present-past. Changes and continuities in the CESAC: The origin of the CESAC were linked to their location in impoverished neighborhoods of Buenos Aires city. It has operated in the meanings about them as institutions for the poor, with limited complexity and different from the hospital logical, based on their resources, organization and practices. This tension is also present in the history of the CESAC studied. Constructing its past raises conflicting senses between nostalgia for the time a team work was done and promoting and prevention activities were developed in the neighborhood and the discomfort and discouragement caused by the precarious conditions in which professionals used to work or the insecurity they experienced there. In this history, that is established as constituting of this present, what is assumed to be the past and a characteristic of a health center under the proposed of Primary Health Care (PHC), appears as a parameter of comparison between what is and what is supposed to be a CESAC, and therefore, how its activities should be performed, how it should be organized or how it should connect with the population.
Inside – Outside. Historical links and ruptures between the CESAC and the neighborhood: The link with the population of the neighborhood has been highlighted as a point of tension in the process of constructing the CESAC and its modalities of intervention. What is seen as signs of this neighborhood, that is to say, the poor living conditions, the violence, the lack of access to resources and a high level of mobility of its population, are understood as generating conditions of "vulnerability" and "marginalization". Based on this characterization different actions have been proposed, even contradictory ones. On one hand, based on the PHC strategy, it is supported and promoted the visits to the neighborhood as a privileged intervention. Whereas, on the other hand, these features have made professionals prefer assitential practice and remain inside the CESAC, based on those dangers. These historical conflicts and contradictions generate discomfort in the proffesional team, limiting the continuity of the proposed strategies and fragmenting the practices inside the CESAC.
Fragmentation-Integration. The scopes and limitations of institutional strategies for attending young people: In the attention orientated to young people of the neighborhood, in particular those who are pregnant, the mentioned fragmentations have expressed differences even in the definition of this situation as a problem or as an expected and natural condition in this context. This, in turn, has established differences on the approaches, even contradictions, depending on the conceptions of what it means to be young in this neighborhood, which have little relation to each other. This could be limiting the access and continuity of young in the CESAC in order to take care of their health.
From these tensions, and those that raised between the planning and coordination of the organization and the professionals autonomy to develop their practices to attend young people, should be considered as obstacles in terms of accessibility and integral care that can arise for young pregnant women in health centers. This aspects, should also be consider as important ones in the implementation of policies to provide them care in this contexts.
The overall objective of this work is to know and analyze the process of implementing health policies aimed at young people, especially those who are pregnant, that live in impoverished neighborhoods of Buenos Aires (CABA) and are attended in public institutions of primary health care.
The methodological approach proposed to account for the objectives of this tesis was the case study strategy. Particularly, it was selected the case of a Health Center and Communal Action (CESAC) situated near the Villa 15 which is located in the district of Lugano in CABA. The choice of this methodological strategy was based on the possibility of integrate both singulars and generals processes in the analysis, which allow us to attend to the relation among several dimensions involved in the implementation of social policies.
For the construction of empirical data, depth interviews were applied to professionals of the CESAC team. To analize that, we followed the general guidelines of grounded theory, using Atlas.ti software as a technical auxiliary. In order to articulate and combine the emergent in the testimonies and the proposed conceptual framework, three main categories were constructed. The construction of such categories enabled the expression of tensions and conflicts present in the testimonies, as well as the points in common and connections between them.
Present-past. Changes and continuities in the CESAC: The origin of the CESAC were linked to their location in impoverished neighborhoods of Buenos Aires city. It has operated in the meanings about them as institutions for the poor, with limited complexity and different from the hospital logical, based on their resources, organization and practices. This tension is also present in the history of the CESAC studied. Constructing its past raises conflicting senses between nostalgia for the time a team work was done and promoting and prevention activities were developed in the neighborhood and the discomfort and discouragement caused by the precarious conditions in which professionals used to work or the insecurity they experienced there. In this history, that is established as constituting of this present, what is assumed to be the past and a characteristic of a health center under the proposed of Primary Health Care (PHC), appears as a parameter of comparison between what is and what is supposed to be a CESAC, and therefore, how its activities should be performed, how it should be organized or how it should connect with the population.
Inside – Outside. Historical links and ruptures between the CESAC and the neighborhood: The link with the population of the neighborhood has been highlighted as a point of tension in the process of constructing the CESAC and its modalities of intervention. What is seen as signs of this neighborhood, that is to say, the poor living conditions, the violence, the lack of access to resources and a high level of mobility of its population, are understood as generating conditions of "vulnerability" and "marginalization". Based on this characterization different actions have been proposed, even contradictory ones. On one hand, based on the PHC strategy, it is supported and promoted the visits to the neighborhood as a privileged intervention. Whereas, on the other hand, these features have made professionals prefer assitential practice and remain inside the CESAC, based on those dangers. These historical conflicts and contradictions generate discomfort in the proffesional team, limiting the continuity of the proposed strategies and fragmenting the practices inside the CESAC.
Fragmentation-Integration. The scopes and limitations of institutional strategies for attending young people: In the attention orientated to young people of the neighborhood, in particular those who are pregnant, the mentioned fragmentations have expressed differences even in the definition of this situation as a problem or as an expected and natural condition in this context. This, in turn, has established differences on the approaches, even contradictions, depending on the conceptions of what it means to be young in this neighborhood, which have little relation to each other. This could be limiting the access and continuity of young in the CESAC in order to take care of their health.
From these tensions, and those that raised between the planning and coordination of the organization and the professionals autonomy to develop their practices to attend young people, should be considered as obstacles in terms of accessibility and integral care that can arise for young pregnant women in health centers. This aspects, should also be consider as important ones in the implementation of policies to provide them care in this contexts.
Título obtenido
Magister de la Universidad de Buenos Aires en Políticas Sociales
Institución otorgante
Universidad de Buenos Aires. Facultad de Ciencias Sociales