The history of health workers as public policy
This issue of Ciência e Saúde Coletiva, dedicated to the history of the health workers, is an expression of the permanent concern of the Casa de Oswaldo Cruz in associating historical knowledge with the challenges posed by the field of community health in our times. This engagement, whose most significant landmark was the participation of this Fiocruz unit, since 2003, in the History and Health Observatory of the network Human Resources in Health Observatory ObservaRH, motivated the organization of the international symposium History of Health Workers from a Comparative Perspective. Held in Rio de Janeiro, in April 2006, the event was supported by the Work and Knowledge Management Secretariat (Ministry of Health, Brazil), WHO and PAHO- Brazil, and furnished the basis for this thematic number. With this initiative we intend to value the historical approach and to join the agenda of the WHO, who choose the health workers as the central theme of its World Health Report 2006 Working together for Health.
History as an instrument of knowledge and critical reflection has been present in the field of health since the very beginning. Today this presence is strengthened in the international agenda. Historians, specialists from other areas and managers claim for a more active meeting between history and health, aiming at a present and future understanding of the reconstruction of the health systems. By analyzing processes in space and time, by placing health and disease into the context of society and culture the historians can tell us about practices of the past, enlighten options and facilitate comparisons. This increasing demand arises from the understanding that history, when relating and explaining health and disease processes in specific contexts of space and time, forms, questions and transforms its proper object through the impact caused upon the comprehension of individual and collectives actors, professional identities and their formation, the functioning of institutions and policies. For us, history is public policy.
Among the topics being progressively valued not only by the historians but also by policy formulators, academics, managers and social activists one must emphasize the historical studies on health workers, their education, work conditions, organization and development. This is not just about making a traditional approach to the qualification of human resources in the sense of preparing professionals for acting in health systems it is about assessing the different economical, political and cultural contexts in which these health workers carry out their activities, not only those trained according to the conventional prescripts of their professional field but also those with formation and practice of non traditional nature.
The great variety of themes, times, spaces and methodologies as well as the quality of the articles published in this issue reveal the maturity of this field, its diversity of institutions and its rich intersections with social sciences. The articles also point to the need for new initiatives for establishing a joint agenda in this "decade of the health workers". What is being presented here represents a contribution towards this goal and, above all, a form of working together for health.
Gilberto Hochman, Fernando Pires-Alves, Nísia Trindade Lima