Abstract

Introduction

In Brazil, children and adolescents represent the social group most exposed to violations of their rights by their family, the State, and society, contrary to the Federal Constitution and its associated laws, such as the Child and Adolescent Statute (ECA)¹1. Cavalcante FG, Marinho ASN, Bastos OM, Valadão de Deus V, Maimone MS, Carvalho MM, Fiaux MP, Valdene RSR. Diagnóstico situacional da violência contra crianças e adolescentes com deficiência em três instituições do Rio de Janeiro. Cien Saude Colet 2009; 14(1):45-56.. Sexual violence (VS) against minors is currently recognized as a violation of fundamental rights, as well as sexual and reproductive rights, and should be understood as a social phenomenon that contains historicity. In the last few decades, we have observed a wider discussion about this theme, accompanied by censorship in the face of silence before the identified situations, in what can be understood as omission and collusion. In this way, the topic came to be debated publicly, framed as a problem to be confronted collectively, in which the plan of action and discourse produced about it is influenced by the current moral standards²2. Lowenkron L. Abuso sexual infantil, exploração sexual de crianças, pedofilia: diferentes nomes, diferentes problemas? Sexualidad, Salud y Sociedad 2010; 5:9-29..

The magnitude of these events continues to gain exposure via the existing systems for reporting incidents of violence. In 2012, the System for Information on Offenses and Notifications (SINAN) recorded 20,299 cases of sexual violence in all age groups, with 15,670 (77.2%) in the age bracket of 0 to 19 years³3. Brasil. Sistema de Informação de Agravos de Notificação (SINAN). [acessado 2013 dez 11]. Disponível em: http://dtr2004.saude.gov.br/sinanweb/tabnet/tabnet?sinannet/violencia/bases/violebrnet.def
http://dtr2004.saude.gov.br/sinanweb/tab... .

There is a consensus that the sectors of Education, Health, Welfare, Public Security, Tourism and Leisure, Culture, and others constitute agencies socially legitimated by the State for confronting sexual violence against this group⁴4. Lopes RE, Malfitan OAPS. Ação social e intersetorialidade: relato de uma experiência na interface entre saúde, educação e cultura.Interface (Botucatu) 2006; 10(20):505-515.. These demands appear in public services and oblige professionals to observe norms and implement measures for the protection of this group. Nevertheless, the literature demonstrates that the professionals who work with these cases do not feel adequately trained, especially when sexual violence is reported⁵5. Granville-Garcia AF, Souza MGC, Menezes VA, Barbosa RG, Cavalcanti AL. Conhecimento e percepção de professores sobre maus-tratos em crianças e adolescentes. Saúde Soc. 2009; 18(1):131-140..

Authors question the training and insist that there is room for a radical revision of the role these institutions play in the promotion of professional competency. The lack of dialog among the training institutions, the organizations responsible for the delivery of services, and civil society is a contradiction if we have in mind the perspective of providing society with professionals capable of engaging with present-day demands and of defending human rights⁶6. Cotta RMM, Gomes AP, Maia TM, Magalhães KA, Marques ES, Siqueira-Batista R. Pobreza, injustiça, e desigualdade social: repensando a formação de Profissionais de Saúde. Rev Brasileira de Educação Médica 2007; 31(2):278-286.. From this perspective, since the 1960s multinational projects have come to incentivize the continuous training of adults. The General Conference of the United Nations Educational, Scientific and Cultural Organization (UNESCO) in Paris in 1966 defined objectives for education, placing a priority on the idea of permanent education as a lifelong process⁷7. Organização das Nações Unidas para a Educação, a Ciência e a Cultura (Unesco). Recomendação relativa à condição docente, aprovada pela Conferência Intergovernamental Especial sobre a Condição Docente. Paris: Unesco; 1966.. In the 1970s, there arose a critical focus based on the consciousness that man is also educated within the reality that surrounds him, and co-educated as a transformative subject in interaction with other men⁸8. Morin E. A cabeça bem feita: repensar a reforma, reformar o pensamento. 7ª ed. Rio de Janeiro: Bertrand Brasil; 2002..

Scholars recognize the polysemy in the concepts of continuous and permanent education, but they are unanimous in affirming the necessity of training professionals for more effective action in attending to children and adolescents exposed to situations of sexual violence⁹9. Finck SCM, Salles Filho NA. Esporte e a formação de professores na prevenção de violências e mediação de conflitos escolares. Acta Scientarium Education 2012; 34(1):111-120.. Continuous education is defined by the Pan-American Health Organization (OPAS) as a permanent process of education, complementing the basic training, which better prepares and trains persons and groups in light of technical, scientific, and social changes¹⁰10. Organización Panamericana de la Salud (OPAS). Oficina regional de la organización de la salud. Educación contínua: guia para la organización de programas de educación continua para el personal de salud. Washington: OPAS; 1978.. For the World Health Organization (OMS), this consists of a process that includes all the experiences subsequent to initial training¹¹11. Organización Mundial de la Salud (OMS). Continuando la educación de los trabajadores de salud: Principios e guias para el desarrollo de um sistema. Genebra: OMS; 1982..

Permanent education consists in bringing about personal development to promote – in addition to specific technical training of subjects –the acquisition of new knowledge, concepts, and attitudes¹²12. Paschoal AS, Mantovani MF, Meier MJ. Percepção da educação permanente, continuada e em serviço para enfermeiros de um hospital de ensino.Rev Escola de Enfermagem da USP 2007; 41(3):478-484.. To improve the quality of services and enable change by including knowledge and practices, Brazil committed itself to investing in public policies that guide this process of training. Among these, we emphasize the National Policy of Permanent Education in Health (PNEPS)¹³13. Brasil. Ministério da Saúde (MS). Secretaria de Gestão do Trabalho e da Educação na Saúde. Política Nacional de Educação Permanente em Saúde. Brasília: MS; 2009. and the National Policy of Permanent Education in Social Control of the Unified Health System – SUS (PNEPCS)¹⁴14. Brasil. Ministério da Saúde (MS). Conselho Nacional de Saúde.Política Nacional de Educação Permanente para o Controle Social no Sistema Único. Brasília: MS; 2007.. The focus of permanent education envisioned by PNEPS represents an important change in the conceptualization and practices of training of service workers. It presumes to invert the logic of the process, incorporating teaching and learning into the everyday life of the organizations and to social and labor practices in their context, recognizing the subjects as actors reflecting praxis, building knowledge and alternative action¹³13. Brasil. Ministério da Saúde (MS). Secretaria de Gestão do Trabalho e da Educação na Saúde. Política Nacional de Educação Permanente em Saúde. Brasília: MS; 2009.. This concept also permeates the educational policies of primary and middle school education, when they choose to address more complex themes – for example violence, which must be discussed in a cross-curricular way in the teaching of children and young people¹⁵15. Brasil. Ministério da Educação (MEC). Secretaria de Educação Fundamental (SEF). Parâmetros curriculares nacionais: introdução aos parâmetros curriculares nacionais. Brasília: MEC/SEF; 1997..

In the same way, in the field of social welfare it is postulated that training should be promoted with the aim of producing and divulging knowledge that develops behavior and technical-managerial capacities, oriented towards more effective exercise of social control and the empowerment of users¹⁶16. Brasil. Ministério do Desenvolvimento Social e Combate à Fome. Secretaria Nacional de Assistência Social. Norma Operacional Básica NOB/SUAS.Política Nacional de Assistência Social. Brasília: NOB/SUAS; 2006..

In light of the intersectoral demand involved in attending to situations of violence against children and adolescents - especially those that are sexual - and the difficulties that have been observed (whether in terms of acting in tandem with other organizations, assisting the families, or observing the directives of public policy about the theme), the question of training managers and professionals takes on a pivotal role¹⁷17. Paixao ACW, Deslandes SF. Análise das políticas públicas de enfrentamento da violência sexual infantojuvenil. Saude Soc.2010; 19(1):114-126..

From this perspective, this article seeks to analyze the offering of training programs to agents of municipal government for confronting sexual violence against children and adolescents in four Brazilian capitals.

Method

This article forms part of a multi-centric research project known as “Evaluation of municipal government strategies in responding to sexual exploitation of children and adolescents in four capitals of the Brazilian macro-regions.” This study focuses on five axes of practice by city governments in confronting such violence (prevention and promotion of bonds with caregivers; care of people in situations of violence; strengthening the system of guaranteed rights; reporting and notification; and holding the perpetrators accountable). The study uses a cluster of indicators constructed by participatory methodologies and confirmed in previous research¹⁸18. Deslandes SF, Mendes CHF, Pires TO, Campos DS. Use of the Nominal Group Technique and the Delphi Method to draw up evaluation indicators for strategies to deal with violence against children and adolescents in Brazil.Rev Brasileira de Saúde Materno Infantil 2010; 10(Supl. 1):s29-s37..

The research design was arranged as a multiple case study¹⁹19. Yin RK. Estudo de caso – planejamento e métodos. Porto Alegre: Bookman; 2001.. The case study constitutes a research method commonly employed in the field of social science. It allows a deeper knowledge – whether exploratory or analytical – about a geographically and temporally delimited subject, with the intention of observing the occurrence of a phenomenon, uniting theory and praxis, experiences acquired by the researchers, along the interpretive way¹⁹19. Yin RK. Estudo de caso – planejamento e métodos. Porto Alegre: Bookman; 2001.^,2020. Gil AC. Como elaborar projetos de pesquisa. 4ª ed. São Paulo: Atlas; 2008..

The case study permits an immersion in empirical investigation, facilitating the collection of relevant and suitable data. It introduces flexible methodological procedures, demanding a certain maturity and capacity for observation from the researcher. This approach can draw upon methods of historical research, making use of documentary analysis, as well as the observation and interviewing of subjects¹⁹19. Yin RK. Estudo de caso – planejamento e métodos. Porto Alegre: Bookman; 2001..

The study is comprised of four cases selected according to the following criteria: (1) Regional diversity; (2) High incidence of reports of sexual exploitation, drawing on a database of information contained in the programs Dial Human Rights, Dial 100, and the Child and Adolescent Unit for the selection of capital cities, taking into consideration the sum total of allegations about sexual exploitation between 2003 and 2010; and (3) the willingness of the municipal government to participate in the study.

The four capitals selected were Porto Alegre, Campo Grande, Belém, and Fortaleza. Belém was the second city with a major occurrence of reports of violence in the North Region. The capital with the most reports (Manaus) was affected by a public calamity due to floods in the research period, and declined the invitation to participate in the study. The Southeast Region was not included in the study because of budget cuts.

The research followed the same accession protocol in all of the capitals. Institutional contacts with the mayors’ cabinets were informed about the submission of the project, its approval by the ethics committee, and successive clarifications of its goals with regard to taking part in the study. After official acceptance of the research project, granted after the signing of a consent form by the mayor, a seminar for introducing the project and the cooperation agreement was held in each capital, in order to facilitate the collection of data, the observance of the timetable, and to define the forms in which the research findings would be delivered.

In all the capitals, such activities involved representatives of the city governments, the mayor’s offices, child protection agencies, and the City Councils for the Rights of Minors. At the conclusion of the study, a public seminar was held to address the dissemination of results and the confirmation of our recommendations.

For our unit of analysis, we took the training programs during the biennium of 2010-2011 by the city government offered to professionals and managers working in the public sector. Carried out between June and November of 2012, the data collection was centered on the utilization of 66 semi-structured interviews with mid-level managers and technicians, who were representatives of city governments in the public policy areas involved with addressing sexual violence against children and adolescents (Healthcare, Education, Social Work, Human Rights, Culture, Sports and Leisure, and the City Guard). Following the indications of the interview subjects, new relevant interlocutors were suggested (the “snow-ball technique”) and interviewed later.

The interviews were transcribed and treated as oral documentary sources. In addition to the testimonials, the written documents pertaining to the training actions mentioned by managers were categorized according to precepts of thematic analysis²¹21. Gribs G. Análise de dados qualitativos. Porto Alegre: Artmed; 2009.. The organization of this documentary archive was guided by a system of categorization oriented by the regulatory basis outlined in the policies, plans, and standards for confronting the phenomenon. Three thematic units were identified in this manner, regarding training oriented in the following ways: (1) toward identification and prevention; (2) to the care of children, adolescents, and relatives; (3) for the systematization and analysis of data regarding reports of sexual violence against children and adolescents.

The results were initially expressed descriptively, grouped by sector of activity (Education, Welfare, etc.), and treated individually for each capital. Afterwards, the principal tendencies and questions observed were debated in the context of the available literature.

Results

Training of professionals in the identification and prevention of sexual violence against children and adolescents

Guidelines for investing in these initiatives are present in the National Plan for the Promotion, Protection, and Defense of the Right to Family and Community for Children and Adolescents; in the National Plan For Confronting Sexual Violence Against Youth; in the National Policy for Confronting Human Trafficking; and in the National Plan for Confronting Human Trafficking. In this collective body of regulations, it is recognized that the purpose of all public policies dealing with violence against minors is the continual training of professionals in the identification and prevention of distinct situations that involve such violence – especially sexual violence. Accordingly, it is hoped that such training initiatives will be present in the managerial programs of municipal city governments.

Regarding the Education sector, managers in Fortaleza, Porto Alegre, and Campo Grande confirm the existence of professionals previously trained by management to deal with violence in the school environment. In Fortaleza, this training occurs yearly via the School That Protects Program, at the federal level, which includes professionals from the System for the Guarantee of Childrens’ and Adolescents’ Rights, with a course load of 120 hours, individual enrollment, and elective participation. Another initiative was offered by the Program in Education Against the Exploitation of Child and Adolescent Labor (PETECA), on a state-wide scale, discussing the theme of sexual exploitation, without, however, making available to us the number of professionals trained in the period 2010-2011.

In Porto Alegre, the interview subjects mentioned the annual seminars from the Network for the Protection of Childhood and Adolescence, involving teachers and professionals from other public policy areas. In 2011, many of these local networks prioritized discussion around the themes of sexual abuse and exploitation. Also in this year, 33 educational and pedagogical advisors participated in training programs carried out by the Program of Integrated and Standardized Management in the Confrontation of Sexual Violence Against Youth in the Brazilian Territory (PAIR). The municipality also made use of the School That Protects Program in offering annual classes of 80 hours to teachers in the system.

These courses address the themes of sexual abuse and exploitation by linking them to human rights, conflict mediation, and the recognition of violence. School professionals participated in the general seminars and others offered by the networks.

In Campo Grande, in 2010, the majority of schools carried out training about violence prevention in partnership with the health sector. The content touched upon the epidemiological profile of violence in this community; situations at risk for violence; types of injuries and the possibility of intervention; the causes of conflict between students; intra-family violence; bullying; and the school as a protective space where violence can be reported. Technicians, advisors, coordinators, and pedagogical supervisors from every school unit participated in the training programs.

The Education representative from the greater municipal area of Belém confirmed that they had not offered training to teaching professionals about violence, citing the accumulation of demands made on their office, although they recognize the importance of this type of training offer. Nevertheless, other initiatives that indirectly related to the prevention of violence were discussed. The representative of the Municipal Secretary of Education (SEMEC) cited the projects “Open School,” which in 2012 involved the students and families of 16 school units, and “More Education,” which carried out workshops and other activitiesoriented toward young people, such as: pedagogical supervision; environmental education; sports and leisure; human rights in education; culture and the arts; digital culture; promotion of health; communication and the use of media; investigation in the field of the natural sciences; and economic education.

The inclusion in the last few decades of the Tourism Sector in the public agenda for the confrontation of sexual violence should be emphasized, especially concerning the phenomenon of sexual exploitation of minors²²22. Childhood Brasil. Projeto Copa Do Mundo de 2014. Prevenção e Enfrentamento à Exploração Sexual de Crianças e Adolescentes no Contexto do Mundial. São Paulo, Recife: Childhood Brasil; 2012..

The city of Fortaleza partnered with the federal Program for Sustainable Tourism and Childhood, who defined the training programs’ content - such as sexual tourism, exploitation and the protection of the rights of minors - as a focal point for youth protagonism.

In Porto Alegre, the training of professionals in the tourism network was offered by PAIR in 2001, with the participation of a single representative who played the role of an intermediary knowledge broker.

In the municipality of Campo Grande, the Tourism Foundation together with the Women’s Council was in charge of these training initiatives. Regarding joint proposals, the secretary of health was cited as one of the organizers while the secretary of tourism was categorized as an invited guest. The representative of the tourism sector assessed that the content of the training left much to be desired, especially pertaining to the confrontation of sexual violence, considering the complexity and length of the Mato Grosso do Sul border.

The following initiatives were also emphasized: the Happy Travels Project, in partnership with the Regulatory Agency of Public Services (AGEPAN) at the state level, in the beginning of 2012, which raised awareness among motorists, owners of bus companies, professionals who work in bus terminals, and the owners of collective transportation vans; and the training program Tips For The Road, by the Social Services of Transportation (SEST) and the National Service for Learning in Transportation (SENAT), geared toward professionals in tourism transportation.

In Belém, the testimony of a representative of the tourist sector affirmed that there were no training programs organized by municipal management in respect to this theme. However, they noted the awareness of local managers about the importance of the subject.

Training of professionals in the care of children and adolescents in situations of sexual violence

In the Principles of the National Plan for Confrontation of Childhood Sexual Violence, it was predicted that the specialized care and public services network of children and adolescents in a situation of sexual violence (as well as their families) would be carried out by specialized, trained professionals. In the area of Health, managers of four municipalities mentioned the existence of professionals previously trained by management in attending to children and adolescents in situations of sexual violence.

In Fortaleza, a representative of the Municipal Secretary of Health (SMS) affirmed that since 2007 they have offered training about both violence in general and sexual violence for city hospitals, family health teams (especially community health agencies – ACS), and for Centers of Psycho-social Care (CAPS). The partnership with the Ministry of Health in the project Integrating Support and Protection Networks for Children and Adolescents permitted the training of professionals for care networks, as did partnerships with other government departments, such as the Guardianship Councils (CT), Municipal Council for the Defense of the Rights of Children and Adolescents (COMDICA), Ceará Forum for Confronting Sexual Violence Against Children and Adolescents (CREAS), Specialized Delegacy to Combat the Exploitation of Children and Adolescents (DECECA), and other organizations in the network²³23. Fortaleza. Secretaria Municipal de Saúde (SMS). Protocolo de acolhimento ao adolescente com avaliação de risco e vulnerabilidade. Fortaleza: SMS; 2012.. In 2010, 40 facilitators were trained in the creation of an ACS. According to information from the 2010 Management Report, the health sector offered a course on the prevention of violence against children and adolescents targeted at 1,618 ACS units, in agreement with the Ministry of Health (MS). This course encompassed 85% of these ACS professionals²⁴24. Fortaleza. Secretaria Municipal de Saúde (SMS). Relatório de Gestão 2010. Saúde, qualidade de vida e a ética do cuidado.Fortaleza: SMS; 2010..

A representative of the SMS of Porto Alegre confirmed that all professionals working in the four basic services of SUS attending to children and adolescents in a situation of “intra-family violence and sexual abuse” (the Reference Center for the Care of Children and Youth, Child Protection Services, and two Centers for Child Psycho-social Care or CAPSI) were trained in the skills of identification, attention, follow-up, and referral. However, no corroborating documentation was presented pertaining to the training given to the two aforementioned CAPSI teams.

A representative of the Municipal Secretary of Health (SESAU) of Campo Grande related that the professionals who work in 12 reference services for the SUS in attending to children and adolescents in situations of “inter-family violence and sexual abuse,” as well as in 62 basic health units, were trained. These training actions were carried out by the Center for the Prevention of Violence (spanning domestic violence, self-harm, sexual violence, and gender violence) in partnership with the Coordinating Committee for Women’s Policies. It was reiterated that in all of the health units there were a minimum of four trained professionals, as one of the criteria for employment in urgent and emergency care was that the Nurse and Social Assistant undergo training in the Center for the Prevention of Violence, in order to become familiar with the Care Network for Victims of Violence. In 2011, the health sector trained 1,800 community agents. In spite of the initiatives having been described, it was not possible to assess the exact number of professionals trained.

In Belém, a representative of the Municipal Secretary of Health (SESMA) informed us that almost the entire network (nearly 200 professionals) was trained in 2011-2012, but there was no monitoring of the impact of this process on their everyday service activities. In spite of training initiatives having been created, the absence of an institutional registry meant that precise information was not available about the number of professionals effectively trained in the biennium analyzed (2010-2011).

In regards to Social Assistance, a strategic sector in attending to children and adolescents in situations of sexual violence, in Fortaleza the teams in the Unified System of Social Assistance (SUAS) have benefited more from training around the theme of sexual violence offered by other government offices – especially those offered by the Municipal Secretary of Human Rights (SMDH) – than from those offered by their own sector. The most recent occurred in 2010, offered by the Public Prosecutor’s office. In spite of information about the holding of these training sessions, we were not informed of the number of professionals trained.

In Porto Alegre, the representative of the Foundation for Social Assistance and Citizenship (FASC) informed us that in 2012 there were 123 professionals working in CREAS, but affirmed that the training was “being implemented” and did not make available any information on the number of professionals trained therein.

In Campo Grande, the Municipal Secretary of Social Assistance (SMAS) informed us that the 60 professionals that work at CREAS participated in training about this theme. PAIR was cited as the guiding institution in the trainings about sexual exploitation. Although there occurred an offer of training, there were no elements regarding their frequency.

About the carrying out of training in the municipality of Belém, it was affirmed that they were individual and isolated, depending on the initiative and effort of the technicians to find qualified activities.

Training of professionals for the systematization and analysis of data regarding notification/communication of sexual violence against this group

Notification/communication is essential for confronting sexual violence against children and adolescents and for the restoration of their rights. In addition to possibly interrupting the abuse and unleashing protective measures and assistance to the victims and family members, it also offers information for the assessment of the local situation and the necessity of public investments. The establishment of notification/communication, systematization, and analysis of information produced by this process are related to the training of the professionals who produce it.

In the sector of Education, the representation of the Municipal Secretary of Education (SME) of Fortaleza confirmed the existence of a trained team, in spite of the absence of systematization and analysis of notification data. The “Portal” technological project that involves electronic books in the school framework was found to be in a phase of implementation. The interview subjects mentioned that the professors trained by the federal School That Protects Program considered the training useful, and considered themselves capable of the identification and reporting of situations of violence in the school environment.

In Porto Alegre, a representative of the Municipal Secretary of Education (SMED) affirmed that there was a team trained to carry out the systematization of data. The SMED was developing a database to consolidate information on the distinct forms of violence present in the school world. Even though the form adopted by all the schools would be generic and universally applied to any quotidian school situation and not only situations of violence and their specificities, it is still useful, given that it serves the purpose of reporting and registering the situations, their referrals, and any developments.

The SMED of Campo Grande, as a consequence of the training process in partnership with SESAU, established a notification form elaborated from the model of a form used by the Ministry of Health that has since been used by all the municipal schools. In as much as it refers to themes of sexual violence and exploitation, the increase in the number of notifications related to a situation of sexual abuse was considered a consequence of participation in these training workshops, viewed as having permitted a different perspective on this type of violence. Nonetheless, there was no difference as far as complaints of sexual exploitation. Although it was not possible to determine the exact number of professionals trained, we perceived from the qualitative information that there was clarity about the importance of training spaces.

According to the SEMEC representative, Belém did not possess a form for the reporting of violence, and the form that was being elaborated had “violence in the schools” as its focus, citing bullying as an example of this phenomenon. No training was offered to professionals in the network, under the justification that there were too many other work demands, in spite of a recognition of the necessity of this training opportunity for professors and education professionals.

In the area of Health, managers of four municipalities mentioned the existence of professionals trained in managing the systematization and analysis of data regarding the notification/communication of situations of sexual violence. The Fortaleza SMS representative informed us that, despite the few notifications made, it made trained professionals available for the systematization and analysis of data for the notification of violence and sexual exploitation, allocated in the centers for epidemiological vigilance established in the coordinating framework of the Regional Secretaries of health. In Fortaleza, in spite of the centers of epidemiological vigilance implanted in the regional framework, the SINAN notification was not implemented in the healthcare sector. The forms are filled out at the health units, but the entry of data into the system is not sufficiently carried out²⁵25. Fortaleza. Secretaria Municipal de Saúde (SMS). Plano Municipal de Saúde de Fortaleza para 2010-2013. Uma construção coletiva. Fortaleza: (SMS); s/d..

The General Coordinating Committee for Health Vigilance (CGVS), part of the Porto Alegre SMS, confirmed the existence of a team trained for the systematization and analysis of data on the notification of violence and sexual exploitation. The representative of the SMS described how, in spite of there being a SINAN form from the Ministry of Health (MS), not all the units used them. He emphasized that there exists much built-up resistance on the part of professionals against the filling out of the forms.

In Campo Grande, the representative of SESAU informed us that there was a team trained for the ongoing work of systematization and analysis of data on violence. In spite of using the regular SINAN form, we were told that the reports on the forms also included subjective content when they were filled out.

Regarding Belém, the representative of SESMA informed us that, in conjunction with the Center for Prevention of Domestic Violence and Promotion of Peace (NUPVID), they offered training for the entire network with a focus on the process of reporting. The increase in the number of notifications and reporting units was indicated to be a result of this initiative of establishing the SINAN form. On the other hand, the representative of SESMA added that there was only one professional trained in the systematization and analysis of data on the reporting of sexual violence, and that this was not their only work duty.

Regarding the field of Social Assistance, we were informed that in Fortaleza’s Municipal Secretary of Social Assistance (SEMAS) and in their SMDH there is a trained team, but no mention was made of the frequency of training. The two Secretaries have a specific form for the recording of reports of violence, however only the SMDH presented systematized data about their attendance.

The Municipal Secretary of Human Rights and Urban Security (SMDHSU) of Porto Alegre communicated that they did not carry out a systematization and analysis of data on the notification/communication of inter-family violence and sexual exploitation, in addition to not having a standardized form for this purpose. They emphasized that the secretariat had a “direct hotline” (0800-6420100) that received complaints and afterwards forwarded this information to the Guardianship Councils (CT) and to the State Department of Children and Adolescents (DECA).

The representative of SMAS in Campo Grande noted the existence of a standardized form for these notifications/communications, however they did not mention the model. Nevertheless, a copy of the form was not forwarded to our research team.

A representative of the Pope John XXIII Foundation (FUNPAPA) of Belém affirmed that they had professionals trained for the consolidation of data pertaining to violence and sexual exploitation, however they did not carry out systematization of this information. It was mentioned that a specific form was used by the teams in Social Assistance.

Discussion

In respect to the unequal investment of the four capitals in the training of professionals in distinct public policies, a lack of specificity in the treatment of themes of sexual violence and a considerable lack of institutional memory was observed, complicating the process of analysis or of assessment and monitoring of professional training strategies.

A registry of these training actions is a fundamental investment, as it permits a measurement of how many professionals were included, in which territories they work, what knowledge and competencies were addressed, and which still need further work. The areas of Social Assistance, Education, and Health are responsible for the majority of public policies oriented toward childhood and adolescence, however we observed an unequal investment in terms of training, even when the importance of training had been recognized by the majority of managers.

Health was the area that trained the most professionals, and dealt in a more developed way with the topic of notification and reporting in the training content, considering it indispensable for assessing and confronting sexual violence against children and adolescents. The Centers for the Prevention of Accidents and Violence had a particularly important role as catalysts in the training programs in the capitals studied, as is also demonstrated in other studies on the subject²⁶26. Souza ER, Valadares FC. Políticas públicas de prevenção dos acidentes e violências no âmbito da saúde: avanços e perspectivas. In: Lima MLC, Falbo Neto GH, organizadores. Avaliação da política nacional de morbimortalidade por acidentes e violência, nos municípios de Pernambuco com mais de 100.000 habitantes. Recife: Editora Universitária da UFPE; 2012. p. 21-30..

The visibility and trajectory that the theme of sexual violence has been gaining in the area of Health – associated with the concern for the continued education of public sector workers in every area – inspired the adoption of a pedagogical matrix guided by the area of Health, which includes certain content in the training offerred²⁷27. Brasil. Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Atenção integral para mulheres e adolescentes em situação de violência doméstica e sexual: matriz pedagógica para formação de redes. Brasília: MS; 2011.. The commitment to the training of professionals in basic healthcare, especially the ACS, was emphasized in two of the capitals studied. This choice corroborates the recognition of the potential that the strategic model of family health can play in the identification and even the prevention of situations of violence in the daily life of families and communities²⁸28. Barros DF, Barbieri AR, Ivo ML, Silva MG. O contexto da formação dos agentes comunitários de saúde no Brasil. Texto contexto - enfermagem 2010; 19(1):78-84.. Nevertheless, we observed little investment in the training actions with an emphasis on prevention of violence and promotion of protective networks. This failing is identified as critical by scholars of violence who point to the crucial role that actions related to the attendance to offenses and injuries stemming from the violence perpetrated, in detriment to the activities of promotion and advocacy of non-violent relations, of conflict mediation, and of a culture of peace²⁹29. Branco MAO, Tomanik EA. Violência doméstica contra crianças e adolescentes: prevenção e enfrentamento. Psicologia & Sociedade 2012; 24(2):402-411..

The area of Social Assistance has shown considerable fragility regarding the investment in the process of permanent training, which can be associated on one hand with the recent consolidation of SUAS in relation to other areas, and on the other hand with the relative absence of a core of permanent workers, causing a high rotation of temporarily contracted professionals. Considering that the identification of vulnerable situations can lead to the violation of rights and violence, in which the attendance to persons in situations of violence constitutes an institutional mission for the teams in this sector, this lacuna in relation to the training of professionals on the subject takes on proportions of an undeniable contradiction³⁰30. Rosa MAFP. Gestão integrada dos serviços e benefícios da política de assistência social: uma análise dos Centros de Referência de Assistência Social (CRAS) de Maracanaú [dissertação]. Fortaleza: Universidade Estadual do Ceará; 2011.. We emphasize, furthermore, the inductive role of federal and state programs in Tourism and Education. Confronting sexual tourism in the context of large sporting and cultural events becomes indispensable and strategic to raising awareness and training those who work in this sector³¹31. Brasil. Ministério da Educação (MEC). Secretaria de Educação Continuada, Alfabetização e Diversidade (Secad). Proteger para Educar: a escola articulada com as redes de proteção de crianças e adolescentes. Brasília: Secad/MEC; 2007.. However, actions in this area are still minimal, and more oriented towards youth protagonism and leadership than to professionals in the supply chain of tourism production. Education displayed little protagonism in training about sexual violence against children and adolescents. Despite the many opportunities for further work suggested by the literature that involve the operation of Education workers in the prevention of sexual violence, few training initiatives were observed to these ends³²32. Barbosa GF. Formas de prevenir a violência sexual contra a criança na escola- um olhar da psicanálise e da saúde pública[dissertação]. Rio de Janeiro: Universidade Veiga de Almeida; 2008..

The area of sports, leisure, and culture seems distant from confronting sexual violence. Finck and Salles Filho⁹9. Finck SCM, Salles Filho NA. Esporte e a formação de professores na prevenção de violências e mediação de conflitos escolares. Acta Scientarium Education 2012; 34(1):111-120., in analyzing the approach of sports to the training of professors and teachers in physical education, conclude that the frameworks in academic curriculums are still remote from addressing violence prevention. This shortcoming limits the ability of these educators to deal with themes such as sexuality, corporeality, and sexual rights. Few initiatives included the participation of more than one sector of public policy in the training process. The PAIR initiative was seen as a standard for quality and an opportunity for promoting cross-disciplinary approaches to the theme in different sectors. In light of the complexity of the phenomenon of sexual violence, the polysemy of its meanings and experiences - as well as the distinctions between institutional approaches faced with concrete situations – interdisciplinary and inter-sectorial actions are welcome and necessary²²22. Childhood Brasil. Projeto Copa Do Mundo de 2014. Prevenção e Enfrentamento à Exploração Sexual de Crianças e Adolescentes no Contexto do Mundial. São Paulo, Recife: Childhood Brasil; 2012..

It can be further noted the trainings have had an insufficient impact on the systematization and analysis of reporting data on sexual violence against this group, which can be associated with the type of training offered, the small didactic investment, and even the low valorization of recordkeeping.

Final considerations

In conclusion, we suggest the construction of a training plan about violence and the sexual rights of minors - and in particular sexual violence - that deals with the ways to identify and act upon these situations, which include: (1) planning the program of activities; (2) measures to cover all the professionals in the networks; and (3) recording the number of trainings, their content, their systematic nature, and the professionals involved. Such training can be single sector or inter-sectorial, simultaneously touching upon other themes, rooted in a perspective of continuity with and inclusion of other professional categories.

References

Publication Dates

History