The text constructed by José Ivo Pedrosa is courageous in the sense of trying – from a view within the field of Popular Education and Health (PEH) as an active subject in its construction – to face the limits present in PEH. In this sense, the author points out some contradictions in the participation of groups of the Popular Education field in planning and implementing policies build from a perspective of social inclusion, such as the National Policy on Popular Education in Health (PNEP-SUS). He also problematizes the popular movement’s relations with the process of PEH institutionalization as an expression of popular participation. And, finally, he dialogically defends PEH as a political practice.

Despite proposing the discussion of politics, José Ivo also indicates principles that compose the PEH field, methodological strategies, and practical expressions of the several groups that articulate as popular educational collectives.

By considering the consequences of the PEH institutionalization, the text considers popular groups and movements as those organized after the creation of the National Articulation of Movements and Practices of Popular Education and Health (Aneps) in 2003. He also contextualizes the strengthening of the field and its participation in the PEH institutionalization processes in the management of the Ministry of Health (MS) and some local administrations. Thus, he problematizes how these groups participate in the formulation and implementation of policies in public administration spaces.

The election of President Lula in 2003 mobilized popular movements to participate in a project of comprehensive and intersectoral public policies with popular participation. Therefore, in a favorable political context, PEH institutionalization occurred with the organization of committees and working groups in dialog with the MS.

The consequences of the institutionalization occurred both in the MS – with the creation of new action spaces – and together with the popular movements. They incorporate ways of making PEH based on the logic of representation through their participation as representatives of local and regional movements in state and national committees and working groups. In addition to the direct relationship with their bases, representation presupposes an organization and hierarchy that are not always present in the popular movements that, in general, are organized in a more free, fluid, and less structured manner.

Representation as a form of organization and participation does not automatically define the prioritization of some of the principles guiding popular education practices, such as dialog, problematization, respect for the diversity of knowledge, and shared constructions of health practices and knowledge. Even if it does not fit the idealization of any participation form, the institutionalization of PEH collectives was another challenge in maintaining a permanent dialog between the movements and their bases and problematizing their actions.

Stotz¹1 Stotz EN. Educação Popular e Saúde e democracia no Brasil. Interface (Botucatu). 2014; 18 Suppl 2:1475-86. Doi: https://doi.org/10.1590/1807-57622013.0464.
https://doi.org/10.1590/1807-57622013.04... , when discussing Popular Education and Health and Democracy in Brazil, pointed out that there is an impasse placed in the possibility that institutionalized participation may limit the movements’ freedom of thought and actions, even with the inclusion of demands from popular groups in the construction of policies. Citing the experience of institutionalizing PEH through the ANEPS, the author points out that the typical activism of the movements and organizations has expanded given the requirement to meet the agenda of the governmental processes. So, this form of action can hinder the critical reflection about the practices by the subjects involved.

Therefore, it seems that the PEH institutionalization built powerful processes, as it enabled the inclusion in committees and activities linked to programs from health secretariats of representatives of groups and popular demands, which are neither included nor listened to in these power spaces. Despite this great power, the effort for a critical analysis of the PEH institutionalization experience during the period indicated by Pedrosa – 2003 to 2016 – must be broadened so that it is possible to carry out critical reflections about this practice according to Freire²2 Freire P. Pedagogia da autonomia: saberes necessários à prática educativa. São Paulo: Paz e Terra; 1996..

Valla³3 Valla VV. Sobre participação popular: uma questão de perspectiva. Cad Saude Publica. 1998; 14 Suppl 2:7-18. Doi: https://doi.org/10.1590/S0102-311X1998000600002.
https://doi.org/10.1590/S0102-311X199800... has already told us about the limits of institutionalized social participation and its importance of not being the only space for vocalizing demands and building policies and practices aimed at popular interests. In addition, José Ivo highlights a contradiction related to the ways of participating, which is the overvaluation of identity struggles in relation the class struggle present in all the other fights for social rights and not necessarily identified as problems to be faced. In this sense, I believe that the PEH collectives must incorporate the relationship between identity struggles and class struggle as one of the issues to be problematized along with the specific health care policies.

The questions asked about the resignification of the critical pedagogy by PEH in the face of neoliberal politics, the intentionality of the training processes, the presence of the PEH principles in participatory processes, and so many others indicate the limits of PEH and of the PNEP-SUS but also the power of the field and of politics.

Building critical reflection processes in a politically conservative environment strongly limits the ability to analyze the social practices, the dialog between knowledge and management in the health systems, and the identification of the class relationships present in the daily lives and work of women and men of the popular classes.

In addition to this structural limit in the development of PEH actions that critically reflect on their practices, there is a difficulty in the articulation of the popular groups with their bases, between popular groups, and between them and professionals allied to the interests and demands of popular groups. Sometimes, the differences among several groups – which often isolate themselves in the fights they prioritize – are overvalued. Although legitimate, the differences not always give visibility to the living and working conditions that can unite the popular groups and which could be the “linkage” of the movements in their collective actions.

The power of PEH is expressed in the large number of meetings, seminars, and activities carried out by the collectives and groups linked to it in the period of its institutionalization and later. Likewise, the construction of knowledge through the production of reflective books and articles and the systematization of experiences has indicated the articulation power of this movement of groups and collectives.

By considering PEH as a political and scientific field, it is necessary to strengthen strategies in both fields. In this sense, if institutional political space is lost on the one hand; on the other, we can maintain/retake ways of participation in non-institutionalized spaces, which are the origin, the basis of the popular social movements.

Concerning the scientific field, we have to expand the systematization of experiences, qualifying the theoretical and practical products, identifying the theoretical-methodological matrices that guide the PEH practices. The popular practices are also syntheses of professional, scientific, and traditional knowledge and, in this way, are hybrid and produce dialogs that include syntheses of several pieces of shared knowledge, which are often invisible or unidentified.

Considering the context of State reduction and privatization of the social rights, the PNEP-SUS, as a State policy, seems to have no prospect of being maintained, but the starting point is also the resumption; moreover, the fight for the theoretical and methodological principles of the PNEP-SUS – dialog, kindness, problematization, shared construction of knowledge, emancipation, and commitment to the construction of the Popular Democratic Project.

The proposal inserted in the policy, its principles, and its intentionality, can and will be sought by the groups, movements, health and education professionals, and students who are already in that path, and have its principles as a foundation.

For this, considering the enormous diversity of knowledge and cultures present in the PEH field, it is essential to reassert the need to produce consensus through dialogs among different stakeholders focused on the reflection on the health care practices and, also, the reflection on the fight strategies for health and for living well.

In these pedagogical – and therefore political – processes, we must not give up radical manners of constructing and taking care of the collectively defined paths, capable of destabilizing the ways of thinking about popular education, as our master Victor Valla⁴4 Arroyo MG. As indagações desestabilizadoras do injusto viver. In: Valla VV, Algebaile E, Guimarães MB, organizadores. Classes populares no Brasil: exercícios de compreensão. Rio de Janeiro: Fiocruz, Escola Nacional de Saúde Pública; 2010. p. 11-4. did.

By understanding Popular Education as a political option, it is possible to assert that radicalizing the PEH practices means strengthening the principles of dialog, participation, problematization, and action to favor the formation of the critical awareness of popular movements and groups in the perspective of political struggle and social transformation.

References

Publication Dates

History