THE SIGNIFICANT INCREASE IN THE INCORPORATION OF NEW TECHNOLOGIES and intervention models in the field of collective health makes the evaluation processes extremely important to guide the adjustments and the organization of health systems. Health intervention, like all social phenomena, is complex, dynamic and contextually diverse, requiring the production of responses in an opportune context and time. The constant political, organizational and interpersonal challenges involved in actions of health promotion, prevention and control of diseases impose for the evaluation the use of multiple techniques of the methodological repertoire of the evaluator.
The special thematic issue of the journal 'Saúde em Debate', Monitoramento e Avaliação em Saúde para a Ação (Health Monitoring and Evaluation for Action), is a publication focusing on the evaluation practice, the study of the influence of evaluations and of monitoring systems to support health projects, programs and policies.
The articles that compose it are organized around five problematic axes: a) contexts and potentialities of monitoring and evaluation for action; b) modeling of complex interventions and of monitoring and evaluation processes for management; c) elaboration and implementation of evaluation processes for the improvement of health actions, programs and policies; d) translation of findings of evaluative processes in collective health practices, and e) quality of evaluation, training and evaluation training.
The first problematic axis aggregates original articles that involve the contents of strategic analysis applied to the evaluation and a set of evaluative processes thematizing the construction of indicators applied to different problems found within the Unified Health System (SUS). The second and third nuclei, of substantial applicability, comprehend the experience accumulated in two fundamental aspects of the evaluation processes, which are: the modeling of complex interventions and the implementation evaluations. Modeling, an essential component of the planning and the choice of relevant assessment models, is exemplified in the various experiments presented. The articles referring to implementation studies emphasize the importance of diversity present in the different situations of interaction between interventions and contexts.
The challenges for the institutionalization of evaluation in the health services system have been increasingly analyzed from the perspective of translation, whether considering the use of integrated methodologies for the identification and analysis of interests of the actors involved in the evaluation processes, for the study of processes of negotiation and mediation involved in the assessment of merit and value, 'transvaluation', or in the establishment of quality and ethics for the evaluation processes. Those issues are addressed in the last two problematic axes in original articles and experience reports in institutional contexts. We hope that this issue may contribute to the enhancement of the evaluation culture in the Brazilian health system, enabling the capacity of, in addition to carrying out evaluations, utilizing them and favor in-service training processes that stimulate a reflexive public management.
We would like to express our gratitude to all workers of the Ministry of Health (MS) involved in the institutionalization of Monitoring and Evaluation initiatives, especially the Monitoring and Evaluation Department of the SUS (Demas), of the Executive Secretariat, and its directors, Paulo de Tarso de Oliveira, Paulo Eduardo Sellera and Joaquim José Fernandes da Costa Junior, for the encouragement, collaboration and support in the production of the thematic issue.
Elizabeth Moreira dos Santos
Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (Ensp), Laboratório de Avaliação de Situações Endêmicas Regionais (Laser) - Rio de Janeiro (RJ), Brasil. Ministério da Saúde, Secretaria Executiva (SE), Departamento de Monitoramento e Avaliação do SUS (Demas) - Brasília (DF), Brasil. Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva (Iesc) - Rio de Janeiro (RJ), Brasil.Gisela Cordeiro Pereira Cardoso
Fundação Oswaldo Cruz (Fiocruz), Escola Nacional de Saúde Pública Sergio Arouca (Ensp), Laboratório de Avaliação de Situações Endêmicas Regionais (Laser) - Rio de Janeiro (RJ), Brasil.Egléubia Andrade de Oliveira
Universidade Federal do Rio de Janeiro (UFRJ), Instituto de Estudos em Saúde Coletiva (Iesc) - Rio de Janeiro (RJ), BrasilMaria Lucia Frizon Rizzotto
Universidade Estadual do Oeste do Paraná (Unioeste) - Cascavel (PR), Brasil. Centro Brasileiro de Estudos de Saúde (Cebes) - Brasil.
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