Normative moment of National Health Plans of Brazil and Canada in the light of Mario Testa

Vale, Paulo Roberto Lima Falcão do; Lizano, Verónica Cristina Gamboa

doi:10.1590/0103-11042019S520

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• Saúde debate 43 (spe5) • Dec 2019 • https://doi.org/10.1590/0103-11042019S520 copy

Normative moment of National Health Plans of Brazil and Canada in the light of Mario Testa

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The study aims to compare the main guidelines of the National Health Plans of Brazil and Canada in the light of Mario Testa. The normative moment of both documents were compared, considering the guidelines of the mentioned plans, analyzed according to the strategies of strategic thinking addressed by Mario Testa. The Atlas.ti program was used, exploring as analysis categories the keywords that identify each of the guidelines, as well as the three strategies: institutional, programmatic, and social. As main results, we find that the national health plans of Brazil and Canada converge on the keywords related to care actions directly, although the North American country plans a greater number of health surveillance activities compared to Brazil. Both countries guide the normative moment of planning through programmatic strategies, which are intersectoral in the Brazilian scenario. Differences point to intersectoral action in Brazil and the organization of care with well-defined hierarchical levels of health care. However, the predominance of programmatic strategies in Canada allows us to infer that this scenario enjoys the consolidation of decision-making processes, as well as ensuring the social rights of the population, resulting in specific institutional and social strategies.

KEYWORDS
Health planning; Health policy; Strategic planning; Health management; Health systems

List of guidelines of Health Canada
1.	Provide advice, research and analysis of strategic policies to support decision-making on health care issues, as well as support from programs to provinces and territories, partners and interested parties on health system priorities.
2.	Ensure the continuity of occupational health services of federal civil servants who can deliver results to Canadians in all circumstances and organize health services for Internationally Protected Persons (IPP).
3.	Improve access to health services in minority communities of official languages and increase the use of both official languages in the provision of health services.
4.	Ensure that health products are safe, effective and of high quality for Canadians.
5.	Manage the health and safety risks of Canadians associated with food and its consumption and allow them to make informed decisions about healthy eating.
6.	Protect the health of Canadians through the assessment and management of health risks associated with environmental contaminants, particularly substances, and provide advice and guidelines to Canadians and government partners on the environmental impacts of environmental factors such as air and water contaminants and a changing climate.
7.	Identify, assess, manage and communicate health or safety risks to Canadians associated with consumer goods and cosmetics, as well as to communicate the dangers of chemicals at the workplace.
8.	Minimize the health risks for Canadians associated with the use of tobacco products and the illicit use of controlled substances and precursor chemicals.
9.	Environmental and occupational radiation monitoring, management of inter-organizational plans, procedures, capabilities and committees for a nuclear emergency that requires a coordinated federal response, a national radon program and regulation of radiation emitting devices.
10.	Protect the health and safety of Canadians over the use of pesticides.
11.	Contribution and direct expenses related to child development, mental well-being and healthy life, control and management of communicable diseases, environmental health, clinical and customer care, as well as home and community care.
12.	Provide benefits in a way that contributes to improve the state of health of the First Nations (indigenous nation) and Inuit (indigenous Eskimo nation).
13.	Help improve the capacity of the First Nations and the Inuit to influence and/or control the provision of health programs and services for individuals, families and communities of the Inuit and First Nations.

List of guidelines of the Brazilian National Health Plan
1.	Extend and qualify access to health services in an appropriate time, with emphasis on humanization, equity and health care needs, improving the policy of primary and specialized care, ambulatory and hospital.
2.	Improve and implement the Health Care Networks in the health regions, with emphasis on the articulation of the Urgency and Emergency Network, Stork Network, Psychosocial Care Network, Care Network for the Disabled Person, and the Health Care Network of People with Chronic Diseases.
3.	Promote comprehensive care for people in life cycles (child, adolescent, young, adult and elderly), considering gender issues, sexual orientation, race/ethnicity, situations of vulnerability, specificities and diversity in primary care, thematic networks and health care networks.
4.	Reduce and prevent risks and harm to the health of the population, considering the social determinants, through surveillance, promotion and protection actions, focusing on the prevention of chronic non-communicable diseases, accidents and violence, the control of communicable diseases and the promotion of healthy aging.
5.	Promote the health care of indigenous peoples, improving the actions of primary care and basic sanitation in the villages, observing health practices and traditional knowledge, and articulating with other SUS managers to provide complementary and specialized actions with social control.
6.	Increase the population's access to medicines, promote rational use and qualify pharmaceutical assistance within the scope of SUS.
7.	Promote the production and dissemination of scientific and technological knowledge, health situation analysis, health innovation and the expansion of national production of strategic technologies for SUS.
8.	Improve the regulatory framework and health surveillance actions, to ensure health protection and sustainable development of the sector.
9.	Improve the regulatory framework of supplementary health, stimulating innovative management and surveillance solutions, focused on efficiency, access and quality in health care, considering the sustainable development of the sector.
10.	Promote, for the needs of the SUS, training, permanent education, qualification, the appreciation of workers, the devaluation and the democratization of labor relations.
11.	Strengthen the instances of social control and the channels of interaction with the user, with guarantee of transparency and citizen participation.
12.	Improve the inter-federative relationship and the work of the Ministry of Health as federal manager of the SUS.
13.	Improve spending patterns, qualify tripartite financing and resource transfer processes, with a view to stable and sustainable SUS financing.

Keywords	National Health Plan - Brazil 2016 to 2019	Health Canada 2017 a 2018	Total
Access to health services	1	2	3
Primary Health Care	1	1	2
Social control	2	0	2
Comprehensive care	1	0	1
Funding	1	0	1
Training/qualifications of health worker	1	0	1
Role of the manager	1	1	2
Health research	1	0	1
Attention Networks	1	0	1
Health and harms risks	1	3	4
Worker health	0	1	1
Indigenous health	1	3	4
Supplementary health	1	0	1
Food safety	0	1	1
Pharmaceutical assistance	1	1	2
Health surveillance	1	4	5

Planning Strategies	National Health Plan - Brazil 2016 a 2019	Health Canada 2017 a 2018	Total
Institutional	2	1	3
Programmatic	6	10	16
Social	5	2	7
Total	13	13	26

Keywords	Canada			Brazil
Keywords	Institutional strategies	Programmatic strategies	Social strategies	Institutional strategies	Programmatic strategies	Social strategies
Access to health services					1
Primary Health Care					1
Social control						2
Comprehensive care						1
Funding				1
Training/qualifications of health worker						1
Role of the manager	1			1
Health research						1
Attention Networks					1
Health and harms risks		2			1
Worker health		1
Indigenous health		2	1
Supplementary health					1
Food safety		1
Pharmaceutical assistance		1			1
Health surveillance		3	1
TOTAL	1	10	2	2	6	5

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E-mail: revista@saudeemdebate.org.br

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[1] Collaborators

Vale PRLF (0000-0002-1158-5628)^* * Orcid (Open Researcher and Contributor ID). and Lizano VCG (0000-0002-7391-8176)^* * Orcid (Open Researcher and Contributor ID). also shared the following responsibilities: 1) contributed substantially to the design and planning, and the analysis and interpretation of the data; 2) contributed significantly to the drafting and critical revision of the content; and 3) participated in the approval of the final version of the manuscript.