Right to Health and Social Participation: simulation of the Municipal Health Council in Basic EducationAbstract
Social Participation encompasses actions promoted by various social forces to influence the formulation, implementation and evaluation of public policies. This article aims to analyze the teaching-learning process, seeking to develop theoretical and practical knowledge related to social participation in health within the community and the school context. This qualitative research conducted with 8th-grade students from an Elementary School included the following stages: diagnostic pre-evaluation, pre-simulation, simulation of a Municipal Health Council meeting, and post-evaluation. The collected data were analyzed and categorized through the content analysis proposed by Bardin. Three categories were identified: Health, Rights and Social Participation. The educational activities and the simulation encouraged a broadened understanding of health, the recognition of civil, political, economic, social and cultural rights, the identification of violations of rights in the community; and the recognition of social participation as a means of ensuring rights and approaching the Municipal Health Council.
Keywords:
Basic Education; Simulation; Municipal Health Councils; Social Participation; Right to Health
Resumo
A Participação Social engloba ações promovidas por diversas forças sociais com o intuito de influenciar a formulação, a execução e a avaliação de políticas públicas. O objetivo deste artigo é analisar o processo de ensino-aprendizagem, visando ao desenvolvimento de conhecimentos teórico-práticos relacionados à Participação Social em saúde na comunidade e no contexto escolar. Trata-se de pesquisa qualitativa, desenvolvida com alunos do 8º ano do Ensino Fundamental II, que contemplou as seguintes etapas: pré-avaliação diagnóstica, pré-simulação, simulação de uma reunião do Conselho Municipal de Saúde e pós-avaliação. Os dados coletados foram analisados e categorizados por meio de análise de conteúdo proposta por Bardin. Foram identificadas três categorias: saúde, direito e participação social. As atividades educativas e a simulação estimularam a compreensão ampliada de saúde; o reconhecimento de direitos civis, políticos, econômicos, sociais e culturais; a identificação das violações de direito na comunidade; e o reconhecimento da participação social como forma de garantir direitos e se aproximar do Conselho Municipal de Saúde.
Palavras-chave:
Educação Básica; Simulação; Conselhos Municipais de Saúde; Participação Social; Direito à Saúde
Introduction
Social Participation (SP) encompasses actions promoted by various social forces with the aim of influencing the formulation, implementation and evaluation of public policies (Damanik et al., 2023). With the 1988 Brazilian Federal Constitution, advances were observed concerning the devices that guarantee SP in the field of Public Administration (Brazil, 1988). In the scope of health, Law nº 8.080/90 (Brazil, 1990b) establishes the community’s right to participate in the construction of the Unified Health System (SUS, as per its Portuguese acronym) through participation in the Municipal Health Councils (MHC).
MHC are advisory and deliberative bodies that play a fundamental role in standardizing, mobilizing and overseeing the actions of the State, as well as working to develop, implement and evaluate health policies (Brazil, 1990b). Although the legislation guarantees the population’s participation in public policies, recent studies point to the need for measures to strengthen their engagement and representativeness in these spaces (Santos; Moreira; Bispo-Júnior, 2021).
In the context of education, Article 2 of the Law of Guidelines and Bases of National Education highlights the purpose of education as the full development of the student and his/her preparation for the exercise of citizenship, which includes the exercise of civil, political and social rights, as well as the fulfillment of duties, in accordance with the laws and principles in force in a given society (Brazil, 2018). The aim is for the individual, based on his/her autonomy and freedom, to be guaranteed the exercise of civil, political and social rights, and to be active and able to get involved, through SP, in broad decision-making, with a view to transforming his/her daily lives.
The Common National Curriculum Base (BNCC, as per its Portuguese acronym), a document that guides the development of school curricula and directs public education policies, also reinforces the importance of educating students from a participatory perspective linked to citizenship (Brazil, 2018). Nevertheless, when analyzing the construction and applicability of BNCC, Koldehoff and Andreis (2024) argue that, as a national curricular practice, it is still necessary to strengthen actions aimed at integral and human education, based on the pillars of citizenship and emancipation.
Among the strategies focused on strengthening citizenship, the Health at School Program (PSE, as per its Portuguese acronym) - Decree nº 6.286/2007 (Brazil, 2007) - should be emphasized. It proposes to link SUS actions to public Basic Education (BE) networks in order to optimize accessible spaces, equipment and resources, through health promotion and disease prevention actions. One of its objectives is to help us to tackle the vulnerabilities that can compromise the full development of children and young people in the public education system.
As education is explored from the perspective of citizenship and SP, one must question which teaching strategies are connected to the content that enables the exercise of citizenship. In this sense, simulation was adopted in this study, as it is one of the potential teaching strategies for political and participatory education, since it consists of developing a real-life scenario in a safe space and in a way that can promote, improve and validate a participant’s progress. Unlike traditional teaching strategies, which still persist in BE, in this pedagogical strategy, the student is no longer a passive recipient and acts in the construction of his/her own learning. This paradigm shift creates conditions for students to develop initiative, decision-making, critical and reflective thinking, as well as exercising a sense of responsibility, ethics and politics (Bresolin et al., 2022).
Considering the need to break with traditional teaching strategies in order to strengthen SP in BE students, an MHC simulation template was developed and validated by a committee of experts to be applied to Elementary School students (Barbosa; Liberale; Ventura, 2023). This study aims to analyze the teaching-learning process, to develop theoretical and practical knowledge related to SP in health in the community and in the school context among Elementary School students. To this end, it is proposed to investigate the students’ prior knowledge related to SP and compare the learning process before and after the MHC simulation.
Methodology
This is qualitative research, bearing in mind that the phenomenon under study is complex and of a social nature, not contemplating quantification (Minayo, 1998). The description of the method was prepared based on the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (Tong; Sainsbury; Craig, 2007).
The data was collected in a state school in the countryside of the state of São Paulo (Brazil) between February and May 2022. The school was chosen as the study environment due to the authors’ previous relationship with the educational institution, through an extension project developed four years ago, from the beginning of the partnership until the collection of data for this research. In addition, considering that the school is in a neighborhood characterized by multiple situations of social vulnerability, the coordination and teachers showed an interest in reducing students’ unfamiliarity with MHC and SP in health. Nevertheless, it was after inviting the students that the researchers had their first contact with the study’s target audience.
A total of 22 8th-grade students from Elementary School II were invited to participate in the study. Of these, 17 agreed to participate in it, but three students did not attend the meetings. Accordingly, the sample consisted of 14 students. When choosing the school year, the demands of the coordinators and teachers were taken into consideration, in terms of the availability of classes that would not affect the curriculum.
The students were invited verbally, in person, during classes provided by the teachers. They were approached twice on different days. The sample was by convenience, since the students were included in the study according to their availability and interest (Cohen; Manion; Morrison, 2007).
Inclusion criteria were: students regularly enrolled in the 8th grade of Elementary School II and who duly signed the Free and Informed Consent Form (FICF) and the Free and Informed Assent Form (FACF). Exclusion criteria were students who did not attend school regularly and who did not take part in the pre-simulation activities, given that this phase was fundamental to the development and performance of the MHC simulation.
This study includes the following stages: diagnostic pre-evaluation, pre-simulation (educational activities), simulation and diagnostic post-evaluation.
First stage: diagnostic pre-evaluation
Diagnostic evaluation consists of surveying, projecting and retrospecting the student’s development situation (Santos; Varela, 2007). For Ausebel, the object of teaching becomes meaningful as it relates to the students’ prior knowledge. Diagnostic evaluation seeks, from the survey of prior knowledge, to plan strategies to overcome the difficulties found, readjusting the educational plan (Ausubel, 2003).
Based on Ausubel’s perspective of meaningful learning, this study used semi-structured interviews to identify the participants’ prior knowledge. To this end, a script was drawn up containing guiding questions, in such a way as to open up, broaden and deepen communication (Minayo, 1998). In general, the aim of the interviews was to get to know and deepen their understanding of health, their rights and duties, as well as of SP and MHC.
The interviews were recorded, transcribed and analyzed. The (pre-)diagnostic evaluation was carried out over four days in February 2022. Each interview lasted an average of 15 minutes. At the end of each interview, field notes were taken on the main aspects listed by the participants, their perceptions and questions.
Before the interviews, a pre-test was carried out with the objective of improving the way the interviews were conducted and making the necessary adaptations to the semi-structured script. This stage was held with members of the study and research group to which the authors of this study belong and who had previous experience with this data collection strategy. The pre-test was applied to four undergraduate students. It lasted two hours.
After the development of the pre-test, the interview script was restructured in order to ensure the clarity, objectivity and relevance of the questions. The pre-test was also important to enable the authors to conduct the interviews, allowing the effectiveness and fluidity of the interactions.
Second stage: pre-simulation
Five educational activities lasting 1 hour and 20 minutes were carried out every week between March and May 2022. The activities took place during class time provided by the teachers and agreed with the school management. The main objective of the meetings was to bring the students closer to the theoretical and practical knowledge of SP.
Planning was based on the prior knowledge and knowledge gaps identified in the previous phase. This stage was designed so that the students could develop the skills, knowledge and competences to participate in the simulation, providing support for decision-making in the simulation (Luckesi, 2009). To this end, the document prepared by the International Federation of Health and Human Rights Organizations (IFHHRO, 2012) was used and adapted for application in the context of BE. This material lists practical steps to improve health conditions, based on Human Rights.
The content covered at this stage was the concept of health, rights and duties, SP and MHC CMS. The lack of medication distributed by SUS was the central problem of the simulation. This issue was raised by other students from the same educational institution in a previous study (Barbosa; Liberale; Ventura, 2023).
The teaching strategies used were the construction of a collective story, brainstorming, working in small groups, case studies, a round-table discussion with a municipal health counselor, interviews and educational games. In all meetings, a field diary was used, which was essential to gather perceptions and information that were not obtained through semi-structured interviews (Minayo, 2001). Subsequently, these notes complemented the data analysis and allowed us to monitor the process of the experience. At this stage, in addition to the researchers, there was the participation of an undergraduate nursing student, who contributed to the planning and execution of the activities. An average of two to four mediators participated in all the activities.
Third stage: simulation
This stage consisted of applying a simulation template for an ordinary meeting of MHC that had been developed and validated in previous research (Barbosas; Liberale; Ventura, 2023). The context of the scenario was the “lack of medication supply by SUS”. This problem had been identified by other Elementary School students from the same school institution.
The roles that made up the simulation were the president of MHC; user representatives; health professional representatives; government representatives; and observers. For the roles that make up the MHC staff, the parity provided for in Law nº 8.142/90 (Brazil, 1990c) was followed. During the simulation, the observers were given a checklist, which helped to analyze the performance of their peers and the discussion in the debriefing (Barbosa; Liberale; Ventura, 2023).
Fourth stage: post-diagnostic evaluation
In order to understand each participant’s experience throughout the research, a diagnostic post-evaluation was carried out using semi-structured interviews once again. This was held according to the same standards established in the first stage. The interviews took place in May 2022 and started one day after the end of the simulation. Each interview lasted an average of 30 minutes. The interviews were recorded, transcribed and analyzed.
Data analysis
The data collected in the interviews and the complementary data from the field diary were analyzed and categorized through the content analysis proposed by Bardin (2016).
Ethical aspects
All phases of this research were initiated after authorization by the Research Ethics Committee (REC), under Certificate of Presentation of Ethical Appreciation (CAAE, as per its Portuguese acronym) number 47018921.6.0000.5393. Resolutions nº 446/13 and nº 510/16 on the ethical requirements of research with human beings were respected.1
Results
Among the 14 participants, seven were males and seven were females. All lived in the neighborhood of the school institution and were between 13 and 14 years old. Through the analysis of the interviews, it was possible to identify three categories and their respective subcategories, which are displayed in Chart 1:
In the subcategory of the concept of health, at the first moment of data collection, this concept was linked to the biomedical model and there were a few mentions of health in relation to diseases (S8). After the educational activities, there was progress towards a broader health model; with this, it was possible to identify the relationship between health and the social context in which the students were inserted, such as the school cafeteria and the square in the neighborhood where they live (S1).
Diseases and bacteria. That’s all I know (S8).
Health means taking care of yourself, looking after your body, eating well, and exercising. To do this, the environment needs to be clean [...] because sometimes the cafeteria isn’t a completely clean environment (S1).
It is worth underlining that, in both moments, the participants related health to well-being linked to the habit of healthy living. Nevertheless, in the post-evaluation, the participants deepened their understanding of the concept, through examples.
Health is exercising, working, eating healthy things like fruits, vegetables, rice and beans, meat and fruits (S12).
At both times of data collection, some participants reported that they do not talk about health at school. In the pre-evaluation, some pointed out that there is a predominance of discussion about health in Science, Life Project and Physical Education classes, with the main subject being measures to prevent Covid-19 (S10). In the post-evaluation, the participants mentioned that they discuss health at mealtimes in the cafeteria (S11).
In the first days of school, we talked about the coronavirus and how we had to take care of ourselves, not share materials, the same water bottle, and use alcohol gel (S10).
In the cafeteria, they serve food with a lot of fat [...] (S11).
With regard to the conception of rights, in the pre-evaluation, most of the participants said they did not know what rights mean and four related them to injustice, equality and respect (S9). In the post-evaluation, most of them mentioned the right to equality, justice and responsibility plus new perceptions of the concept, linking the right to quality health, education, life, family, expression, leisure, work and voting (S13 and S14).
Rights that all human beings have, equal rights (S9).
To have good health care, medicines at the health centers and our right to have a voice and the right to express what we think (S13).
Rights are something we need to live (S14).
In addition, there was a deepening of the theme (S4), where, contrary to the pre-evaluation, only three participants answered that they did not know what is/what they understood as rights.
What everyone has [...] everyone doesn't, because not everyone can achieve something. Many people end up losing their rights, due to their conditions, the color of their skin. I don’t think it’s very fair. Everyone should have equal rights. The right to go to school, to learn to read and write, to have access to health care, to have a family and to receive affection from someone (S4).
In the subcategory regarding violation of rights, in the diagnostic pre-evaluation, two participants identified non-compliance with Covid-19 prevention measures as a violation of rights and two participants argued about the importance of gender equality (S11). In the post-evaluation, half identified violations of rights, including within the school environment. In the community where they live, they highlighted the delay in medical care and the lack of access to health facilities. The other half did not point out any violations of rights in the community (S10).
There are many sexist men who say that only women need to wash dishes and everything else, I think that both need to perform the same things (S11).
We have very few hospitals; so, we have to go up to the other neighborhood to go to the hospital. Last time, the hospital we went up to closed, but currently there are very few consultations (S10).
With regard to the subcategory related to conception of SP, in the pre-evaluation, the participants linked SP to communication (S3), interaction with peers and the idea of helping people or institutions. One participant, when asked if he had ever held SP, replied that he had already held it in the Student Association (SA). SP linked to communication and interaction was maintained in the post-evaluation, plus the understanding of collectivity as a guarantee of rights and power of decision (S1).
People who find it easy to talk and converse with other people [...] Helping people is also a way, isn’t it? (S3).
You won’t act just with yourself, but with everyone around you, fighting for the same thing you are trying to fight for. Acting together (S1).
In the post-evaluation, the majority associated the SA setting with their experience of SP at school; when asked about forms of SP in the community, they identified MHC. One participant mentioned voting as another form of SP in the community. The relationship between SP and different forms of Social Mobilization were present, namely: protest, petitioning and raising money to help institutions and/or people. One participant, when asked what he understood as SP, both inside and outside school, said he did not know.
With regard to the CMS subcategory, at the first moment of data collection, when asked about their knowledge of the CMS, ten were unaware of it and four said they had heard of it but couldn't say what it was. At the second data collection point, four said they didn't know anything about it and three said they knew about it but had forgotten what it was. For the rest, the MHC was linked to a group of people whose function is to improve/take care of the population's health, with supervisory actions and the management of public money (S4). It was also clear that the participants see the role of the MHC as helping the community.
MHC is basically taking care of health, overseeing and managing income. They also discuss improvements (S4).
Discussion
In the pre-diagnostic evaluation, the results showed a predominance of the biomedical conception of health, which defends the unicausality of health. In the post-diagnostic evaluation, this concept broadened to include biopsychosocial aspects, well-being and healthy habits. This evolution is related to the historical construction of the social change that came about with the Federal Constitution of 1988 (Brazil, 1988), when health was recognized as being linked to various social determinants, such as education, as expressed in Law nº 8080/90 (Brazil, 1990b).
The results showed that health was discussed in Science, Life Project and Physical Education classes. However, the self-perception of health connected to the fact that they are producers and/or reproducers, consciously or unconsciously, individually or collectively, was identified after the educational activities were carried out, when it was reported that health is also discussed during meals in the cafeteria.
In this context, how can we encourage and strengthen training based on the interdependence of health actions and the extent of their involvement? Freire (1967) points to problematizing education as a possible way forward. Problematizing education is a way of stimulating critical and reflective awareness of the reality in which the subjects are inserted. The structuring axes of problematizing education are dialog from the perspective of constructing understandings, mediation in and by the world, discovery, the process of seeking and gaining knowledge, creation, and collaborative practice (Bernz; Mesquita, 2024).
Considering the points made about problematizing education and the health perspective, from an educational point of view, the intention is to encourage the construction of other ways of relating to oneself and the world. This process involves more understanding and respect, and less polarization, conflict and violence; more involvement and belonging, and less indifference and blame-shifting; more collaboration and less competition. It occurs through the improvement of various skills, including listening, welcoming, building bonds and co-responsibility (Bernz; Mesquita, 2024). In this sense, integrating problematizing education with other concepts can be interesting, such as the concept of self-activity presented by Dewey (2003).
Education based on self-activity involves stimulating emotional, physical and intellectual initiatives as opposed to the passive absorption of teaching content (Dewey, 2003). The starting point for all learning will always be genuine interest; from this, students will be invited to solve real problems. It will be up to the teacher to help when necessary and it is worth underlining that helping does not mean dictating the process of how to do it. On the contrary, whenever possible, it means letting students solve their own problems.
Another element observed in the results was the identification and claiming of rights and duties. Thus, at the first stage of data collection, few students were able to talk about the rights they had. At the second stage, the content of the interviews showed that there had been progress in understanding the issue, since examples of civil, political, economic, social and cultural rights were listed. Gender equality and access to the health care network were examples cited in the interviews.
It is worth highlighting that the historical affirmation of Human Rights in Brazil, consolidated with the promulgation of the Federal Constitution (FC) in 1988, is based on an international movement marked in 1948 by the approval of the Universal Declaration of Human Rights by the United Nations (UN), which was the basis for the creation and adoption of various international instruments on the subject. In articles 3 to 21, the Declaration establishes civil and political rights, such as the right to life, security, equal treatment before the law, property and freedom. These rights are considered negative and justify the impossibility of state interference in the individual’s sphere, except to guarantee the prevalence of freedom itself. Articles 22 to 27 establish social rights, which reflect the claims of individuals before the state - work, education, health, housing, leisure, security and social insurance. They are considered positive rights and presuppose the extension of state competence, requiring intervention by the public authorities (UN, 1948).
Knowing the rights established and guaranteed by the Brazilian FC is important, since a full citizen is one who understands himself/herself as the holder of rights (Galvão; Vieira; Vidal, 2024). From this perspective, the exercise of citizenship is not something that has always existed, but a social construction that has been shaped throughout history and is related to the guarantee and exercise of civil, political and social rights. In this way, the deepening and recognition of rights is essential in order to know and reflect on reality, so that people can actively transform the community in which they live, through intervention and re-creation (Freire, 1967).
In the category related to SP, in the two times of data collection, the relationship between SP and communication can be observed. Communication is essential to mobilize the community for SP, as it contributes to the collectivization process (Toro; Werneck, 2004).
The learned hegemonic model of Human Communication, which basically involves the transportation of information in the form of a Sender, Message and Receiver, has proved to be incipient when the intention is to promote communication aimed at understanding, respect and involvement. This is because this hegemonic model tends not to consider other elements that are present in communication. Suzart (2024) warns that, in fact, when one is in dialog with another person, previous experiences, desires and beliefs are accessed, contributing to individual and collective construction.
The complexity of communication was identified in the results because, despite the participants emphasizing communication as an essential process for SP, weaknesses and problems in communication and interaction between participants were noted. In this sense, it is important to strengthen active learning strategies focused on developing communication skills that go beyond the hegemonic model, longitudinally and throughout the students’ training. These aspects are fundamental for the active participation of students in the community, with regard to political, social, cultural and economic issues (Santos; Bastos-Junior, 2023).
The content of the interviews showed that, in the diagnostic pre-evaluation, the participants were unaware of the forms of SP. In the post-evaluation, in addition to highlighting some forms of SP in the community, such as MHC and voting, many recognized SA as an organization representing their demands. Nevertheless, especially in relation to the latter, through the field diary and the experience of educational activities, it was possible to observe a certain distance between the students and its objectives and operation.
In order to encourage a more participatory culture among young people, as well as constantly developing theoretical and practical skills, it is necessary to strengthen participation mechanisms within the school environment, such as SA, given their importance for the development of autonomy, citizenship and youth protagonism. It is therefore essential to rethink the power structure of school institutions, aiming at socialization and decentralization to move towards democratic management. This socialization promotes the development of collective participation and the empowerment of the school community (Falcão; Caldas; Freire, 2023).
The Brazil’s Statute of the Child and Adolescent (ECA, as per its Portuguese acronym) - Law nº 8.069, dated July 13, 1990 - in its article 53, item IV, guarantees the students’ right to organize and participate in student bodies (Brazil, 1990a). Thus, as provided for in the ECA lines, students have the possibility of organizing themselves to participate in student movements. In addition to ECA, the National Education Plan (Law nº 13.005/2014), in goal 19, presents strategies for the implementation of democratic management, such as strategy 19.4, which deals with the implementation of SA in schools: “constitution and strengthening of student and parent participation, through SA and parent-teacher associations” (p. 59-60).
Once again, we can see that, even though it is guaranteed by law, there is still a lot of work to be done: valuing, strengthening and belonging to participatory bodies. Of course, an ideal of participation and full citizenship may be unattainable. However, by experiencing more and more participatory, emancipatory and democratic practices at school, students not only exercise values, but also strengthen social interaction and problem-solving skills so that they move from being spectators to actors and create situations where they can act on the needs of the community by occupying legitimate spaces (Falcão; Caldas; Freire, 2023).
In addition, the first interviews showed that MHC was seen as something distant. After the activities and the simulation, the MHC setting became known. Participants even mentioned overseeing and managing public health as part of their duties. However, it was noted that many students saw helping the population as one of the MHC’s duties, which can be understood as something optional, disconnecting the existence of the Council from an achievement stemming from social movements (Monteiro et al., 2024), as well as its duty to represent the community. Thus, it is still necessary to think about strategies that bring the MHC setting closer to the school context.
This situation becomes even more significant considering that the last few years in Brazil have been marked by setbacks and dismantling of oversight bodies, published via Decree nº 9.759/2019, which extinguished and established guidelines, rules and limitations for councils, committees, commissions, among others (Brazil, 2019). Nonetheless, this measure was revoked by Decree nº 11.371, dated January 1, 2023 (Brazil, 2023). Despite this, the impact of this change on the fight to guarantee rights cannot yet be fully measured or evaluated. What we do know is that we are facing an enormous challenge, aggravated by the period in which some councils became extinct, as well as the escalation of a process of disinformation that involved health and education issues, and probably contributed to delegitimizing or confusing the functions of the councils, as well as discouraging the involvement and engagement of civil society in demanding rights (Brazil, 2024). This is in addition to the challenges posed by the Covid-19 pandemic in the areas of education and health.
Finally, the importance of access to information for SP was not identified in the interviews. Some participants also linked SP to different forms of Social Mobilization, but there is an important difference between the names. Social Mobilization and SP involve a participatory culture, which includes actions that, by identifying problems in the community where the participants live, such as the accumulation of garbage, lack of lighting and space for leisure, can jointly raise hypotheses and propose improvements in the political, social, economic, cultural and emotional spheres. However, only SP is linked to the deliberative process (Silva; Ribeiro, 2024).
Final considerations
This study achieved its objective of analyzing the teaching-learning process, with a view to developing theoretical and practical knowledge related to SP both in the community and in the school context. The results showed that the educational activities and the simulation created the conditions for the participants to understand health in a broader way; to recognize themselves as holders of civil, political, economic, social and cultural rights; to identify violations of rights in the community; to recognize SP as a way of guaranteeing rights by bringing together SA and MHC, which, until then, were unknown to most students as training tools for a more participatory culture.
The study’s limitations include the fact that, in everyday school life, it is not always possible to use teaching strategies that encourage collaborative communication and social interaction. Another limitation is that the use of the template used for the simulation carried out in this study addressed a specific social and cultural reality. As a suggestion, the creation and strengthening of SA could be an interesting tool for practicing participatory culture and youth protagonism.
Acknowledgements
This project was funded by the National Council for Scientific and Technological Development (CNPq, as per its Portuguese acronym), through the Institutional Program for Scientific Initiation Scholarships (PIBIC, as per its Portuguese acronym).
References
- AUSUBEL, D. P. Aquisição e retenção de conhecimentos: uma perspectiva cognitiva. Lisboa: Plátano Edições Técnicas, 2003.
- BARBOSA, M. L. S.; VENTURA, C. A. A.; LIBERALE, M. Right to health and encouragement of social participation in elementary education. Investigación y Educación en Enfermería, Medellín, v. 47, n. 1, p. e08, 2023.
- BARDIN, L. Análise de conteúdo. São Paulo: Edições 70, 2016.
- BERNZ, M. E.; MESQUITA, P. De uma educação bancária para um caminho educacional de humanização. Cadernos Intersaberes, Curitiba, v. 13, n. 48, p. 52-69, 2024.
-
BRASIL. Conselho Nacional de Saúde. Saúde sem boato. 2024. Disponível em: <https://susconecta.org.br/saude-sem-boato/> Acesso em: 11 dez 2024.
» https://susconecta.org.br/saude-sem-boato - BRASIL. Decreto n.º 11.371, de 1º de janeiro de 2023. Revoga o Decreto n.º 9.759, de 11 de abril de 2019, que extingue e estabelece diretrizes, regras e limitações para colegiados da administração pública federal. Diário Oficial da União, Brasília, DF, 1 jan. 2023.
- BRASIL. Decreto n.º 6.286, de 5 de dezembro de 2007. Institui o Programa Saúde na Escola (PSE) e dá outras providências. Diário Oficial da República Federativa do Brasil, Brasília, DF, 6 dez. 2007.
- BRASIL. Decreto n.º 9.759, de 11 de abril de 2019. Extingue e estabelece diretrizes, regras e limitações para colegiados da administração pública federal. Diário Oficial da União, Brasília, DF, 11 abr. 2019.
- BRASIL. Lei n.º 13.005, de 25 de junho de 2014. Aprova o Plano Nacional de Educação - PNE e dá outras providências. Diário Oficial da União, Brasília, 26 jun. 2014.
- BRASIL. Lei n.º 8.069, de 13 de julho de 1990. Estatuto da Criança e do Adolescente. Brasília: Diário Oficial da União, 1990a.
- BRASIL. Lei n.º 8.080, de 19 de setembro de 1990. Dispõe sobre as condições para a promoção, proteção e recuperação da saúde, a organização e o funcionamento dos serviços correspondentes e dá outras providências. Diário Oficial da União, Brasília, DF, 20 set. 1990b.
- BRASIL. Lei n.º 8.142, de 28 de dezembro de 1990. Dispõe sobre a participação da comunidade na gestão do Sistema Único de Saúde (SUS) e sobre as transferências intergovernamentais de recursos financeiros na área da saúde e dá outras providências. Diário Oficial da República Federativa do Brasil, Brasília, DF, 28 dez. 1990c.
- BRASIL. Ministério da Educação. Base Nacional Comum Curricular. Brasília: Ministério da Educação, 2018.
- BRASIL. Senado Federal. Constituição da República Federativa do Brasil. Brasília, DF: Senado Federal, 1988.
- BRESOLIN, P. et al. Debriefing na simulação clínica em Enfermagem: uma análise a partir da teoria da aprendizagem experiencial. Rev. Gaúcha Enferm., v. 43, e20210050, 2022.
- COHEN, L.; MANION, L.; MORRISON, K. Research Methods in Education. USA-Canada: Routledge, 2007.
- DAMANIK, F. H. S. et al. Community Participation in the Public Decision Process: Realizing Better Governance in Public Administration. Global International Journal of Innovative Research, v. 1, n. 2, p. 88-96, 2023.
- DEWEY, J. Schools of to-morrow. In: BOYDSTON, J. A.; HICKMAN, L. (Eds.). The collected works of John Dewey. The Later Work. Carbondale: Southern Illinois University Press, 2003.
- FALCÃO, N. M.; CALDAS, E. C. R.; FREIRE, M. A. Grêmio Estudantil e a Participação Juvenil: um estudo no centro de educação em tempo integral de Humaitá/AM. Contemporary Journal, v. 3, n. 2, p. 30470-30493, 2023.
- FREIRE, P. Educação como prática da liberdade. Rio de Janeiro: Paz e Terra, 1967.
- GALVÃO, W. N. M.; VIEIRA, S. L.; VIDAL, E. M. Protagonismo estudantil em escolas rurais de ensino médio: uma experiência do Ceará. Educação, v. 49, n. 1, p. e116/1-27, 2024.
- INTERNATIONAL FEDERATION OF HEALTH AND HUMAN RIGHTS ORGANISATION. Passos para Mudança: um guia de ação sobre Direitos Humanos e os trabalhadores de saúde. The Netherlands: IFHHRO, 2012.
-
KOLDEHOFF, M.; ANDREIS, A. M. Diálogo sobre a cidadania na BNCC numa perspectiva freireana. SG, Goiânia, v. 5, p. 1-20, 2023. Disponível em: https://revistas.ufg.br/signos/article/view/77433 Acesso em: 9 jun. 2024.
» https://revistas.ufg.br/signos/article/view/77433 - LUCKESI, C. C. (org.). Verificação ou avaliação: o que pratica a escola? São Paulo: Cortez, 2009.
- MINAYO, M. C. S. O desafio do conhecimento: pesquisa qualitativa em saúde. São Paulo Rio de Janeiro: Hucitec Abrasco, 1998.
- MINAYO, M. C. S. Pesquisa Social: teoria, método e criatividade. Petrópolis: Vozes, 2001.
- MONTEIRO V. A. et al. O papel do conselho de saúde do município de Altos-PI sob a ótica dos representantes das ONGs atuantes. Revista Foco, v. 17, n. 3, e4644, p. 1-19, 2024.
- ORGANIZAÇÃO DAS NAÇÕES UNIDAS. Declaração Universal dos Direitos Humanos. Nova York, 1948.
- SANTOS, E. P. F. C.; MOREIRA, D. C.; BISPO-JÚNIOR, J. P. Avaliação de desempenho dos conselhos de saúde em municípios de pequeno e médio porte. Saúde e Sociedade, São Paulo, v. 30, n. 3, p. e200356, 2021.
- SANTOS, M. R.; VARELA, S. A avaliação como um instrumento diagnóstico da construção do conhecimento nas séries iniciais do ensino fundamental. Revista Eletrônica de Educação, São Carlos, v. 1, n. 1, p. 1-14, 2007.
- SANTOS, R. M; BASTOS-JUNIOR, L. M. P. Cidadania, Participação e Direitos Humanos: Fundamentos Teóricos, Normativos e Metodológicos de um Projeto Transversal com Vistas à Educação de Qualidade. Direito Público, v. 20, n. 105, 2023.
- SILVA, C. I.; RIBEIRO, K. da S. Recursos e poder: a capacidade dos conselheiros de influenciar o processo decisório no CMAS de Lavras por meio da posse de recursos. Revista de Gestão e Secretariado, v. 15, n. 9, p. e4286, 2024.
- SUZART, G. S. A comunicação humana: relevância, relações e reflexões na sociedade contemporânea. Cadernos de Ciências Humanas, v. 21, 2024.
- TONG, A.; SAINSBURY, P.; CRAIG, J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus group. International Journal for Quality in Health Care, Oxford, v. 19, n. 6, p. 349-357, 2007.
- TORO, J. B.; WERNECK, N. M. D. Mobilização social: um modo de construir a democracia e a participação. Belo Horizonte: Autêntica, 2004.
All research data are available in this text.
