Female homicide in Rio Grande do Sul, Brazil

This study aimed to assess the female homicide rate due to aggression in Rio Grande do Sul, Brazil, using this as a "proxy" of femicide. This was an ecological study which correlated the female homicide rate due to aggression in Rio Grande do Sul, according to the 35 microregions defined by the Brazilian Institute of Geography and Statistics (IBGE), with socioeconomic and demographic variables access and health indicators. Pearson's correlation test was performed with the selected variables. After this, multiple linear regressions were performed with variables with p < 0.20. The standardized average of female homicide rate due to aggression in the period from 2003 to 2007 was 3.1 obits per 100 thousand. After multiple regression analysis, the final model included male mortality due to aggression (p = 0.016), the percentage of hospital admissions for alcohol (p = 0.005) and the proportion of ill-defined deaths (p = 0.015). The model have an explanatory power of 39% (adjusted r2 = 0.391). The results are consistent with other studies and indicate a strong relationship between structural violence in society and violence against women, in addition to a higher incidence of female deaths in places with high alcohol hospitalization

Fulfillment of the Brazilian Agenda of Priorities in Health Research

This commentary describes how the Brazilian Ministry of Health's (MoH) research support policy fulfilled the National Agenda of Priorities in Health Research (NAPHR). In 2003, the MoH started a democratic process in order to establish a priority agenda in health research involving investigators, health managers and community leaders. The Agenda was launched in 2004 and is guiding budget allocations in an attempt to reduce the gap between scientific knowledge and health practice and activities, aiming to contribute to improving Brazilian quality of life. Many strategies were developed, for instance: Cooperation Agreements between the Ministry of Health and the Ministry of Science and Technology; the decentralization of research support at state levels with the participation of local Health Secretariats and Science and Technology Institutions; Health Technology Assessment; innovation in neglected diseases; research networks and multicenter studies in adult, women's and children's health; cardiovascular risk in adolescents; clinical research and stem cell therapy. The budget allocated by the Ministry of Health and partners was expressive: US$419 million to support almost 3,600 projects. The three sub-agenda with the higher proportion of resources were "industrial health complex", "clinical research" and "communicable diseases", which are considered strategic for innovation and national development. The Southeast region conducted 40.5% of all projects and detained 59.7% of the resources, attributable to the concentration of the most traditional health research institutes and universities in the states of São Paulo and Rio de Janeiro. The second most granted region was the Northeast, which reflects the result of a governmental policy to integrate and modernize this densely populated area and the poorest region in the country. Although Brazil began the design and implementation of the NAPHR in 2003, it has done so in accordance with the 'good practice principles' recently published: inclusive process, information gathering, careful planning and funding policy, transparency and internal evaluation (an external independent evaluation is underway). The effort in guiding the health research policy has achieved and legitimated an unprecedented developmental spurt to support strategic health research. We believe this experience is valuable and applicable to other countries, but different settings and local political circumstances will determine the best course of action to follow

A checklist for health research priority setting: nine common themes of good practice

Health research priority setting processes assist researchers and policymakers in effectively targeting research that has the greatest potential public health benefit. Many different approaches to health research prioritization exist, but there is no agreement on what might constitute best practice. Moreover, because of the many different contexts for which priorities can be set, attempting to produce one best practice is in fact not appropriate, as the optimal approach varies per exercise. Therefore, following a literature review and an analysis of health research priority setting exercises that were organized or coordinated by the World Health Organization since 2005, we propose a checklist for health research priority setting that allows for informed choices on different approaches and outlines nine common themes of good practice. It is intended to provide generic assistance for planning health research prioritization processes. The checklist explains what needs to be clarified in order to establish the context for which priorities are set; it reviews available approaches to health research priority setting; it offers discussions on stakeholder participation and information gathering; it sets out options for use of criteria and different methods for deciding upon priorities; and it emphasizes the importance of well-planned implementation, evaluation and transparency

A narrative review of health research capacity strengthening in low and middle-income countries: lessons for conflict-affected areas

Conducting health research in conflict-affected areas and other complex environments is difficult, yet vital. However, the capacity to undertake such research is often limited and with little translation into practice, particularly in poorer countries. There is therefore a need to strengthen health research capacity in conflict-affected countries and regions. In this narrative review, we draw together evidence from low and middle-income countries to highlight challenges to research capacity strengthening in conflict, as well as examples of good practice. We find that authorship trends in health research indicate global imbalances in research capacity, with implications for the type and priorities of research produced, equity within epistemic communities and the development of sustainable research capacity in low and middle-income countries. Yet, there is little evidence on what constitutes effective health research capacity strengthening in conflict-affected areas. There is more evidence on health research capacity strengthening in general, from which several key enablers emerge: adequate and sustained financing; effective stewardship and equitable research partnerships; mentorship of researchers of all levels; and effective linkages of research to policy and practice. Strengthening health research capacity in conflict-affected areas needs to occur at multiple levels to ensure sustainability and equity. Capacity strengthening interventions need to take into consideration the dynamics of conflict, power dynamics within research collaborations, the potential impact of technology, and the wider political environment in which they take place.</p

A atuação do serviço de saúde na violência sob o olhar de lideranças comunitárias de Londrina (PR) The health team's performance in the context of violence under the perspective of community-based leaderships in Londrina (PR)

Nos últimos anos, no Brasil, observa-se um aumento da violência urbana. A cidade de Londrina, no estado do Paraná, particularmente, vem assistindo a um preocupante aumento dos índices de violência. Isso tem levado as lideranças da cidade a se mobilizarem. O objetivo deste estudo é levantar qual a visão que lideranças comunitárias de duas regiões da periferia da cidade de Londrina, que apresentam diferentes níveis de mobilização popular, têm da atuação de serviços de saúde sobre a problemática da violência. A abordagem utilizada é de pesquisa qualitativa. Foi utilizado o referencial teórico das Representações Sociais e a técnica da análise de conteúdo de Bardin. Foram realizadas entrevistas semi-estruturadas com lideranças identificadas a partir do processo chamado de "bola de neve" ou amostragem em rede. As entrevistas foram realizadas até que se atingiu a saturação das representações sociais, totalizando vinte e seis entrevistas, treze em cada região pesquisada. Os resultados mostraram que, de modo geral, a atuação dos serviços de saúde é considerada precária na visão das lideranças comunitárias. Na região onde a comunidade é mais mobilizada, porém, essa atuação ocorre de maneira mais articulada. Já na região menos mobilizada, a atuação é mais pontual e foram relatados alguns casos de violência contra o profissional de saúde. Este estudo mostra que é necessário que a saúde invista mais na questão da violência, valorizando a parceria com segmentos organizados da comunidade.<br>In the last few years Brazil has been experiencing an increase in urban violence. Particularly in the city of Londrina (state of Paraná), there has been a disturbing growth of violence rates which has caused the city leaderships to take action. The aim of this study is to investigate what community-based leaderships think about the health team's performance regarding the violence issue. The leaderships are from two regions on the periphery of Londrina which have different levels of community mobilization. This is a qualitative study that used the theoretical framework of the Social Representations and Bardin's content analysis technique. Semi-structured interviews were conducted with leaderships chosen through the "snowball" process or network sampling. Interviews were conducted until a saturation of social representations was reached, totaling 26 interviews, 13 in each researched area. Results showed that, in general, the health team's performance is considered poor by the community-based leaderships. In the region where the community is more proactive, this performance is more articulated, whereas in the less proactive one, the performance is more focused and violence against the health professional has been reported. This study shows that it is necessary for health teams to give more attention to the violence issue, forming partnerships with organized segments in the community