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This paper is an excerpt of an ethnographic study conducted within a doctoral program in a Complementary and Integrative Practices referral unit located in Peruíbe-SP, Brazil. It presents an analysis of the implementation of a Municipal Policy on Complementary and Integrative Practices (MPCIP), including participant observation of meetings held with workers and managers, field diaries, documents from the Brazilian Ministry of Health and the World Health Organization, legislation, and reports of those involved. The analysis was based on hermeneutic interpretation (GEERTZ, 1989), and the main challenges faced during the process are presented. Even though the format of the MPCIP in Peruíbe meets national and international requirements, it only warranted legal-institutional aspects. Despite advancements in policy development, there remain political and operational challenges to its implementation and expansion, which shall be overcome to fully implement Complementary and Integrative Practices in the city's health service. [ABSTRACT FROM AUTHOR]

State and international entities can have profound effects on the development of a country's nursing profession. Through a global health governance lens, this paper explores the development of nursing in Brazil during the early twentieth century, and its intersections with national and international interests. Accordingly, we will show how state policies established an environment that fostered the institutionalization of nursing as a profession in Brazil and supported it as a means to increase the presence of females in nation building processes. The State focused on recruiting elite women for nursing, in part due to the Rockefeller Foundation's involvement in the country. Nurses who worked for Rockefeller came from well-educated classes within US society with specific ideas about who should be a nurse and the roles of nurses in a healthcare system. These women served as the primary vehicles for interacting with Brazilian health authorities responsible for health system development. Their early efforts did not, however, ensure a system capable of producing nursing human resources at a rate that, in present day Brazil, could meet the health needs of the country. Findings from this paper offer new avenues for historians to explore the early roots of professional nursing through a global health governance lens, improve the understanding of the intersection between international politics and professionalization, and highlight how these factors may impact nursing human resources production in the long term. [ABSTRACT FROM AUTHOR]

The population access to the secondary health care services is being pointed, by managers and researchers, as one of the challenges to the implementation of integrality in the Brazilian National Health System (SUS). This paper aims to evaluate the mechanisms used by SUS manager's, in the city of São Paulo, to guarantee medical assistance, from 2005 to 2008. The strategy of case study was chosen, using as data sources such as managers interviews, focus groups with SUS users, and participative observation. Thematic analysis was performed on health services organization, with theoretical references of the integrality concept. We tried to describe the path covered by the users to have access to the services, based on the view of users and managers. Secondary health care services were identified by managers as the "neck of a bottle" and one of the main obstacle to the SUS integrality. To overcome this situation, the municipal manager invested in the computerization of services, as an isolated step, and still, without considering user's needs. However, this technological incorporation had low impact on the improvement of the population access to the secondary health care services, which was confirmed by user's source. It is argued that to face such complex problem it will be necessary to articulate actions, not only in health politics but also in health services organization and also in the (re)organization of the working process in any other level of the health system. [ABSTRACT FROM AUTHOR]

This paper briefly outlines how the political scenario and the mobilization of different actors have contributed to the construction of a public health policy in response to the AIDS epidemics in Brazil. Three factors are presented and discussed: the political context of the 1980s, characterized by redemocratization, growth of social movements, and consolidation of the Brazilian health care reform; the socio-cultural context of the 1970s and 1980s, characterized by achievement of individual freedom, which was key to the organization of the AIDS movement; and finally the actions carried out in the international scenario to support the sustainability of the Brazilian domestic policy and the reinforcement of a global response to face the epidemics in lower-middle income economies. [ABSTRACT FROM AUTHOR]