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OBJECTIVE: To examine successful practices of health promotion in health, education, culture, welfare and sport, leisure, identifying the elements of success and challenges in the field. METHODS: A qualitative study with data obtained from in-depth analysis that included participant observation, interviews with managers, coordinators, professionals and participants from 29 practices reported as successful for promoting health in six municipalities of the metropolitan region of Belo Horizonte, MG, Southeastern Brazil, in 2011. The variables of the study were concept, dimension, dissemination and ease of access, identified in practices guided by content analysis. RESULTS: The results indicate a conceptual and methodological uncertainty about health promotion as evidenced by conflicting objects and contradictory purposes. The practices differ in size, coverage and ease of access, determined by inter-sector coordination and political and financial investment. CONCLUSIONS: We identified challenges to health promotion focusing on vulnerable populations, limits to financing and intersectoral partnerships. [ABSTRACT FROM AUTHOR]

Objective: To analyze home care practices of outpatient and hospital services and their constitution as a substitute healthcare network., Methodological Procedures: A qualitative study was carried out using tracer methodology to analyze four outpatient home care services from the Municipal Health Department and one service from a philanthropic hospital in the municipality of Belo Horizonte, Southeastern Brazil, between 2005 and 2007. The following procedures were carried out: interviews with the home care services' managers and teams, analysis of documents and follow-up of cases, holding interviews with patients and caregivers. The analysis was guided by the analytical categories home care integration into the healthcare network and technical-assistance model., Results: Home care implementation was preceded by a political-institutional decision, both with a rationalizing orientation, intending to promote cost reduction, and also with the aim of carrying out the technical-assistance rearrangement of the healthcare networks. These two types of orientation were found to be in conflict, which implies difficulties for conciliating interests of the different players involved in the network, and also the creation of shared management spaces. It was possible to identify technological innovation and families' autonomy in the implementation of the healthcare projects. The teams proved to be cohesive, constructing, in the daily routine, new forms of integrating different perspectives so as to transform the healthcare practices. Challenges were observed in the proposal of integrating the different substitutive healthcare services, as the home care services' capacity to change the technical-assistance model is limited., Conclusions: Home care has potential for constituting a substitutive network by producing new care modalities that cross the projects of users, family members, social network, and home care professionals. Home care as a substitute healthcare modality requires political, conceptual and operational sustainability, as well as recognition of the new arrangements and articulation of ongoing proposals.

Objectives: To assess home care programs implemented in three cities and to identify components indicating the integration of these programs into the reform of health care., Methods: An exploratory descriptive study with a qualitative approach was carried out in the cities of Marília and Santos, state of São Paulo, and Londrina, state of Paraná, Brazil. Empirical data was obtained from interviews with five nurses and one social worker who worked in home care services, and through analysis of reports on these programs. The data was analyzed using the discourse analysis technique., Results: The findings show the importance of home care services as a strategy for dehospitalization and humanization of care. Components were identified showing that home care focused on building up a health care model based on light technology, and multiprofessional and intersectorial work. It was found that, despite advances in the implementation of home care services, there are obstacles for an effective health care model change, such as ineffective referral and counter-referral mechanisms and complex relationship of health care providers with service users, their families and caregivers., Conclusions: Care provided by home care programs is a strategy to decentralized care based on hospitals and to build up a new approach focused on health promotion and prevention, reducing risks and humanizing care. Strategies must be drawn up to allow its implementation in the public health network.