Celia Almeida

Chama a atenção o título desta quarta edição, diferente da anterior. Teriam assumido a denominação contemporânea, justificando a escolha, superando a ambiguidade do título anterior?

This study centers on relationships among national and international actors in preparation of the first health policy document for East Timor, under the United Nations transitional administration, between 1999 and 2002. International cooperation support for the health system rehabilitation process during the post-conflict period is analyzed as part of reconstruction of the State in parallel with construction of the country's political and institutional framework. Knowledge, ideas, "ways of doing," and induced and accepted practices permeate an interplay of power relationships that condition both national political alliance-building and the architecture of international aid, pointing to input to a discussion of how these mechanisms interact at different conjunctures and times in different negotiating frameworks.

This paper offers a critical review of the theoretical literature on the relationship between the production of scientific knowledge and its use in policy formulation and implementation. Extensive academic output, using a diversity of approaches and analytical frameworks, has sought to systematize knowledge transfer categories and strategies with a view to improving the application of scientific knowledge. A considerable part of this thinking addresses the problem from a more traditional perspective, which (explicitly or implicitly) regards research results as an "accumulable product", depicts the decision-making process simplistically and linearly, and thus restricts strategies to the suiting of research endeavors to needs. Newer approaches place greater importance on the complexity of policymaking and the knowledge production process, which are integrated into and explained in particular political and institutional settings. Although the application of knowledge transfer ideas to health policy and systems research does generate some interesting contributions, a long process of theoretical thinking lies ahead.

Este artigo é uma síntese de alguns dos principais resultados das discussões realizadas ao longo de 18 meses entre pesquisadores de diversas instituições, afiliadas à Abrasco, e procura contribuir para a formulação de uma metodologia que permita: a) compreender quais são e como se inter-relacionam os fatores que influenciam a eficiência, a efetividade e a eqüidade no desempenho do SUS; b) melhorar a formulação de políticas e c) monitorar as desigualdades no acesso e na qualidade dos serviços recebidos pelos diferentes grupos sociais no Brasil. A metodologia desenvolvida nutre-se de elementos utilizados nas propostas de avaliação de desempenho dos sistemas de saúde canadense, australiano, inglês e a da OPS e tem o formato de um painel de controle (dashboard), onde podem ser visualizadas simultaneamente diferentes dimensões da avaliação. O artigo descreve a experiência na adaptação e desenvolvimento da metodologia e fornece sugestões no sentido de aplicá-la para melhorar a formulação da política de saúde no Brasil.