ANA FLAVIA PIRES LUCAS D OLIVEIRA
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Medicina Preventiva, Faculdade de Medicina - Docente
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
LIM/39 - Laboratório de Processamento de Dados Biomédicos, Hospital das Clínicas, Faculdade de Medicina
7 resultados
Resultados de Busca
Agora exibindo 1 - 7 de 7
- Obstacles and facilitators to primary health care offered to women experiencing domestic violence: a systematic review(2020) D'OLIVEIRA, Ana Flavia Pires Lucas; PEREIRA, Stephanie; SCHRAIBER, Lilia Blima; GRAGLIA, Cecilia Guida Vieira; AGUIAR, Janaina Marques de; SOUSA, Patricia Carvalho De; BONIN, Renata GranussoSystematic review of the literature addressing obstacles and facilitators for the care of women, in situations of domestic violence (DV) in primary health care (PHC) in Brazil. The bibliographic review found 1,048 references. The analysis encompassed 39 articles complying with the inclusion and exclusion criteria. The material was centered on representations and beliefs of practitioners. The main obstacles were related to: conceptualizing DV as a health issue, resulting into difficulties to identify the problem and managing care encounters; lack of training and teamwork; scarce intersectoral network, fear and lack of time. The facilitators were mainly: introducing a gender and human rights perspective, bonding and embracement, teamwork and multisectoral work. Despite the potential of PHC to address the issue, few studies considered perspectives of management and financing, considered as key to overcome the problems pointed out.
- Primary health care and the specialized care services to women in situation of violence: expectations and mismatches in the voice of professionals(2023) AGUIAR, Janaina Marques de; SCHRAIBER, Lilia Blima; PEREIRA, Stephanie; GRAGLIA, Cecilia Guida Vieira; KALICHMAN, Beatriz Diniz; REIS, Marina Silva dos; LIMA, Nayara Portilho; AZEREDO, Yuri Nishijima; D'OLIVEIRA, Ana Flavia Pires LucasNetworking plays a central role in assisting women in situations of violence. This study analyzes how different the work perspectives are for Primary Care professionals and specialized services professionals in the areas of social and law assistance, and public security in the city of Sao Paulo, Brazil. Semi-structured interviews were carried out with 16 professionals from specialized services and 46 from the health sector. The axes for a thematic analysis were: what professionals know and think about services other than their own; their performance based on that; and their expectations. The findings revealed insufficient knowledge of the different services, resulting in communication difficulties as well as wrong referrals to other services, based on how other services would ideally work. We concluded that each sector is autonomous and its services start from its own field of action to define what would be best for women. The set works more like a mesh of services than a network.
- Historical changes in the intersectoral network of services targeted at violence against women - Sao Paulo, Brazil(2020) AGUIAR, Janaina Marques de; D'OLIVEIRA, Ana Flavia Pires Lucas; SCHRAIBER, Lilia BlimaViolence against women has gained space in the political agenda, driven by the women's movement, with the making of public policies targeted at assistance for women. We analyze the results of a study carried out in the city of SAO Paulo, Brazil, with professionals from the specialized intersectoral services network, focusing on the changes that have occurred due to the Maria da Penha Law. Data show that, in spite of the expansion of the services that provide assistance, defense and protection for women, there are difficulties concerning integrated work in professionals' actions and interaction, which hinders the outline of a common assistance project the most important principle for a networked action. The conclusion is that overcoming these difficulties is a challenge in the current political context of degeneration of the services and weakening of public policies targeted at women's rights.
- Disrespect and abuse in childbirth in Brazil: social activism, public policies and providers' training(2018) DINIZ, Carmen Simone Grilo; RATTNER, Daphne; D'OLIVEIRA, Ana Flavia Pires Lucas; AGUIAR, Janaina Marques de; NIY, Denise YoshieBrazil is a middle-income country with universal maternity care, mostly by doctors. The experience of normal birth often includes rigid routines, aggressive interventions, and abusive, disrespectful treatment. In Brazil, this has been referred to as dehumanised care and, more recently, as obstetric violence. Since the early 1990s, social movements (SM) have struggled to change practices, public policies and provider training. The aim of this paper is to describe and analyse the role of SM in promoting change in maternity care, and in provider training. In this integrative review using a gender-oriented approach, we searched the Scielo database and the Ministry of Health's (MofH) publications and edicts for institutional and research papers on SM initiatives addressing disrespect and abuse in the last 25 years (1993-2018) in Brazil, and their impact on public policies and training programmes. We analyse these groups of interrelated initiatives: (1) political actions of SM resulting in changes in public policies and legislation; (2) events organised by SM for diffusion of information to the public; (3) MofH policies to humanise childbirth with participation of SM; and (4) initiatives to change providers' training, including legal actions based on obstetric violence reports. To promote real change in maternity care, the progression of policies and enabling environment of laws, regulations, and broad dissemination of information, need to go hand in hand with changes in all health providers' training - including a solid base in ethics, gender and human rights.
- Institutional violence, human rights and technical-scientific authority: the complex childbirth situation for women(2020) AGUIAR, Janaina Marques de; AZEREDO, Yuri Nishijima; D'OLIVEIRA, Ana Flavia P. L.; SCHRAIBER, Lilia Blima
- An evidence-based primary health care intervention to address domestic violence against women in Brazil: a mixed method evaluation(2023) BACCHUS, Loraine J.; D'OLIVEIRA, Ana Flavia Pires Lucas; PEREIRA, Stephanie; SCHRAIBER, Lilia Blima; AGUIAR, Janaina Marques de; GRAGLIA, Cecilia Guida Vieira; BONIN, Renata Granusso; FEDER, Gene; COLOMBINI, ManuelaBackgroundHealth systems have a critical role in a multi-sectoral response to domestic violence against women (DVAW). However, the evidence on interventions is skewed towards high income countries, and evidence based interventions are not easily transferred to low-and middle-income countries (LMIC) where significant social, cultural and economic differences exist. We evaluated feasibility and acceptability of implementation of an intervention (HERA-Healthcare Responding to Violence and Abuse) to improve the response to DVAW in two primary health care clinics (PHC) in Brazil.MethodsThe study design is a mixed method process and outcome evaluation, based on training attendance records, semi-structured interviews (with 13 Primary Health Care (PHC) providers, two clinic directors and two women who disclosed domestic violence), and identification and referral data from the Brazilian Epidemiological Surveillance System (SINAN).ResultsHERA was feasible and acceptable to women and PHC providers, increased providers' readiness to identify DVAW and diversified referrals outside the health system. The training enhanced the confidence and skills of PHC providers to ask directly about violence and respond to women's disclosures using a women centred, gender and human rights perspective. PHC providers felt safe and supported when dealing with DVAW because HERA emphasised clear roles and collective action within the clinical team. A number of challenges affected implementation including: differential managerial support for the Nucleo de Prevencao da Violencia (Violence Prevention Nucleus-NPV) relating to the allocation of resources, monitoring progress and giving feedback; a lack of higher level institutional endorsement prioritising DVAW work; staff turnover; a lack of feedback from external support services to PHC clinics regarding DVAW cases; and inconsistent practices regarding documentation of DVAW.ConclusionTraining should be accompanied by system-wide institutional change including active (as opposed to passive) management support, allocation of resources to support roles within the NPV, locally adapted protocols and guidelines, monitoring progress and feedback. Communication and coordination with external support services and documentation systems are crucial and need improvement. DVAW should be prioritised within leadership and governance structures, for example, by including DVAW work as a specific commissioning goal.
- Violência institucional, autoridade médica e poder nas maternidades sob a ótica dos profissionais de saúde(2013) AGUIAR, Janaina Marques de; D'OLIVEIRA, Ana Flavia Pires Lucas; SCHRAIBER, Lilia BlimaThe current article discusses institutional violence in maternity hospitals from the health workers' perspective, based on data from a study in the city of Sao Paulo, Brazil. Eighteen health workers from the public and private sectors were interviewed, including obstetricians, nurses, and nurse technicians. A semi-structured interview was used with questions on professional experience and the definition of violence. The analysis revealed that these health workers acknowledged the existence of discriminatory and disrespectful practices against women during prenatal care, childbirth, and the postpartum. Examples of such practices cited by interviewees included the use of pejorative slang as a form of ""humor"", threats, reprimands, and negligence in the management of pain. Such practices are not generally viewed by health workers as violent, but rather as the exercise of professional authority in what is considered a ""difficult"" context. The institutional violence is thus trivialized, disguised as purportedly good practice (i.e., ""for the patient's own good""), and rendered invisible in the daily routine of care provided by maternity services.