Avaliação da política de regionalização: elementos para o desenho de uma rede de atenção à saúde como suporte ao enfrentamento da violência sexual no Ceará

Abstract

Sexual violence is a complex social phenomenon that requires multifaceted responses for its effective confrontation (Couto et al., 2018). This type of violence, predominantly directed at women, children, and adolescents, is frequently classified as a Wicked Problem. The aim of this study was to evaluate the health regionalization policy of the State of Ceará as a basis for creating a healthcare network model focused on assisting victims of this type of violence. To achieve this, the perspective of In-Depth Evaluation was adopted, aiming to analyze the central components of the health regionalization policy in the state, considering territorial and temporal aspects related to the profile of sexual crime occurrences (Rodrigues, 2008). The research follows a mixed approach, combining documentary and statistical research with the main data collection and analysis strategies. The results indicate that Ceará has a network of public services aimed at assisting victims of sexual violence, suggesting the feasibility of integrated action among different sectors, such as security, justice, and social assistance. However, it is observed that sexual violence is not explicitly addressed in health priorities or regional healthplans, highlighting the need for its inclusion in these documents. The panorama of sexual violence in Ceará from 2009 to 2023 shows an increasing trend in the occurrence records. During this 14-year period, 26,801 victims were registered, with significant peaks in 2013 and 2019. When analyzing these data, it is noted that the majority of the victims are women (80.32%) aged between 0 and 19 years, with the highest concentration in the age group of 10 to 14 years (37.82%), followed by children aged 5 to 9 years (19.17%) and 0 to 4 years. These data are alarming, as they reflect the vulnerability of a population largely unable to resist or consent. Finally, the essential elements for building a health policy focused on strengthening and improving care for victims of sexual violence in Ceará were proposed, considering regional specificities, based on the Ex-ante Analysis Guide of the Civil House (Brazil, 2018). It is expected that the findings of this research will contribute to the formulation of more effective public policies to combat sexual violence in Ceará, using health regionalization as a crucial strategy to adapt responses to the state's territorial needs.