O valor social da criança para o governo : motivações dos gestores públicos do Ceará para priorizar a saúde infantil

Abstract

Brazil and, especially, the state of Ceará, have demonstrated a significant reduction in the Infant Mortality Rate in the last 29 years. In recognition of the good results obtained in the State, mainly from 1987 to 1990, the United Nations Children’s Fund considered the experience from Ceará an example to be followed by other governments. Although some papers have already been published regarding Ceará’s experience in reducing its infant mortality rate, as of yet, no study has truly addressed the managers ́ reasons for prioritizing children’s health during their management. This paper aims to identify the motivations of public authorities, who were in office in Ceará from 1987 to 2006, to prioritize child’s health in public policies. Furthermore, this paper also aims at understanding the perceptions of these public authorities regarding the social value of children and the lessons learned with Ceará’s experience. This is an evaluative social research, adopting a qualitative approach, conducted by means of semi-structured interviews with three former governors and seven former health secretaries of the State of Ceará, during the above- mentioned period in time. The material obtained from the interviews was submitted to a thematic content analysis. The results obtained, in relationship to the public authorities’ main motivation to invest in children’s health were: “the belief that it would be possible to do so or someone convinced them that it would be possible to reduce infant mortality rate with basic health measures; being sensitive to the epidemiological situation of the child’s health; to continue the initiatives rolled out from previous governments; due to the authorities’ background and their successful experience in children’s health; political will, political decision and the commitment made to invest in children’s health, in people and human development”. Concerning the social value of children, the public authorities’ perceptions were: “taking care of children benefits everyone, in the present and future; children need to be a priority since they are more vulnerable; reducing child deaths became more relevant for public authorities; a child is a symbol of purity and innocence”. The main lessons learned from the study were: “political will, commitment and decision from public authorities are instrumental in order for public policies to be successfully implemented; good planning is necessary, with a clear definition and dissemination of government goals; proper diagnosis is key as well as a monitoring and evaluation system to prove and share the results obtained; the importance of leadership and a competent technical team, that is integrated, has autonomy, and is both motivated and engaged; the public policies that are producing good results should be continued”. Finally, based on the findings of this research, it was possible to recognize that public authorities can be convinced to prioritize children’s health with in government investment and it is possible to obtain good results as long as the government receives counseling and support from motivated, competent, experienced and autonomous technicians on how to conduct health policies.