Suchergebnisse

OBJETIVO Analisar o sistema de governança regional em saúde quanto a estratégias e disputas de gestão. PROCEDIMENTOS METODOLÓGICOS Pesquisa qualitativa com gestores de saúde de 19 municípios que integram a região de saúde no estado da Bahia. Foram realizadas 17 entrevistas semiestruturadas com gestores/gerentes (estadual, regional e municipal), grupo focal, observações na Comissão Intergestores Regional e documentos institucionais, em 2012. Foram analisados os componentes político-institucional e organizacional e interpretados pela hermenêutica-dialética. RESULTADOS A comissão intergestores regional foi a principal estratégia da governança regional, sendo ferramenta fundamental para fortalecimento da governança por reunir diferentes sujeitos responsáveis pela tomada de decisão nos territórios sanitários e pela negociação da alocação de recursos e distribuição dos estabelecimentos de uso comum na região. A rotatividade de secretários de saúde, baixa autonomia nas decisões executivas, a qualificação técnica insuficiente para exercício da função e o atravessamento das políticas partidárias na tomada de decisão são fatores que obstruem a comissão intergestores regional às demandas sociais. Recursos financeiros insuficientes não viabilizam o cumprimento da programação pactuada integrada nem o aumento da oferta pública na rede e impunham ao gestor a compra de serviços no mercado privado por valores acima da Tabela do Sistema Único de Saúde. Foram relatados atravessadores contratados para agilizar o acesso aos serviços especializados (diagnóstico, terapêutico e/ou cirúrgico) em outros municípios mediante pagamento direto a médicos por procedimentos já custeados pelo Sistema Único de Saúde. CONCLUSÕES A rede regionalizada de saúde apresenta padrão de governança conflitante e com institucionalidade intermediária. A comissão intergestores regional necessita incorporar, à rotina de gestão, dispositivos mais democráticos que logrem articulação com instituições de ensino, permeáveis às demandas sociais, para definição das políticas regionais. ; OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee's permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table). The study determined that "facilitators" under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical) services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of governance and intermediate institutionalism. The regional interagency committee's managerial routine needs to incorporate more democratic devices for connecting with educational institutions, devices that are more permeable to social demands relating to regional policy making.

As diretrizes do Decreto nº 7508, de 28 de junho de 2011, têm contribuído para ampliar a capacidade de governança dos pequenos municípios nas regiões de saúde. O objetivo do estudo foi identificar potencialidades e entraves no processo do planejamento regional integrado na região de saúde 29, do Rio Grande do Sul. Consiste em um estudo de caso, realizado mediante informações provenientes de entrevistas semiestruturadas, observações de campo e registros documentais, analisados pelo método de Análise de Conteúdo. Participaram do estudo gestores de saúde de cinco municípios e três servidores estaduais vinculados à 16ª Coordenadoria Regional de Saúde, selecionados intencionalmente. Emergiram cinco categorias de análise: a Comissão Intergestores Regional (CIR) como espaço de articulação; o fortalecimento do Sistema Único de Saúde; a fragilidade da gestão; individualismo ao olhar o processo; e o que tem pautado as reuniões da CIR. Os resultados apontam que o processo de planejamento regional integrado tem avançado, no sentido da CIR constituir-se como um espaço de apoio mútuo entre a gestão municipal e estadual. No entanto, as decisões são tomadas com embasamento mais político do que técnico, com pouco monitoramento do acesso às ações e aos serviços de saúde, dificultando a capacidade de controle e negociação com os prestadores. Considera-se que a CIR necessita ser fortalecida e consolidada por meio da qualificação da gestão e da participação efetiva dos gestores municipais e estaduais de saúde, a fim de possibilitar a governança regional. ; The guidelines of Decree No. 7508 - June 28, 2011 - have contributed to enhance the capacity of governance of small municipalities in health regions. The objective of this study was to identify the potential and the obstacles in the process of integrated regional planning in health region 29, Rio Grande do Sul. This is a case study carried out through information from semi-structured interviews, field observations, and documentary records, analyzed according to Content Analysis method. The study had participation of health managers of five municipalities and three state public servants linked to the 16th Regional Health Coordination, selected intentionally. Five categories of analysis emerged: the Regional Intermanagers Committee (CIR) as a space of coordination; the strengthening of the Brazilian Unified Health System; the weakness of the management; individualism in observing the process; and what has guided the meetings of the CIR. Results indicate that the integrated regional planning process has advanced, in the sense of CIR being constituted as a space of mutual support between the municipal and state management. However, decisions are made with more political than technical basis, with little monitoring of the access to health actions and health services, hindering the ability of control and negotiation in relation to service providers. It is considered that the CIR needs to be strengthened and consolidated through improvement of the management and through effective participation of state and municipal health managers in order to enable regional governance.

This review focuses only on specific studies into the SUS regionalization process, which were based on empirical results and published since 2006, when the SUS was already under the aegis of the Pact for Health framework. It was found that the regionalization process is now underway in all spheres of government, subject to a set of challenges common to the different realities of the country. These include, primarily, that committee-structured entities are valued as spaces for innovation, yet also strive to overcome the bureaucratic and clientelist political culture. Regional governance is further hampered by the fragmentation of the system and, in particular, by the historical deficiency in planning, from the local level to the strategic policies for technology incorporation. The analyses enabled the identification of a culture of broad privilege for political negotiation, to the detriment of planning, as one of the main factors responsible for a vicious circle that sustains technical deficiency in management. ; Univ Fed Sao Paulo, Escola Paulista Med, Dept Med Prevent, R Botucatu 740-4, BR-04023062 Sao Paulo, SP, Brazil ; Univ Sao Paulo, Fac Med, Dept Med Prevent, Sao Paulo, SP, Brazil ; Escola Nacl Saude Publica, Rio De Janeiro, RJ, Brazil ; Univ Fed Sao Paulo, Escola Paulista Med, Dept Med Prevent, R Botucatu 740-4, BR-04023062 Sao Paulo, SP, Brazil ; Web of Science

The objective of this study is to investigate the fiscal capacity of the Brazilian states in the light of estimates of their indices of Autonomy, adopting as timeframe analysis the period following approval of the Fiscal Responsibility Act, passed in the year 2000. The text provides a brief discussion of the concept of Federalism, Fiscal Federalism, and the issues related to resource allocation and federal conflicts. Then a brief description of the major economic events that occurred in the Brazilian economy in the period 1990-2010 and its repercussions in the tax structure of the federated entities is made. A special chapter discusses the indicators investigated. It is also analyzed the trajectory of the Index Autonomy of the states, through a cut sub-regional. Given the regional approach is possible to perceive the existence of a strong asymmetry in the fiscal capacity of the states due to the high degree of regional income disparity in this country's federalist scenario.

The main subject of this study is to propose an agenda to understand capabilities and limitations of state governments in Brazilian federalism. Governance capabilities, named here as economic-fiscal and political-institutional capabilities, are brought to the focus of the analysis. It is well known that our federalism has been recentralized in the past two decades and a small role is due to state governments. Otherwise the federal government in the president Lula administration has, after a decade (in the 1990's) of low levels of economic growth and repression on state budgets, boosted the national economy through expansion in social expenditures, public investment and public credit to the private sector. Very fruitful impacts were noted on state economies and finances but what it is not known is whether state governments had prepared themselves, in terms of strategic orientation and planning, to this new and positive scenario.

The article analyzes the evolution of regionalism in Latin America from the 1990s. It exhibits the options that consider to the countries in their foreign policies against the initiatives of the United States and the changes in the international system. One sets out the functional importance of the emergent powers (PEMS) and the regions in the present phase of Capitalism. Finally, the article analyzes the perspective of regionalism in Latin America as much in the international system as in the construction of a regional model of governance. Adapted from the source document.

The current water governance in Brazil contributes to the increase of water scarcity problems in the São Francisco basin, contributing to conflicts over water use. This paper assesses the challenges and barriers of water governance in the São Francisco river basin based on a robust collection and analysis of data from various repositories and institutions at the national, state, river basin and municipal levels. The methodology includes an analysis of institutional interaction by examining the coordination of water resources plans, a review of the implementation of basin tributary committees and the quantity and quality available data related to water management. Most tributaries' river plans were developed by the government; therefore, many of the plans analyzed conflicted with other regional plans due to a lack of coordination of proposed actions. In addition, the semiarid region has implemented few tributary river committees and the basin as a whole lacks an appropriate mechanism for generating, updating and sharing comprehensive information relevant to water management. It is therefore imperative to improve coordination between plans using integrated assessment and decision-making tools, and to reinforce public participation through tributary committees. Further, a collaborative data platform should be adopted, from which it will be possible share information generated in different sectors of society. ; A atual governança Hídrica no Brasil contribui para o aumento dos problemas oriundos da escassez hídrica na bacia do São Francisco, majorando os conflitos pelo uso da água. Este artigo tem o objetivo de avaliar alguns desafios e oportunidades da governança hídrica na bacia do São Francisco com base numa robusta coleta e análise de dados nos mais diversos órgãos e instituições em escalas nacional, estadual e de bacia. A metodologia inclui a análise da interação interinstitucional através do exame da coordenação dos planos de recursos hídricos, a análise da implementação dos comitês de bacias dos rios afluentes e a quantidade e qualidade acessível de dados relativos à gestão de águas. A maioria dos planos dos rios afluentes vigentes foi elaborada pelo poder público e consequentemente, boa parte dos planos analisados apresentam propostas com divergências regionais em suas diferentes escalas de planejamento e apresentam falhas na sinergia entre as ações dos diversos planos. Além disso, a região semiárida padece com a baixa implantação dos comitês de bacias de rios afluentes e a bacia como um todo sofre com a falta de um mecanismo apropriado de produção, atualização e compartilhamento de informações relevantes para a gestão hídrica. Portanto, faz-se necessário aprimorar o mecanismo de articulação entre os planos com o uso de ferramentas de avaliação integrada e de contexto decisório, fortalecer a participação pública através de comitês de rios afluentes e a adoção de uma plataforma de dados colaborativa donde se possa compartilhar informações geradas em diferentes setores da sociedade. ; A atual governança Hídrica no Brasil contribui para o aumento dos problemas oriundos da escassez hídrica na bacia do São Francisco, majorando os conflitos pelo uso da água. Este artigo tem o objetivo de avaliar alguns desafios e oportunidades da governança hídrica na bacia do São Francisco com base numa robusta coleta e análise de dados nos mais diversos órgãos e instituições em escalas nacional, estadual e de bacia. A metodologia inclui a análise da interação interinstitucional através do exame da coordenação dos planos de recursos hídricos, a análise da implementação dos comitês de bacias dos rios afluentes e a quantidade e qualidade acessível de dados relativos à gestão de águas. A maioria dos planos dos rios afluentes vigentes foi elaborada pelo poder público e consequentemente, boa parte dos planos analisados apresentam propostas com divergências regionais em suas diferentes escalas de planejamento e apresentam falhas na sinergia entre as ações dos diversos planos. Além disso, a região semiárida padece com a baixa implantação dos comitês de bacias de rios afluentes e a bacia como um todo sofre com a falta de um mecanismo apropriado de produção, atualização e compartilhamento de informações relevantes para a gestão hídrica. Portanto, faz-se necessário aprimorar o mecanismo de articulação entre os planos com o uso de ferramentas de avaliação integrada e de contexto decisório, fortalecer a participação pública através de comitês de rios afluentes e a adoção de uma plataforma de dados colaborativa donde se possa compartilhar informações geradas em diferentes setores da sociedade.

This dossier proposes the analysis of the relationship between local power and public management. Studies on local power have a long tradition in political thought, going back to authors such as Machiavelli, Tocqueville and Stuart Mill, sometimes emphasizing its role as a school of democracy, or else as a more efficient means of providing public services. The proximity between rulers and citizens was seen as fundamental for the constitution of political ties, a sense of collectivity and allocative efficiency.The Brazilian case is emblematic for understanding these relationships, since the municipalities were raised to the level of a federative entity, therefore, with their autonomies preserved. The municipalist discourse was in tune with decentralization and democratization, which became key words in the new Constitution.Local power always refers to the municipal sphere. However, this does not occur as a limit. The location is not restricted to municipalities. Whether because local power can be associated with intraterritorial dimensions that can be political subdivisions of the municipal space. Or because, the local power can cover more than one municipality, therefore, the local associated with the regional one.The municipality, the understanding of its management and its public policies are challenging scenarios that make it possible to verify ways in which local power occurs and, mainly, what impacts they generate on local state capacities and on municipal governance. The question that arises is that those two virtuous effects, in the view of modern political theorists, generated by local power, may not occur synergistically and simultaneously, and public management is part of this context. In other words, greater democratization may not have an effect on the quality of public service provision, and vice versa.In the Brazilian case, classical studies understood local power as efforts made by political actors for the preservation and predominance of their interests, which in general can be classified as private. In this context, local power can be seen as antagonistic to the notion of republican State if patrimonialist logics still persist in the functioning of local governments. These are issues that still impact Brazilian municipalities, especially micro and small ones, in which phenomena of oligarchization of power still exist, as is the case of families that succeed each other in command of local politics. This type of reality, if it does not prevent it, makes it more difficult to analyze them based on the references of urban policies that presuppose public debate and the participation of actors and processes that influence the production of policies in cities (Marques, 2018).Public management presupposes impersonal methods and specific rationalities for the conduct of the State in search of efficiency. In the context of patrimonial relations whose local power emerged, public management was unable to follow its bureaucratic paths, coexisting with precariousness and discontinuity. Thus, relations of conflicts and disputes between local power and public management were established.Local government gains evidence in these relationships, as it has the double challenge: (1) to create interfaces and connections between the porosity of local power, to be an executive representation of local political forces and (2) to promote the constancy that public management would presuppose, since the local government acts with defined purposes in a territorially delimited jurisdiction.This text, as well as those presented in the Dossier, seeks to advance the challenge of delimiting the relationships between the concepts of local power and public management. As such, the theme of local government becomes a cross-cutting theme that seeks to stitch together the analyzes and concepts.This text is organized into four sections, in addition to this introduction. The first part discusses the concept of local autonomy to understand central aspects related to politics. The second takes a brief look at local power in Brazil to understand historical and contemporary aspects of the concept. The third part presents a debate on the impacts that the relations between local power and public management generate on contemporary urban governance. Finally, the last part presents the texts that make up the Dossier. ; Este dossier propone el análisis de la relación entre el poder local y la gestión pública. Los estudios sobre el poder local tienen una larga tradición en el pensamiento político, remontándose a autores como Maquiavelo, Tocqueville y Stuart Mill, destacando en ocasiones su papel como escuela de democracia, o bien como medio más eficiente de prestación de servicios públicos. La proximidad entre gobernantes y ciudadanos fue vista como fundamental para la constitución de lazos políticos, sentido de colectividad y eficiencia distributiva.El caso brasileño es emblemático para comprender estas relaciones, ya que los municipios fueron elevados al nivel de una entidad federativa, por lo tanto, con sus autonomías preservadas. El discurso municipalista estaba en sintonía con la descentralización y la democratización, que se convirtieron en palabras clave de la nueva Constitución.El poder local siempre se refiere al ámbito municipal. Sin embargo, esto no se presenta como un límite. La ubicación no está restringida a los municipios. Ya sea porque el poder local puede estar asociado a dimensiones intraterritoriales que pueden ser subdivisiones políticas del espacio municipal. O porque, el poder local puede abarcar más de un municipio, por lo tanto, el local asociado al regional.El municipio, la comprensión de su gestión y sus políticas públicas son escenarios desafiantes que permiten verificar las formas en que se produce el poder local y, principalmente, qué impactos generan en las capacidades estatales locales y en la gobernabilidad municipal. La pregunta que surge es si esos dos efectos virtuosos, a juicio de los teóricos políticos modernos, generados por el poder local, no pueden ocurrir de manera sinérgica y simultánea, y la gestión pública es parte de este contexto. En otras palabras, una mayor democratización puede no tener un efecto sobre la calidad de la prestación de los servicios públicos y viceversa.En el caso brasileño, los estudios clásicos entendían el poder local como esfuerzos realizados por actores políticos para la preservación y predominio de sus intereses, que en general pueden clasificarse como privados. En este contexto, el poder local puede ser visto como antagónico a la noción de Estado republicano si aún persisten lógicas patrimonialistas en el funcionamiento de los gobiernos locales. Son cuestiones que aún impactan a los municipios brasileños, especialmente a los micro y pequeños, en los que todavía existen fenómenos de oligarquía del poder, como es el caso de las familias que se suceden en el mando de la política local. Este tipo de realidad, si no lo impide, dificulta su análisis a partir de los referentes de políticas urbanas que presuponen el debate público y la participación de actores y procesos que inciden en la producción de políticas en las ciudades (Marques, 2018) .La gestión pública presupone métodos impersonales y racionalidades específicas para la conducta del Estado en busca de la eficiencia. En el contexto de relaciones patrimoniales cuyo poder local emergía, la gestión pública no pudo seguir sus caminos burocráticos, conviviendo con la precariedad y la discontinuidad. Así, se establecieron relaciones de conflictos y disputas entre el poder local y la gestión pública.El gobierno local gana evidencia en estas relaciones, ya que tiene el doble desafío: (1) crear interfaces y conexiones entre la porosidad del poder local, ser una representación ejecutiva de las fuerzas políticas locales y (2) promover la constancia que la gestión pública presupondría, ya que el gobierno local actúa con fines definidos en una jurisdicción delimitada territorialmente.Este texto, al igual que los presentados en el Dossier, busca avanzar en el desafío de delimitar las relaciones entre los conceptos de poder local y gestión pública. Así, el tema del gobierno local se convierte en un tema transversal que busca hilvanar los análisis y conceptos.Este texto está organizado en cuatro secciones, además de esta introducción. La primera parte discute el concepto de autonomía local para comprender aspectos centrales relacionados con la política. El segundo analiza brevemente el poder local en Brasil para comprender los aspectos históricos y contemporáneos del concepto. La tercera parte presenta un debate sobre los impactos que las relaciones entre el poder local y la gestión pública generan en la gobernanza urbana contemporánea. Finalmente, la última parte presenta los textos que componen el Dossier. ; Esse dossiê propõe a análise das relações entre o poder local e a gestão pública. Os estudos sobre o poder local possuem uma longa tradição no pensamento político, remontando a autores como Maquiavel, Tocqueville e Stuart Mill, ora enfatizando seu papel como escola de democracia, ou então como meio mais eficiente de prover serviços públicos. A proximidade entre governantes e cidadãos era vista como fundamental para a constituição de laços políticos, senso de coletividade e eficiência alocativa. O caso brasileiro é emblemático para compreender essas relações, já que os municípios foram alçados ao nível de ente federativo, portanto, com suas autonomias preservadas. O discurso municipalista sintonizava descentralização e democratização que passaram a ser palavras-chave da nova Constituição. O poder local sempre remete à esfera municipal. Contudo, isso não ocorre como um limite. O local não está restrito aos municípios. Seja porque o poder local pode estar associado com dimensões intraterritoriais que podem ser subdivisões políticas do espaço municipal. Ou porque, o poder local pode abranger mais de um município, portanto, o local associado ao regional. O município, a compreensão de sua gestão e de suas políticas públicas são cenários desafiadores que possibilitam verificar maneiras como o poder local ocorre e, principalmente, quais os impactos que geram nas capacidades estatais locais e na governança municipal. A questão que se coloca é que aqueles dois efeitos virtuosos, na visão dos teóricos da política moderna, gerados pelo poder local, podem não ocorrer de forma sinérgica e simultânea e a gestão pública é parte desse contexto. Ou seja, uma maior democratização pode não gerar efeitos na qualidade da provisão de serviços públicos, e vice-versa. No caso brasileiro, os estudos clássicos compreenderam o poder local como esforços realizados por atores políticos para a preservação e o predomínio de seus interesses, que em geral podem ser classificados como privados. Nesse contexto, o poder local pode ser visto de forma antagônica à noção de Estado republicano se lógicas patrimonialistas ainda persistem no funcionamento dos governos locais. Estas são questões que ainda impactam os municípios brasileiros, principalmente os micro e pequenos, nos quais fenômenos de oligarquização do poder ainda existem, como é o caso das famílias que se sucedem no comando da política local. Este tipo de realidade, se não impede, torna mais difícil analisá-los com base nos referencias das políticas do urbano que pressupõem debate público e a participação de atores e processos que influenciam a produção das políticas nas cidades (Marques, 2018). A gestão pública pressupõe métodos impessoais e racionalidades próprias para a condução do Estado em busca da eficiência. No contexto das relações patrimonialistas cujo poder local emergia, a gestão pública ficava impossibilitada de trilhar seus caminhos burocráticos, convivendo com a precariedade e a descontinuidade. Ficavam assim estabelecidas relações de conflitos e disputas entre poder local e gestão pública. O governo local ganha evidência nessas relações, pois tem o duplo desafio: (1) criar interfaces e conexões entre a porosidade do poder local, para ser uma representação executiva das forças políticas locais e (2) promover a constância que a gestão pública pressuporia, já que o governo local atua com propósitos definidos em uma jurisdição territorialmente delimitada. Esse texto, assim como aqueles que são apresentados no Dossiê, busca avançar no desafio de delimitar as relações entre os conceitos de poder local e gestão pública. Como tal, o tema do governo local passa a ser um tema transversal que busca costurar as análises e conceitos. Esse texto está organizado em quatro seções, além desta introdução. A primeira parte discute o conceito de autonomia local para compreender aspectos centrais relacionados com a política. A segunda lança um breve olhar sobre o poder local no Brasil para compreender aspectos históricos e contemporâneos sobre o conceito. A terceira parte apresenta um debate sobre os impactos que as relações entre poder local e gestão pública geram na governança urbana contemporânea. Por fim, a última parte apresenta os textos que compõem o Dossiê.

The article explores European integration theorization, although an extensive overview on the full range of theories & theoretical approaches is ruled out. At the outset, the emphasis is on how conventional frameworks approached regional integration. Subsequently, we focus on the debate opposing liberal intergovernmentalism & supranational governance. The final section presents contemporary theoretical alternatives, notably institutionalist, constructivist & discursive analysis approaches. References. Adapted from the source document.

This article aims to investigate the origin of unbalances and tensions between central and subnational governments concerned to the allocation of resources and decentralization of public policies. One argue that Brazilian federalism in recent years (2000-2012) has establishing a high level of centralization in two essential dimensions of intergovernmental relations - contributing to tensions and negative reactions in subnational governments, particularly on the state or provincial governments. Firstly, the high degree of centralization of fiscal resources by central government. Secondly, the increasing control, at central level, of capabilities and initiatives for designing and implementing public policies. These two characteristics of centralization degree mean that subnational levels of government are prone to have a reduced and limited role in our federalism in contrast to constitutional prescriptions.

Brazil, together with India and South Africa, now represent a renewed source of international pressure, views, and resources. IBSA has brought together these three developing nations, that are regional powerhouses, therefore simultaneously opening space for affirmative multilateralism, intra-South political coordination. They countries have been dedicating special attention to the rule-making process of global governance agendas and institutions. While broadening and deepening the scope of their responsibilities and commitments to other developing countries, they have been crafting innovative forms of inter-state collaboration. The chance to sit together at the UNSC in 2011 as non-permanent members became a major opportunity for IBSA. During this year, this group was able to share and reinforce the values and perspectives on world politics and security in an effort to strengthen a Southern critical appraisal of the post-cold war liberal peace concepts and prescriptions. Whereas western powers have downplayed the importance of reviewing its methods and procedures UNSC, IBSA countries have transmitted their special concern with the flaws of UN bureaucratic coordination, the needs for improvement in the links between SC, the GA and the executive boards of the UN agencies. Brazil has become especially concerned with the question of legitimacy of the use of force in international intervention as well as the humanitarian impact of military action and the importance of solutions which sought equilibrium between peace, solidarity, sovereignty and sustainable development."Assistance and cooperation, rather than coercion must be our watchwords", have been Brazil's pledge at the UNCS.

The META MPE Project "Socioeconomic and Environmental Diagnosis of Small-scale Mining in Brazil," is a comprehensive study of the SSM sector within the Brazilian context. Carried out on request from the Brazilian Ministry of Mining and Energy (MME), the study has as its objective to analyze the socioeconomic and environmental dynamics of SSM universe in Brazil and, from the evaluation of the sector's current conditions, to recommend public policy aiming at its organization and promotion. In this way, the diagnostic made by the Projekt-Consult/RCS Global Consortium has the purpose of providing information for strategic planning. This study was requested by MME from the acknowledgment that the array of existing information on SSM in Brazil had several constraints. Being exclusively based on data related to formalized operations, it does not reflect the practical reality of the sector in the country. Official statistics are incomplete, outdated to some extent, and scattered throughout various institutions within the Brazilian public administration. In order to bridge this gap, a survey was done to include – on top of documentation analysis, case studies in five regions selected to represent the universe of substances extracted by SSM in Brazil, viz. gold (Tapajós mining reserves, in Pará, and in the Peixoto valley, in Mato Grosso), clay (Santa Gertrudes ceramic hub, in São Paulo), gems and precious stones (Jequitinhonha and Mucuri valleys, in the Northeast of Minas Gerais), and construction aggregates (Recife metropolitan area, in Pernambuco). There was also done a comprehensive survey of the literature and documentation on the economic impact at local, regional, and national levels, as well as that related to SSM public policies. Upon overlaidand compared, the bibliographic analyses and the considerations on legislation and public policy for SSM, the case studies revealed the existence of behavioral and organizational standards in the SSM universes that brought up a fresh view of the sector. Qualitative data represents the analysis base for this socioeconomic and environmental report. It covers features that cannot be analyzed exclusively from quantitative data, such as the characteristics of the forms of organization, the social structure of mining communities, environmental impact and the connections between the SSM sector and the economic, governmental, and social sectors. The analysis included issues such as gender, labor relations and other variables, such as age, education level, professional autonomy, and migration. From the analysis of this data, the motivation of social players, in adopting particular lifestyles, and in choosing specific economic and environmental behaviors, become evident, as well as the stance of stakeholders in this area regarding the formalization process. Hence the report characterizes the SSM universe in Brazil in detail, by dealing with social, cultural, economic, political, and environmental issues. The five case study reports found in Volume II of Report 3 provide input for the final analysis of the domestic scenario of SSM. However, Volume I of Product 3 and each case study report making up Volume II can be read independently. There is a great variation in the forms of organization of MPE in Brazil. The role of the MPE sector in each locality is different in social, cultural and economic terms. The degree of inclusion in the economic system, in the legal system, and capital-labor relationships in the extraction process are all important variables. However, the people involved in the activity also share several important characteristics, even if there are differences in terms of the mineral substance extracted and the type of mining. The analysis of public policies shows that these do not always meet the needs of the sector. It can be concluded, for example, that the mineral extensionism initiative did not work as expected due to difficulties in coordination and cooperation between the agents involved. In addition, it is possible to infer that the mineral APL projects also did not materialize as foreseen for a different reason: the lack of capacity to create structures of mutual trust between the agents involved in the activity. Finally, the analysis of the socioeconomic dynamics of the SSM and of the public policies aimed at it, reveals the presence of governance mechanisms inherent to informality intrinsic to the studied universes. The results point to the existence of a self- sustaining cycle of informality, from a history of years of misinformation, conflicting policies and distrust of the players in the sector when it comes to government policies, associated with the complex process of formalization and the punitive approach of agents in charge of overseeing activities. The report presents, in its Chapter 9, some reflections on the challenges and possibilities for a more efficient SSM organization, and Chapter 10 shows the conclusions and proposals for developing public policies for this sector.

Over the past decade, Brazil has launched a foreign policy that has revealed its aim to broaden its influence in the design of the global multilateral architecture, and increase both its presence in UN peace operations and its cooperation in the development of low-income countries (LICs) in Latin America and Africa. In order to achieve this aim, the Brazilian government has been stimulating the country's international participation in humanitarian assistance actions, in UN-led peace missions and in cooperation for development initiatives. This paper will present three illustrative cases, which demonstrate the different forms this participation can take and the variety of methods of intervention they may involve: Haiti, Bolivia and Guinea-Bissau. These cases reveal the diversity of Brazilian involvement in Sousth-South Cooperation( SSC), regarding political motivations, cultural affinities and regional/global aspirations. They also help illustrate certain plasticity in Brazil's performance as an emerging donor. The three cases portray the multidimensional nature of the Brazilian South-South agenda, in which security, development, and political and institutional support are intertwined. In addition, these countries represent areas of high interest in Brazilian foreign policy. In the case of Bolivia, its importance relates to the Brazilian interest in promoting democratic stability in South America. In the case of Guinea-Bissau, its importance relates to the Brazilian aim to strengthen its commitments to the Community of Portuguese Language Countries (CPLP), as an instrument to foster relations with the African continent. Finally, in the case of Haiti, its significance is related to Brazil's stance when intervention takes place in vulnerable states with the aim to improve Brazil`s presence in global governance associated with the promotion of sustainable development in the low income countries.

A boa nutrição é o sustentáculo do bem-estar humano. Boa nutrição antes do nascimento e ao longo da infância permite que o cérebro funcione e evolua sem problemas e que os sistemas imunológicos se desenvolvam com mais vigor. Para as crianças pequenas, um nível de boa nutrição afasta a morte e prepara o corpo para crescer e desenvolver todo o seu potencial. No decorrer da vida humana, a boa nutrição leva a melhor aproveitamento escolar, mães mais bem alimentadas que dão à luz crianças mais bem nutridas, e adultos que tem maior probabilidade de serem produtivos e receber salários melhores. Durante a meia-idade, a boa nutrição origina metabolismos melhor preparados para proteger contra doenças associadas a mudanças na dieta e atividade física. Sem uma boa nutrição as vidas e meios de vida das pessoas são como que construídos em areia movediça. ; Supplementary Online Materials ix Acknowledgments x Abbreviations xii Executive summary xiii Chapter 1 ntroduction 2 Chapter 2 Nutrition Is Central to Sustainable Development 7 Chapter 3 Progress toward the World Health Assembly Nutrition Targets Is Too Slow1 5 Chapter 4 The Coexistence of Different Forms of Malnutrition Is the "New Normal" 22 Chapter 5 The Coverage of Nutrition-Specific Interventions Needs to Improve 29 Chapter 6 Interventions Addressing the Underlying Determinants of Nutrition Status Are Important, but They Need to Be More Nutrition sensitive 38 Chapter 7 The Enabling Environment Is Improving, but Not Quickly Enough 47 Chapter 8 The Need to Strengthen Accountability in Nutrition 56 Chapter 9 What Are the Priorities for Investment in Improved Nutrition Data? 67 Chapter 10 Key Messages and Recommendations 71 Appendix 1 The Nutrition Country Profile: A Tool for Action 75 Appendix 2 Which Countries Are on Course to Meet Several WHA Targets? 77 Appendix 3 Which Countries Are on Course for Which WHA Targets? 79 Appendix 4 Donor Spending on Nutrition-Specific and Nutrition-Sensitive Interventions and Programs 84 Appendix 5 How Accountable Is the Global Nutrition Report? 86 Appendix 6 Availability of Data for Nutrition Country Profile Indicators 88 Notes 91 References 95 PANELS Panel 11 Types of Nutrition Investment, Lawrence Haddad 4 Panel 21 Nutrition and the Sustainable Development Goals—No Room for Complacency, Michael Anderson 11 Panel 22 Some New Data from India: What If?, Lawrence Haddad, Komal Bhatia, and Kamilla Eriksen 12 Panel 23 How Did Maharashtra Cut Child Stunting?, Lawrence Haddad 13 Panel 24 Can Improving the Underlying Determinants of Nutrition Help Meet the WHA Targets?, Lisa Smith and Lawrence Haddad 14 Panel 41 Malnutrition in the United States and United Kingdom, Jessica Fanzo 25 Panel 42 Regional Drivers of Malnutrition in Indonesia, Endang Achadi with acknowledgment to Sudarno Sumarto and Taufik Hidayat 26 Panel 43 Compiling District-Level Nutrition Data in India, Purnima Menon and Shruthi Cyriac 27 Panel 44 Targeting Minority Groups at Risk in the United States, Jennifer Requejo and Joel Gittelsohn 28 Panel 51 Measuring Coverage of Programs to Treat Severe Acute Malnutrition, Jose Luis Alvarez 37 Panel 61 Trends in Dietary Quality among Adults in the United States, Daniel Wang and Walter Willett 41 Panel 62 How Did Bangladesh Reduce Stunting So Rapidly?, Derek Headey 43 Panel 63 Using an Agricultural Platform in Burkina Faso to Improve Nutrition during the First 1,000 Days, Deanna Kelly Olney, Andrew Dillon, Abdoulaye Pedehombga, Marcellin Ouédraogo, and Marie Ruel 45 Panel 71 Is There a Better Way to Track Nutrition Spending? 48 Panel 72 Tracking Financial Allocations to Nutrition: Guatemala's Experience, Jesús Bulux, Otto Velasquez, Cecibel Juárez, Carla Guillén, and Fernando Arriola 49 Panel 73 A Tool for Assessing Government Progress on Creating Healthy Food Environments, Boyd Swinburn 51 Panel 74 Engaging Food and Beverage Companies through the Access to Nutrition Index, Inge Kauer 52 Panel 75 How Brazil Cut Child Stunting and Improved Breastfeeding Practices, Jennifer Requejo 54 Panel 81 Scaling Up Nutrition through Business, Jonathan Tench 61 Panel 82 How Civil Society Organizations Build Commitment to Nutrition, Claire Blanchard 62 Panel 83 Building Civil Society's Capacity to Push for Policies on Obesity and Noncommunicable Diseases, Corinna Hawkes 63 Panel 84 Can Community Monitoring Enhance Accountability for Nutrition?, Nick Nisbett and Dolf te Lintelo 64 Panel 85 National Evaluation Platforms: Potential for Nutrition, Jennifer Bryce and colleagues 65 Panel 86 The State of African Nutrition Data for Accountability and Learning, Carl Lachat, Joyce Kinabo, Eunice Nago, Annamarie Kruger, and Patrick Kolsteren 66 ; PR ; IFPRI1; CRP4; B Promoting healthy food systems ; DGO; A4NH; PHND ; CGIAR Research Program on Agriculture for Nutrition and Health (A4NH)