Inter-sector network in Brazil’s School Health program: Subjects, perceptions, and practices

Abstract

This study evaluated the implementation of the School Health Program (PSE in Portuguese) in the city of Belo Horizonte, Minas Gerais State, Brazil, the mechanisms favoring inter-sector action, and municipal administrators’ perceptions concerning inter-sector collaboration. A case study was developed with document search and the application of an online questionnaire. The document search analyzed federal and municipal legislation on the PSE published in the Federal Register and Municipal Register and news on the program published in the Municipal Register. A semi-structured online questionnaire was completed by 30 municipal administrators. Content analysis was used on the qualitative data from the document search and questionnaire. The quantitative data were interpreted by descriptive analysis using Stata v. 13. Integrative mechanisms were identified in the federal and municipal provisions and in the unique PSE model adopted by the city. These mechanisms can potentially promote permanent linkage between health and education. However, the study with municipal administrators showed limited use of these mechanisms and the predominance of a sector-based logic in the program. There was evident difficulty in developing inter-sector collaboration in the program’s activities. The potentialities of inter-sector action identified in the official documents and described in the institutional news failed to reverberate in either the administrators’ practices or the impact on the schools’ territories.