The contribution of A systematization evaluative approach to implement A health promotion project in Capela do Socorro, Sao Paulo, Brazil

Abstract

The Capela do Socorro is one of the 31 Regional City Halls of the city of Sao Paulo (Fig. 15.1). It is the most heavily populated and has a high rate of urbanization and population growth (Table 15.1). However, with its 134.2 km2 of area, it does not have the highest population density in the city. The industrial development of the 1970s had a significant impact on Capela do Socorro. Because it had a large rural area and was relatively close to the Jurubatuba industrial center, and because of the dynamic trade and services center located at the southern and south-western parts of the metropolitan area, the region has been absorbing a portion of the city's urban growth. A large working class population flocked to Capela in search of areas where urban land was affordable and had not yet any urban infrastructure in place, such as public transportation, water supply, public lighting, and social facilities. The Headwaters Protection Act1, enacted in 1976, covering 82% of the territory of Capela do Socorro, defined density limits for occupation of the land and hindered the development in the area. As a result, the land was virtually excluded from the formal real estate market and consequently land prices dropped significantly. Instead of protecting the natural water reserves as expected, this depreciation of land value led to the quick expansion of clandestine land division and to the setting up of slums around the region's water reserves. The end result was a highly concentrated low-income population living in poor housing in Capela do Socorro (Tables 15.2 and 15.3), neighboring a smaller portion of the territory (18%) with better infrastructure, where a higher average income population lived. The Healthy Cities strategy was adopted in 2003 to provide a structure to actions undertaken by the Deputy-mayor and his advisory group. An earlier initiative had been the Inter-DepartmentNucleus (N'ucleo Intersecretarial da Capela do Socorro - NICS), set up in 2001 to plan intersectoral actions within the purview of what was then the RegionalAdministration for Capela do Socorro.Over a two-year period, the multi-professional group that was developing this earlier initiative, put into practice an integrated and participatory management model that later was formalized and expanded to the municipal administration as a whole with the creation of the Decentralization Law for the City of Sao Paulo. In March 2002, based on the experience of this Nucleus, the City Administration of Sao Paulo decreed the creation of Local Administrations that would pave the way for the partition of the city into Regional city halls. The Decentralization Law was at that time going through the Municipal Legislative Branch. From March to June 2002, the Local Government of Capela do Socorro carried out an intergovernmental strategic planning process that led to the following mission statement of the local administration: To construct an environmentally healthy Capela do Socorro through sustainable and joint development, encouraging and enabling the participation of the population and the exercise of their citizenship. (Local Government Capela do Socorro, 2002a). The Healthy Capela pilot plan, which later became a framework for the pursuit of institutional partnerships and the engagement of the communities and the population as a whole, was also drafted at this time. Among the Healthy Capela Program's goals, of interest to this paper is that of carrying out integrated intersectoral actions between the public and private spheres. Associated with this goal is the following strategy: linkage of the various forums and participation channels in the region, comprising Health Management Councils (unit-level and district-level), School Boards, Forum of Delegates to the Participatory Budget, NeighborhoodCivil Defense Nuclei, among others, regarding health promotion. In May 2003, the Healthy Capela do Socorro Seminar officially launched the Healthy Capela Program. It was proposed at this seminar to set up four local Healthy Capela commissions. Following the recommendation of the regional office of the Pan American Health Organization (PAHO) in Brazil, the management group of Capela do Socorro County, the Center for Studies, Research and Documentation on Healthy Cities - CEPEDOC and the School of Public Health of the University of Sao Paulo began to work closely together. A partnership was set up and extended to other key stakeholders, including the business community, social movements, non-governmental organizations, and universities in the region. This partnership developed several joint actions, involving four planning workshops, which were attended by representatives of the four commissions initially set up by the project, an international seminar and the assessment of the management model based on the principles of Healthy Cities. This chapter will examine part of the Healthy Capela Program assessment project, focusing on the systematization of the experience lived in the period from 2001 to 2004 (Jara, 1996, 2001). © 2008 Springer Science+Business Media, LLC.