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Charting the Brazilian Comprehensive Healthcare Policy for Men (PNAISH), from its formulation through to its implementation in local public health services

The scope of this article is to see how the Brazilian Comprehensive Healthcare Policy for Men (PNAISH) has been implemented in the Unified Health System, from the standpoint of health professionals. A case study, involving five cases (each from a different macro region of Brazil) conducted using ethnographic techniques of data collection charted the progress of PNAISH implementation based on an anthropological approach using Lipsky's idea of street-level bureaucracy. PNAISH is contextualized in historical terms with national and international documents. Acknowledging the inevitable gap between the formulation and the implementation of any policy, an attempt is made to see how this gap has evolved by analyzing the transition of PNAISH into city Action Plans (PAs). It was revealed that the implementing agents had little knowledge of PNAISH, of the local health care network for men, of the techniques required to meet men's specific needs and of the concept of gender. It faced institutional obstacles, such as lack of an organizational structure, of a consolidated healthcare network - where the user receives services with different degrees of complexity within the system - and resources in general, especially human resources.

Men's health; Healthcare policy; Public healthcare policy; Anthropology; Qualitative research; Brazil


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