Context of vulnerability: concept and practice in the São Paulo State Program STD/AIDS, Brazil
C. Westin, M. Giovanetti, A. Yamaçake, L.C. Campos, V. Cervantes, N.S. Santos, E. Filipe
Programa Estadual de DST/HIV/AIDS - Secretaria Estadual de Saúde, Prevenção, São Paulo, Brazil
Issues: The State Program for STD / AIDS in São Paulo, through the Prevention area, watching prevention initiatives targeted at specific groups who follow closely the recommendations of federal and state agencies and the difficulty of municipal STD / AIDS managers in their qualified situational diagnoses, proposed a strategy of action based on the concepts of vulnerability, human rights, social participation, decentralization and intersectoriality.
Description: The work was carried out from 2006 to 2007 with 11 municipalities aiming at: contribute to the improvement of diagnostics of vulnerability to STD/HIV/AIDS in those municipalities through a collective construction, encouraging co-responsibility of different government sectors and NGOs.Criteria for selection of municipalities were based on the geographical location and socio-economic diversity of the state. Municipalities were invited to attend workshops for data collection in the available different information systems (SINAN, IBGE, IPVS) and for identification of the vulnerability contexts. Hypotheses about the contexts of local vulnerabilities were developed and were refined in a final workshop involving all the institutions and key actors participating in the process.
Lessons learned: The process allowed the local managers approximation to reality hitherto unknown, identifying potential partners in different communities.
The use of key actors' "perceptions", though essential, is fraught with subjectivity and therefore liable to be charged with prejudice and moral values, leading to distortions of interpretation of reality, to individualization of social and programmatic issues.
Next steps: Provide the geo-process information available to municipalities as a means to facilitate the viewing of them;
Monitor the unfolding of the process in each municipality;
Enlarge the proposal to other cities from State of Sao Paulo.
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