Social control in indigenous health policy: CONDISI's performance in guaranteeing differentiated care in medium and high complexity services in DSEI AL/SE.
Indigenous Health Policy; Social Control; Interculturality; Differentiated attention to health.
Access to health care for culturally distinct minorities is a challenge for the Brazilian public health system in view of its cultural and ethnic specificities. A major achievement arising from the struggle of indigenous peoples is the National Policy for Health Care for Indigenous Peoples (PNASPI), which requires differentiated care at all levels of health care. For this reason, this dissertation deals with the implementation of this policy, emphasizing the advances that occurred with the implementation of the Indigenous Health Care Subsystem (SASI-SUS) and the Special Indigenous Health Districts (DSEIs) and the challenges present in guaranteeing a differentiated attention in all levels of health care. The starting point was the following research problem: How has the District Council for Indigenous Health (CONDISI) acted as a mechanism for participation and social control, to guarantee a differentiated service in medium and high complexity services that provide care to indigenous population within the scope of DSEI AL/SE? In this way, the research aims to analyze CONDISI's performance in guaranteeing access to health, with emphasis on differentiated care in medium and high complexity services, which provide health care to the indigenous population within the scope of DSEI AL/SE, as per recommended in the PNASPI. Bibliographical and documental research was used. The bibliographical research covered the productions around the indigenous health policy, social control, and ethnic and cultural specificities in a historical perspective. The documentary research was carried out by consulting official documents such as ordinances, resolutions, technical standards, cartography and the minutes of CONDISI meetings, between 2016 and 2019. The analysis provided an understanding of the difficulties that are processed within CONDISI in terms of refers to the exercise of social control, which is still fragile, but its clashes and discussions and the correlation of present forces are important to guarantee the implementation of the health policy for indigenous peoples with differentiated care that respects ethnic cultural particularities.