The use of the geographic scale in health: the scales of visceral Leishmaniasis/O uso da escala geografica na saude publica: as escalas da leishmaniose visceral

• Published in: Ciência & saude coletiva 2019-10, Vol.24 (10), p.3825
• Main Authors: Matsumoto, Patricia Sayuri Silvestre, D'Andrea, Lourdes Aparecida Zampieri
• Format: Article
• Language: Spanish
• Subjects: Health planning; Health systems agencies; Leishmaniasis; Public health; Public health movements; Visceral leishmaniasis
• ISSN: 1413-8123
• DOI: 10.1590/1413-812320182410.25452017

The geographical scale has been broadly discussed in an attempt to formulate a concept that succeeds in explaining different space-related realities. In the various sectors of health planning, geographic categories and concepts have been adopted without understanding the problems inherent to the geographical scale, which directly affects public policies implemented and, consequently, people's lives. The scope of this paper was to discuss the concept of scale based on the different scale levels and the difficulty of their implementation by means of the activities of the organs that operate in public health surveillance that deal with visceral leishmaniasis. A systematic review of the literature was conducted to show how the debate about geographical scale and health is still incipient. Geographical concepts were used, integrating municipal, state and national policies from the perspective of the geographic scale. Thus, the contention is that cooperation between health agencies and society is possible by the transposition of scales, creating an environment of solidarity and a more effective health system. The discussion does not end here, but it will make it viable to reflect on the theoretical and methodological options in research and in public health. Key words Scales, Geographic scale, Health systems agencies, Visceral leishmaniasis, Public health surveillance A escala geografica tem sido amplamente discutida na tentativa de formar um conceito que de conta de explicar as diferentes realidades do espaco. Nos diversos seguimentos de planejamento em saude, faz-se uma adocao das categorias e conceitos geograficos sem entender os problemas inerentes a escala geografica, o que afeta diretamente nas politicas publicas implantadas e, consequentemente, na vida das pessoas. O objetivo deste artigo foi discutir o conceito de escala a partir dos seus diferentes niveis, e debater a dificuldade de articula-los por meio da atuacao dos orgaos de vigilancia em saude publica brasileira que lidam com a leishmaniose visceral. Realizamos uma revisao de literatura para demonstrar como o debate do conceito de escala geografica com a saude e ainda incipiente. Utilizamos conceitos geograficos, integrando as politicas municipais, estaduais e nacional sob a otica da escala geografica. Dessa forma, acreditamos que seja possivel uma articulacao dos orgaos dos sistemas de saude com a sociedade na transposicao de escalas, num acontecer solidario, produzindo um sistema de saude mais ef