Difusão internacional de práticas integrativas e complementares em saúde: desafios na implementação na atenção primária à saúde no Brasil e no Rio Grande do Sul

Abstract

This research analyzes the challenges related to the international dissemination of Integrative and Complementary Health Practices (ICHP) as a public policy. The investigation seeks to identify challenges present at three levels: international, national, and state by examining the Alma Ata Declaration and the role of the World Health Organization (WHO), Brazil and the state of Rio Grande do Sul, respectively. In general, ICHP, also known as Complementary Traditional Medicines (CTM), are multi-professional treatment resources based on traditional knowledge for multidimensional care of each patient, individually: physical, emotional and spiritual. Considering that the WHO has published guidelines on the topic, that Brazil instituted its National Policy on Integrative and Complementary Health Practices in 2006, that the government of the state of Rio Grande do Sul created its State Policy on ICHP in 2013, but that such practices are still not accessed uniformly by users of the Brazilian National Health System (SUS), the questions guiding this study are as follows: what mechanisms have been used in the process of disseminating ICHP? What are the state agents involved in the diffusion of ICHP? What are the challenges to the dissemination of ICHP policy? This study is based on the premise that domestic and international politics are interconnected in today’s world and that domestic matters are influenced by foreign concepts and/or ideas and vice-versa. Eventual challenges to this adaptation process may be overcome by certain policy diffusion mechanisms. Following a qualitative, and analytical-descriptive approach, this thesis draws on primary and secondary sources, ultimately suggesting that despite institutionalization and the use of such mechanisms, ICHP, due to their attributes, are still viewed as non-priority issues and suffer from stigmatization in the healthcare field because they are related to traditional and/or popular knowledge, much of which still lacks scientific evidence from clinical trials.