Analysis of policy: The environmental health program, Recife, Brazil

The Environmental Health Program (EHP) from Recife / Brazil was developed in order to implement actions directed to the environment with the aim of promoting and protecting the population’s health from the identification, elimination or reduction of risk factors or situations associated with the occurrence of diseases or disorders. The EHP recovers in its theoretical framework the principles of the Unified Health System (universality, fairness and completeness) and the ideology of Health Promotion.
The EHP was implanted in 2001. Recife, located in Northeastern Brazil, accumulates many social contrasts, and has a population of about 1.5 million inhabitants.
Between 2005 and 2008 was conducted an analysis of policy of the EHP, aimed to understanding the process of formulation and implementation of the Program between the years 2001 and 2006. It had by reference the principles of Health Promotion and Comprehensive Analysis of Policies, according Walt and Gilson (1994).
It was a qualitative study, focusing on the literature review, analysis of documentation and on 20 semi-structured interviews with stakeholders.
The context of formulation and implementation of the EHP, the contents of the Program, the process of the policy, and the actors who influenced the same was analyzed.
The results showed the elections of the new Mayor in 2001 and the choice of managers with expertise I public health and politically strength as key factors. The content of the proposal was considered consistent with the principles of health promotion, but was evidenced a certain imbalance between the theoretical content of the EHP and what was actually developed. Regarding the process, the main findings related to the participatory process of development and deployment of the EHP. About the actors, managers at different levels and the technicians of the Health Secretary of Recife was identified as keys to the development of the EHP.