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Objective: we conducted an overview of systematic reviews aiming to describe the existing interventions to increase the adherence to the TB’s treatment by homeless people. Methods: The effects and local applicability of these interventions in Brazil were obtained in a policy dialogue with stakeholders. Results: Four interventions were effective: Financial incentives; Housing; Case management Programs; Assertive community treatment. Conclusion: It is recommended to combine all interventions to achieve effectiveness.

Introduction: The increasing technical and scientific production in public health over the years requires from professionals and managersthe hability to find evidence that is useful for health care services systems and its practices.Objective: To assist readers to identify updated scientific production and are from different sources of information.Methods: Considering the diversity of scientific evidence sources and their technical specificities, basic considerations for planning and conducting structured searches were described.Results: A list of strategic data bases was presented for the Public Health field and a detailed guide was described to the reader of how to carry out structured searches in Pubmed and the Virtual Health Library (BVS).Conclusion: A systematized and explicit was obtained from the evidence in order to answer questions concerning public health is a practice that needs to be stimulated to better inform health care decision makers, systems and services.Key words: health based evidence, health information, public health

Introduction: The Health Technology Assessment (HTA) supports managers to make decisions based on accurate scientific background for a proper use of technologies within health systems. Purpose: The purpose of this study was to make a situational diagnosis in the Federal District (Distrito Federal), identifying institutions that already produced or that had the potential to provide HTA, aiming to support the establishment of a district network concerning this subject. Method: A cross‑sectional study was carried out using an on‑line questionnaire (Google Docs) developed to identify the potential and the capacity of the educational and research institutions as well as the Federal District hospitals to analyze and/or produce clinics and economics evidences. At the same time, tow seminars were held with total attendance of 136 participants, aiming to disseminate the knowledge and to increase the questionnaire answers. Results: 70 questionnaires were sent, with answer rate of 16,3%. Fifteen institutions were identified, able to initiate the cooperation for the activation of the Federal District network. The following issues were identified and can be highlighted as obstacles to implement the HTA actions: low politic‑institutional commitment, lack of physical infrastructure and well‑prepared team. Conclusion: The activation of a district network might improve both local capacity to carry out health technology assessment as well as to increase the collaboration within Projects related to educational applied researchers, increasing the connection capacity for the production and dissemination of HTA studies.

O Grupo de Pesquisa Politicas Publicas em Saude (GPPPS), registrado no Diretorio do CNPq, foi formado para o desenvolvimento dessa area de pesquisa na Gerencia Regional de Brasilia da Fundacao Oswaldo Cruz (FIOCRUZ/Brasilia). Este grupo visa fornecer instrumentos, metodos, projetos, linhas e tematicas de pesquisa para subsidiar e fortalecer o programa de pos‑graduacao em politicas publicas de saude da Escola Fiocruz de Governo (PPGPPS/EFG). Este grupo tambem consolida a area de pesquisa na instituicao, resultado da congregacao dos programas de pesquisa e cooperacao tecnica existentes, assim como fomenta o surgimento de novas tematicas e programas. Essa edicao da revista Comunicacao em Ciencias da Saude e resultado de uma cooperacao com a Escola Superior de Ciencias da Saude (ESCS), instituicao de ensino superior mantida pela Fundacao de Ensino e Pesquisa em Ciencias da Saude (Fepecs) da Secretaria de Estado de Saude do Distrito Federal. O trabalho do grupo foi trilhado em duas linhas de pesquisa visando otimizar suas producoes tecnicas e bibliograficas: i) formulacao, implementacao, monitoramento e avaliacao de politicas, tecnologias e programas de saude; e ii) politica, planejamento, administracao e gestao de sistemas e organizacao. Para o ano de 2017, os membros elegeram discutir avaliacao de impacto de pesquisa em politicas de saude. A avaliacao de impacto da pesquisa utiliza triangulacao de metodos, incluindo tecnicas de analise de publicacao e citacoes, entrevistas com pesquisadores, avaliacao de pares, estudos de caso e analise de documentos de politicas existentes. No campo da saude ha um crescente reconhecimento de que o investimento em pesquisa em saude deve levar a melhorias nas politicas, na alocacao de recursos e na saude da comunidade1. No entanto, os impactos da pesquisa sao complexos e dinâmicos, nao lineares e de natureza difusa e os indices tradicionais de produtividade de pesquisa nem sempre valorizam a pesquisa aplicada, pesquisa‑acao e pesquisa operacional. Dessa maneira, o desafio e identificar abordagens sistematicas que possam sinalizar impactos de pesquisa na politica e pratica de saude. Os metodos de avaliacao de impacto de pesquisa multidimensional devem ser amplamente utilizados na pratica por diversos pesquisadores e instituicoes de ciencia e tecnologia. Para gerar informacoes sobre o impacto social do conhecimento produzido sao necessarios estudos que possibilitam avancar para alem dos indicadores academicos e o primeiro passo e sistematizar e disseminar a producao institucional 2,3 . Nessa edicao apresentamos diversos tipos de producao tecnico cientifica realizadas por pesquisadores da Gerencia Regional de Brasilia da Fundacao Oswaldo Cruz no intuito de iniciar um processo de analise dessas contribuicoes para politicas publicas e para o beneficio da sociedade e do Estado brasileiro. Os estudos sobre parcerias para o desenvolvimento produtivo apresentam um modelo de avaliacao de uma politica de transferencia tecnologica adotados pelo governo federal. Os trabalhos na area de vigilância incluem discussoes sobre vigilância e controle de agravos especificos e saude ambiental. Na area da educacao, os estudos estao direcionados a educacao em saude nos movimentos sociais de povos e populacoes do campo, da floresta e das aguas e programa saude na escola. No campo de redes de colaboracao, os trabalhos apresentam discussoes sobre metodos para construcao de ambientes sociais autonomos, dialogo prospectivo para integracao de politicas em territorios. Temas envolvendo fome e excesso de peso na perspectiva de atores especificos foram abordados em tres artigos. Tambem estao inseridos trabalhos contendo diagnostico situacional de saude bucal na regiao de Goias e um diagnostico sobre avaliacao de tecnologias em saude no territorio do Distrito Federal. Trazemos tambem um artigo que discute conceitos e governanca em territorios saudaveis e sustentaveis cuja compreensao apoiara a cooperacao vigente entre a Fiocruz Brasilia e a Secretaria de Saude do Distrito Federal, assim como aprimorar o Programa Institucional de Territorios Saudaveis e Sustentaveis. Por fim, apresentamos uma revisao sistematica sobre efetividade de programas de prevencao de obesidade na adolescencia e um artigo contendo metodo para realizacao de buscas estruturadas da literatura no campo da saude coletiva. Esperamos que essa edicao tenha demonstrado parte da producao dos membros do grupo de pesquisa em politicas publicas de saude da Fiocruz Brasilia. Adicionalmente desejamos que a disseminacao desses resultados proporcione troca de experiencias e contribua para acoes no territorio do Distrito Federal e da regiao Centro‑Oeste do pais.

Introdução: As metodologias utilizadas para a busca de evidências são apropriadas para auxiliar na separação de informação confiáveis de livre acesso. No entanto, quando falamos no Direito em Saúde Baseada em Evidências se faz necessário algumas diretrizes para uma boa estruturação de perguntas de pesquisa para melhor uso de base de dados factíveis. Objetivo: demostrar como formular perguntas no campo da judicialização da saúde e como buscar evidências da literatura científica para melhor instruir processos. Métodos: revisão de artigos referente ao campo de sistematização de pesquisa científica para tomada de decisões e caracterização das opções de perguntas existentes e bases de dados relevantes. Resultados: Existem quatro métodos para elaboração de uma pergunta estruturada contendo informações sobre População, Intervenção, Comparador, Outcomes (desfechos), sendo os acrônimos PICO, SPIDER, SPICE, ECLIPSE os mais usados. A formulação da pergunta subsidia de forma mais adequada a busca nos diferentes tipos de bases da literatura. Essas bases podem ser de estudos de síntese e revisões sistemáticas; bases da literatura gerais; bases de produção técnica científica específicas; bases de dados consideradas literatura cinza e bases de guias e diretrizes clinicas. Conclusão: o uso de evidencias cientificas tem se tornado cada vez mais necessário com a judicialização requerendo a prática de fazer perguntas para buscar respostas na literatura científica visando instruir processos judiciais no campo da saúde.

Introduction:São Paulo city in Brazil has implemented social and health care for homeless people with pulmonary tuberculosis since 2007. We conducted a health technology assessment (HTA) of the interventions provided based on a national theoretical model using 2015 data and an overview of systematic reviews. The HTA was requested by national policymakers. The results demonstrated that the interventions for pulmonary tuberculosis were satisfactory. The municipal secretariat implemented actions to improve the national treatment recommendations and adopted incentives to increase adherence to treatments. Our objective was to describe the feedback process for the Health Secretariat.Methods:The feedback was categorized as: (i) an executive abstract with key messages (i.e. ninety-seven percent of notified cases underwent sputum smears, nineteen percent were hospitalized, and fifty-nine percent were cured) reported to policymakers involved in the surveillance program; and (ii) three meetings were organized jointly by the research group and local policymakers.Results:In 2016 we conducted a meeting to present the results. Thirty-nine professionals involved in the primary care team working on the streets (thirty-five percent) and the Tuberculosis Surveillance and Control Program (five percent) were present. The main barriers presented by the professionals were issues of human resources (i.e. suboptimal professional staff and having two different social organizations responsible for health care). The main facilitators presented by professionals were: (i) using homeless-peers as healthcare workers; (ii) having a network linking the primary care and surveillance programs; and (iii) periodic training.Conclusions:In addition to the positive results, the HTA presented an opportunity to discuss the sustainability of incentives for adhering to treatments adopted by the policymakers, such as meal allowances and housing support, to improve social conditions among the homeless.

Introduction:The Federal District in Brazil has about 2.9 million inhabitants and the public health system is focused on medical specialties, with one university hospital and twenty regional hospitals. This ecosystem is favorable for fostering health technology assessment (HTA) to improve the efficiency and effectiveness of health care. The objective was to identify institutions that could form a HTA network to support decision-oriented evidence in the public health system.Methods:Stakeholders from the hospitals and training/research institutions in the Federal District were surveyed. An online questionnaire (Google Docs) was developed to identify the potential and capacity of institutions to analyze or produce clinical and economic evidence. Two HTA seminars were held to spread knowledge about HTA and to encourage stakeholders to complete the survey.Results:The questionnaire response rate was thirty-five percent (25/70). Fifteen institutions were cited by the respondents as having the potential to build a HTA network. Twelve of the institutions produced rapid reviews and clinical guidelines, but only three of these had an organized priority setting process or produced assessments at the request of the hospital manager. The challenges identified were training and willingness of decision makers to organize HTA units in the hospitals.Conclusions:An executive group was created which defined a strategy to support the implementation of HTA units as part of the HTA National Network (REBRATS). A regulation proposal was also created to encourage decision makers to activate a HTA network in the Federal District.

Introduction:We conducted health technology assessments (HTAs) of the interventions used between 2012 and 2014 to improve the treatment of homeless people with pulmonary tuberculosis in the Federal District of Brazil. The HTA, which was not ordered by policymakers, was based on the evidence-based national theoretical model compared with local interventions indicated in focus groups, semi-structured interviews, and secondary data produced by the Health Secretariat. The results demonstrated that the implementation of the interventions was unsatisfactory. Our objective was to present the feedback process for policymakers and the Health Secretariat, particularly its challenges.Methods:The feedback was categorized as: (i) an executive abstract with key messages (i.e. underreporting of cases in the surveillance system, lack of primary care, and underestimation of the health problem) reported to policymakers involved in the surveillance and healthcare systems; and (ii) oral presentations in eight meetings organized by the research group and local policymakers.Results:Between 2016 and 2017 we conducted eight feedback meetings. All of the professionals (n = 8) involved in the Tuberculosis Surveillance and Control Program were present in at least one of the meetings, but healthcare professionals and the Secretary of Health did not participate. The barriers presented by the professionals were: (i) lack of material resources (i.e. cars and gas, phones, diagnostic tests, medications); (ii) lack of human resources (i.e. suboptimal professional staff); and (iii) feeling insecure when performing extramural activities due to the potentially unsafe work environment.Conclusions:Gathering feedback on a HTA that was not ordered by policy makers can be a challenge. Mainly we demonstrated a negative result on research done in a vulnerable population with a neglected disease, in this case tuberculosis. However, this provided an opportunity for professionals in the surveillance system to discuss the challenges of implementing tuberculosis control among the homeless population.