Trajectory of the 15 years of implementation of the School Health Program in Brazil

ABSTRACT The aim of this study is to analyze the evolution of the implementation of the School Health Program (PSE) over its 15 years in Brazil. A mixed methodological approach was used, involving a combination of document analysis and ecological study with secondary data from 2007 to 2021 recorded in the historical process of implementing the PSE in Brazil. It was observed that in these fifteen years the PSE has advanced not only significantly impacting the percentage of municipalities that joined the Program, but also in its structure and format, having the territory as the main locus of its development, and the articulation between health and education as the driving strategy of local arrangements. Furthermore, the PSE’s intersectoral management model helps the articulation of health and education networks in an interfederative manner. Therefore, this historical analysis gives an overview of school health in Brazil from the perspective of the PSE and provides the perspective of improvement necessary for the sustainable and qualified continuity of the Program.摘要 本研究旨在分析巴西学校卫生项目（School Health Program，PSE）实施15年来的发展演进历程。本研究采用混合研究方法，结合文献分析与生态学研究设计，使用2007年至2021年巴西PSE实施历史进程中收录的二手数据。研究观察到，在这15年间，PSE不仅在参与项目的市政辖区占比层面实现了显著提升，其结构与形式也得到了完善；项目以地域空间为发展的核心场域，并将卫生与教育领域的协同联动作为地方治理安排的核心驱动策略。此外，PSE的跨部门管理模式有助于以联邦制跨层级协同的方式，推动卫生与教育网络的联动整合。综上，本历史分析从PSE的视角梳理了巴西学校卫生工作的整体脉络，并为该项目的可持续、高质量延续提供了必要的优化方向。