The Performance as Educator in the Health System : Implications for Brazilian Health Workers Education Process

This paper has the purpose of discussing the performance as health educators in the Brazilian Unified Health System (SUS) and also emphasizing the importance of the educational process for health workforce qualification as well as management device of health systems. This performance has been a strong strategy for SUS implementation process in Brazil.


Introduction
The processes of continuing education of health professionals are recognized as key strategies to achieve the development of health systems (OMS, 2007).Such processes are also related to the achievement of the millennium development goals (MDGs), as are a prerequisite for improving the planning, as well facilitating interactions between areas and sectors, particularly health and education (WHO, 2013).
The Alliance for Workforce Health (GHWA) established in 2006, linked to the World Health Organization (WHO), has expressed the challenge to develop proposals to extend universal health coverage on a global level by policies qualifying and increasing the number of health workers (Noronha, 2013).
In this context, the aim of this article is to discuss the relationship between the health and education fields, and the professional practice as educators in both areas.
For this discussion, initially, I will present my understanding about education, dialoguing with authors with international recognition, which express different views and dimensions of this concept.After that, I'll identify and differentiate the processes of work in the health field, emphasizing the educational dimension in each of them, as well as the important performance of educators.Finally, I'll focus on the performance as health educators given their cooperation to the management of universal health systems, having the Brazilian Unified Health System (SUS) as an example.
The primary issue is to understand education as one of the most complex human's characteristics and the central point of humanity's development.Thus, it is its function to be the specific strategy chosen by our specie to rescue all the production that has been made all over time in order to make it accessible to future generations.This includes different kind of knowledge, ideas, symbols, customs and skills developed by men in the process of transforming the nature and the human production (Saviani, 2003).It is important to recognize that education happens in different socials spaces.It is an original family responsibility, that is after being developed by other institutions as the church, the school, other social groups and the work.
For Dewey, the education's purpose is the social and economic development.Thus, education is a condition necessary to achieve it.According to this view, education has a socialization and an individualization meaning, with emphasis in the subjectivity, as well as in the consensus of adaptation (Saviani, 1986).
Freire, on the other hand, considers education as a tool for making individuals capable of interpreting the world they live in, realizing the relationships established between them, making use of communication and action in order to reject any condition of accommodation.Men in collaboration with other men must build a story toward the transformation of social reality.Thus, education means political consciousness and transformation (Freire, 2005).
For Saviani, the purpose of education is to promote humanity.Thus, the human existence, "becoming a man" is learned in the relations established by men, and transmitted to the new generations through educational action (Saviani, 2007).This process makes humans be able to understand all the elements of your situation to act on it, towards expansion of freedom, communication and collaboration between men (Saviani, 1986).
Based upon the contribution of the above authors, education is seen in a critical perspective as a characteristic of the human species, a social value and a right of every citizen going beyond the acquisition of knowledge for solving problems or for development of skills required for the job.According to this line of thought the education's purpose is the full development of a person, reaching all human potentialities (Saviani, 2003).Consequently, to be "an educator" means to be conscious that this job isn't a neuter position.
What is the contribution of this view of education in order to identify the practices of professionals as health educators?
We could say it is to direct the work in the health field with potential of transforming and in a fairer way.
In the health field it is possible to identify four major areas of work: the teaching, the research, the assistance and the management processes (Queiroz & Salum, 1996).Although each one has a particular process producing different results, for all of them, education is the specific instrument that intersects all the processes, becoming it possible the update of knowledge, the staff's qualification as well as the changes required in the health practice.

The Teaching Process
Since 1990, with the regularization of the Brazilian Unified Health System (SUS), many policies have been created in order to organize the formation of the health labor force.The main objective of the proposed educational process is to be very close to the services organizations and the population health needs.The Ministry of Education in Brazil and a team formed by Teachers, Undergraduate Coordinators, Graduate Coordinators and health professionals were involved in several arrangements, being the most important points: changing in curriculums of all health courses, the early practical experiences in the health services and adequate knowledge about SUS policies, as historical and structural bases.It has been developed as a continuing process that requires professional's competency in the educational system, and a careful organization of the health services in order to achieve the purposed challenges (Sarreta, 2009).Some actors of this process have always performed as educator when supporting the fight of health professionals and the population to assure the SUS as a social right and a universal policy.

The Research Process
Living in a modern society is extremely complex and the health field within this context is not different.There is a whole range of relations involving feelings, environment, products, technologies, foods, medicines, diseases and work conditions that need to be known, measured and quite controlled.I believe the research process does this role and offers to the persons, in general, and to health professionals, in particular, a large and constant knowledge production.Everyone that has acting on this condition should move his thoughts and his practices.These movements need an actor, the educator.It is his responsibility to prepare researchers that can ask the right questions to the reality and discover ways how to answer them, making life easier, pleasant, healthy and fairer.Thus, it is not enough for researchers to produce any kind of knowledge, but it is essential that they understand who will be benefit from it.

The Assistance Process
This work has been evaluated as the most important in the health field.Many efforts have been directed to it, as well as it has been recognized as the priority for health professional practice.Currently, this discussion has becoming even more relevant to the health systems organization's focus (Starfield, 2002).Thus, several protagonists have been concerned about transforming health practices according to the Brazilian Health Reform's principles.At the same time, others political subjects have been developing strategies to approach the labor force formation and the health services organization connecting both to the learning and teaching processes in order to form professionals for the SUS (Ceccim & Feuerwerker, 2004).
These protagonists at the services and the political subjects in the educational system have ethical and political commitments with the health system organization and the performance as educators.

The Management Process
This process represents a strong strategy for the consolidation of the health system.It brings in the development of daily actions, the influences, the joints and the inherent conflicts to the other processes of the field: the assistance, the education and the research.The management of a health service not only expresses the standard of care required, as well the efforts the professionals make use to better qualify them to respond to the requirements of their position.To qualify the assistance as well as achieving excellence in management there is a need of professionals acting as educators.Their responsibilities are assuring not only particular situations to develop the learning of the health staff, but also to recognize the professionals with specific potentialities so they can offer the best possible assistance to the population.The management process should reveal the health system policies and the field organization knowledge (Ceccim & Feuerweker, 2004).

Conclusion
Thus, the performance as health educators has been a strong strategy for SUS implementation process in Brazil.This work, the educational process, represents one of the most important health system management devices.In each one of these processes, to be a health educator in a critical perspective means having commitments with justice and responsibility to offer specific strategies for teaching students, workers, researchers and the overall population about health's right.This practice has implications for the specific way to be and to see life, supporting people to achieve the highest human values: the health and education.I agree with Sarreta who discusses the importance of recognizing the educational process in daily work as a permanent challenge.