Salud Colectiva最新文献

How urban Chinese women understand and morally evaluate surrogacy remains an insufficiently explored area, despite the persistence of this practice in clandestine forms under a strict legal ban in China. From the perspective of moral sociology, this qualitative study foregrounds these overlooked voices through semi-structured interviews with 24 women in Nanjing, conducted between May and July 2025. The findings reveal a form of "pragmatic ambivalence": rather than holding binary positions of approval or rejection, participants articulate a nuanced and context-dependent stance. This stance is shaped by three key dimensions: (1) embodied reproductive experiences that heighten ethical sensitivity; (2) fertility pressures and practical reproductive needs that drive conditional support; and (3) legal prohibition and dominant moral norms that reinforce structural skepticism. We argue that women's attitudes do not constitute abstract choices, but are situated within the tension between bodily autonomy and familial obligation.

The rise in the population experiencing homelessness has become one of the defining social contradictions of our time. In Brazil, this increase persists even in the face of positive outcomes from economic and social assistance policies aimed at reducing poverty, underscoring the phenomenon's multicausal nature. The essay reconstructs the historicity of the dispositifs of normalization, governmentality, and counter-right, showing how bare life is actualized in territories where the state of exception operates as rule. Building on this foundation, it analyzes the multiple dimensions - economic, political, racial, security-related, and care-related - that converge in the growth of homelessness in Brazil, emphasizing the structural production of expropriation, precarization, and wounded subjectivities; while also highlighting the creative and political vitality of favelas and peripheral territories, the emergence of insurgent citizenships, and forms of territorial self-governance that challenge the neoliberal order. Finally, it proposes care, solidarity, and the commons as transformative horizons capable of reorienting the State toward a pedagogical and dialogical model grounded in radical democratization and in the reconstruction of social bonds based on justice, autonomy, and respect for human rights.

In an adult-centered and adultist culture, state interventions addressing violations of the rights of children and adolescents are grounded in a paternalistic view that limits their ability to exercise autonomy, despite international treaties that guarantee it. In Chile, there are protection and reintegration programs that intervene according to the needs identified at the family, community, and institutional levels, including health-related needs. This exploratory qualitative study analyzed 13 interviews with health professionals experienced in adolescent care, conducted in the Metropolitan Region between April 2022 and April 2023, identifying the coexistence of two care perspectives: a paternalistic one, centered on adult accompaniment, and another oriented toward fostering autonomy and the exercise of rights. The paternalistic perspective is based on perceptions of risk and trauma, which may restrict autonomy in sexual and reproductive health. The study suggests that healthcare workers should integrate an intersectional approach to ensure relevant and nonjudgmental sexual and reproductive health care, incorporating the relational dimension of autonomy, particularly for vulnerable and priority groups.

This article offers a critique of the hegemony of the factory model as the organizational matrix of social institutions. This factory model has hindered an understanding of both the ontological complexity of the social world and the singularity of territories. Drawing on a theoretical articulation that includes contributions from Nietzsche, Spinoza, Bourdieu, Elias, Santos, Deleuze and Guattari, as well as traditions from critical geography and institutional analysis, the text argues that the uncritical adoption of the industrial paradigm dehumanizes and fragments social problems, reinforcing the reproduction of social inequalities. It examines how, in the nineteenth century, the relationships between states and professionals developed within "processes of integration and differentiation" that excluded territories. In contrast, the article underscores the need to design small-scale, rhizomatic, relational, and playful institutional arrangements capable of engaging with situated forms of knowledge and strengthening processes of publicizing social problems within territories. The article concludes that transforming social fields requires abandoning the factory imaginary, recovering the artisanal character of social work, and building institutions rooted in the power of territories, proposing that "the way out of the labyrinth is from above."

In Chile, childhood rehabilitation is recognized as a right supported by regulatory frameworks. However, its implementation presents limitations that restrict access and continuity of care, and the experiences and strategies of women caregivers who use the system have received limited attention in the design and evaluation of public policies. In this context, this article characterizes the therapeutic rehabilitation pathways of children with disabilities in the western area of Santiago, Chile, from the perspective of their primary caregivers. Between August 2023 and March 2024, drawing on a qualitative methodology with an ethnographic approach, participant-observation accompaniment, recorded in field notes, and semistructured interviews were conducted with 13 women. The findings reveal fragmented trajectories marked by multiple barriers to access, a high burden of family management, and discontinuities in care. Four key moments were identified: suspicion and diagnosis, institutional transitions, development of interventions, and therapeutic discharge. Caregivers sustain care processes through everyday strategies that integrate public, community-based, and private forms of support. Within this framework, the article discusses the limitations of current public policies and reinterprets rehabilitation as a contextualized practice sustained by affective and unequal care networks.

From a gender perspective, this study examines how women seek help in response to experiences of intimate partner violence, distinguishing between dynamics of intimate terrorism and situational violence in a rural community in Chiapas, Mexico. A probabilistic study was conducted between July and August 2017 with the participation of 141 women aged 15 years and older, using an adaptation of the National Survey on the Dynamics of Household Relationships (ENDIREH). In addition, from July to December 2017, in-depth interviews were conducted with intentionally selected women and local leaders, along with participant observation. Among survivors, 59% disclosed the violence, and only 7.1% sought formal help, mainly those who experienced intimate terrorism. Most sought help from their families, and 78.9% felt supported by them; this support included emotional assistance, confronting aggressors, and protecting women. Emotions such as fear and shame, impunity, traditional gender norms, socioeconomic factors, and restricted social networks inhibit help-seeking. In this context, community health programs can play a key role in strengthening social networks and providing care.

In this article, we inquire into how mental health praxis reproduces stigma toward users of mental health centers in the Biobío Region of Chile, focusing on the relational space of interactions where stigma is expressed and sustained. Based on a qualitative research design with an ethnographic approach, from June to September 2018 we conducted participant observation in both formal and informal contexts of health services, as well as ethnographic and semi-structured interviews. We identified a persistent tension between the community mental health model promoted by public health policies and biomedical approaches to the care of users with psychiatric diagnoses. These tensions shape the daily practice of health personnel and, consequently, the type of interventions that users receive in their interactions and participation within health services. They manifest in at least two dimensions: first, in the predominance of the biomedical model over other medical practices, which impacts and constrains the exercise of professional roles; and second, in the working conditions faced by mental health professionals, which lead them to experience burnout. We argue that both dimensions, in their interrelation, influence trajectories of mental health care and contribute to the reproduction of stigma toward people living with mental health conditions.

Drawing on critical theory and philosophical hermeneutics, this essay examines the processes of industrialization and "cobotization" of scientific practice, understood as the incorporation of generative artificial intelligence into the production and validation of scientific knowledge. The text addresses, first, the narrative objects of science, understood as devices for building consensus within scientific communities; second, the effects of the industrialization of scientific practice, the expansion of the scientific-editorial industrial complex, and the loss of the social meaning of the text; and third, the shift from industrialization to cobotization, both in the interpretive experience of science and in the processes of scientific validation that technify communicative action. These processes, which erode and disarticulate language communities, highlight the need to recover the interpretive experience as an intrinsically human action and to revalue our own environments of scientific validation, in order to restore the relational, situated, and reflective character of communicative action that is intrinsic to the narrative objects of science.

Food and nutrition education interventions in Mexican basic education schools have focused on conveying information and targeting children, but they overlook determinants of learning eating habits, such as compliance with or violation of official regulations on food offerings in schools. This article describes the results of an educational intervention aimed at promoting regulatory compliance favorable to food and nutrition education in four public basic education schools in the central region of Mexico, directed at teachers and cooks who shape the school food environment on a daily basis. A comparative case study was conducted from 2021 to 2023 through a series of thematic workshops with a constructivist approach, adapted to a previously reported diagnosis, and addressed to a total of 38 teachers, 8 cooks, and 105 occasional attendees (students' family members). The impact of the workshops was evaluated through an ex-post analysis of weaknesses, threats, strengths, and opportunities, as well as hypothesis testing on changes in the daily school menus offered. The consistent attendance of the same participants in the workshop sessions contributed to significant improvements in the nutritional quality of the menus offered, and the strategies generated in the workshops by teachers and cooks to intervene daily in their environment proved to be the most effective. Workshops with constantly changing attendees involved more members of the community but had less impact on regulatory compliance favorable to food and nutrition education.