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Sala Aberta sobre o POM-S – Plano Operacional Municipal de Saúde de Adolescentes — Transcript

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0:00due to some activity, it will be made
0:03available later. So, let's go. Good
0:09morning, my people. Good morning. Good
0:10morning. Good morning to everyone.
0:12Coordinators and health mobilizers from
0:15the states of Alagoas, Paraíba, and
0:17Pernambuco. It is a joy to be here with
0:20you. The room is full, beautiful,
0:22blooming, and everyone is very anxious
0:24because this live stream was highly
0:26anticipated. A request in every group,
0:29right? It is indeed a need for us to be
0:32together on this agenda, as Grácio was
0:34already telling us. But I will pass the
0:38floor back to our coordinator so she
0:40can say good morning to you all and we
0:42can start this very beautiful movement
0:44here in favor of the health of children
0:47and adolescents, but above all
0:48adolescents today.
0:51So now for real, we were just chatting
0:53before, now it's for real. I want to
0:57reiterate what I said earlier, eh, in
1:00parallel, eh, first to thank, eh, the
1:03presence of all of you. An immense joy
1:08to be here, eh, to count on this
1:10partnership, on this complicity that we
1:13have, right? First with you, because
1:17you are there in the territory, eh, you
1:20are making it happen, but also this
1:23complicity, right, of those who believe
1:25in this transformation of care that
1:28promotes the well-being of adolescents,
1:31of adolescence, right? And then there
1:34is this complicity with UNICEF here in
1:36the person of Sâia, in the person of
1:38Aline. Eh, and it is truly nostalgic to
1:42talk about the longing we have for
1:43these moments, right? Of the in-person
1:46moments, the hugs, the affection. But I
1:50usually say that, eh, it is through
1:52affection that we manage to overcome
1:54challenges, because when we, eh, when
1:57we put in the, eh, the affection, right
1:59, eh, I think the cognitive functions
2:01better and we create strength, energy
2:03to seek it out. So, I am that person
2:07who believes and does things with great
2:09grace, with great faith. Those who know
2:12me know that, right? And that is what
2:14we want to present to you today, right?
2:17The importance of this moment, the
2:20importance of us talking, right, about
2:22this care, eh, for children and
2:24adolescents. And UNICEF, as I said,
2:29this material is a very important,
2:32necessary material, right? And it came,
2:37eh, to fulfill the role of an existing
2:39void, right, still, of, eh, in this
2:41partnership, because UNICEF is, in
2:44partnership with the Ministry of Health
2:46, too, right? Uh, it doesn't make sense
2:50to do anything beyond what is already
2:52in institutionalized public policy,
2:54right? So, uh, to reach this point,
2:58UNICEF was there with the ministry, and
3:02I want to thank UNICEF for this trust,
3:05but also, you know, for the fact that
3:08you believe in our work, and that
3:11strengthens us to keep moving forward.
3:15So, everyone, a very strong,
3:16affectionate hug to each and every one
3:18of you, right? I also want to make a
3:22note here, to give a hug to Flávio, to
3:24our team, right, who is here, and
3:26without them, we wouldn't have been
3:28able to get anywhere near where we are,
3:31right? So, Flávio, Karina, Eula, I
3:35don't know if there's anyone else from
3:38our group, Salete, uh, they're all here
3:40, anyway.
3:42I'm around, you know, Graça? Carlinha,
3:46I didn't hear you, but, uh, this is the
3:48team that's really in charge, that's
3:50with you in this dialogue. So, a big
3:54hug to the people of Alagoas, to the
3:56people of Pernambuco, and to the people
3:59of Paraíba. So, it's over to you now,
4:02everyone. Hugs, hugs, hugs.
4:06Thank you, Graça. Guys, it's a
4:07privilege, you know, to have Graça on
4:08the live stream, right? Thank you.
4:11Everything gets so lively, I missed
4:13Graça.
4:15But we really want to thank you for
4:17this support, for this presence. Uh, I
4:20also want to thank you for the presence
4:22today, you know, of Sâmia and Aline,
4:24who are health officers from UNICEF.
4:27Aline is already with us, always
4:29present in all the live streams. And
4:31Sâmia, you are very welcome in this
4:33space that welcomes you, right? People
4:37are very thirsty to learn more about
4:38this Pomes, to hear a little more about
4:40it. So, I'll pass the floor to you,
4:45thank you so much for this trust, and
4:47this partnership work has contributed a
4:49lot in our three states. Aline, the
4:53floor is yours. You are very welcome.
4:56Thank you. Guys, I'm super familiar
4:58with this. I feel at home when I come
5:00here to the Acert live streams and when
5:02I walk through the territories too, you
5:04know? I'll tell you a secret, I went on
5:06vacation, right? I went to visit
5:08Paraíba, Pernambuco, and a little bit
5:11of Alagoas, which I didn't have much
5:12time to talk about. And girl, I was
5:15walking around there and people were
5:17like, "Are you from UNICEF?" because it
5:20had been right after a live stream from
5:22here, I won't name names, but that
5:23happened, you see? It was really cool.
5:26Folks, I can't even buy a pair of jeans
5:28back in Caruaru, because people already
5:30recognize me from being on TV. Jokes
5:35aside, it's really great to be here
5:38with you all, and like Graça, I share
5:40this feeling, this satisfaction of
5:43doing something extremely unprecedented
5:46in our country, which is to look at our
5:49adolescents and let our work, our
5:51intention, make a real transformation
5:54in the lives of adolescents. So, I
5:58think this moment comes to, uh,
6:01effectively fill a gap in public
6:03policies, both national and
6:06international. So, UNICEF, in this role
6:10, wearing this hat as an international
6:13organization, has the commitment to
6:15tell everyone present that what we are
6:18doing is unprecedented and will have,
6:20and I am very confident in what I am
6:23about to say, a fundamental impact on
6:25future generations. I also need to tell
6:31you about our immense effort to reach
6:36this moment. And, echoing what I said
6:40earlier about how awaited and expected
6:44this is, I want to tell you that these
6:47processes also need time to mature. For
6:51us to reap the fruits, they need a
6:53maturation period, which is not always
6:56on the most obvious timelines. So, I
7:00think it arrived at the most mature
7:03moment, because any intention to have
7:05done this live broadcast earlier, the
7:07cashew would still be yellow, so it
7:10wouldn't have worked out very well. So,
7:14this idea that we are here today, on
7:16September 10th, making this collective
7:19movement, with everyone here very
7:21attentive to the issue of adolescent
7:23health, I think it comes at a very
7:25opportune time. And I want to
7:28congratulate ST, our implementing
7:30partner, for all this reach and
7:32articulation in involving everyone
7:35present here. So, without further ado,
7:39I want to say that today we will build
7:41these plans theoretically together with
7:44you: presenting how they were conceived
7:47and also the practical part, how it
7:50works in practice, where you will be
7:52able to find the information, what
7:55instruments you have available today,
7:58and what the deadline for this is and
8:00how you can execute this by the end of
8:03the year. And for this, I would like to
8:08invite my colleague Sâmia Abril, who
8:10is the adolescent health officer based
8:13in Brasília, who is here with us today
8:16to grace us with her knowledge and her
8:18contribution, right? She is one of the
8:22people responsible for this entire
8:23construction, for this whole creation.
8:27So I want to invite Sâmia to give this
8:29presentation, and afterwards, I’ll
8:31return here with you to talk a little
8:33about the practical terms, where we
8:35access the data, what we need to do,
8:37and what instruments we have available
8:39for you, all right? And also to talk
8:43about a topic that I speak about almost
8:45every time you see me, which is teenage
8:47pregnancy, right? So, we also have an
8:50intentional focus for the
8:52municipalities that are facing the most
8:54difficulties with this indicator.
8:57Teenage pregnancy is a UNICEF indicator
8:59. We have noticed municipalities that
9:03have rates of teenage pregnancy higher
9:05than the state average, higher than the
9:08national average. And for these
9:11municipalities, we want to have a very
9:13special and highly differentiated
9:15approach. And counting heavily on the
9:17partnership and enthusiasm of Graça,
9:19Eulalha, and the entire SED team, so we
9:22can get closer to understand the paths
9:24and think of solutions, all right? So,
9:27Sâmia, please, the floor is yours.
9:31Thank you, Aline. No, it's just great.
9:34To be here. I was thinking, you know,
9:36that I know Graça is elsewhere doing a
9:38thousand things, and I feel like
9:39bringing Graça closer. Graça, it’s
9:42great that you are managing, even
9:44amidst your many duties. To be here
9:48with us as well. I think whoever is
9:50bitten by the bug of adolescent health
9:53always wants to be close, right?
9:55Certainly. Interesting. We have this
9:58feeling that anyone working with
10:00adolescent health or working with
10:02adolescents cannot help but be involved
10:05, right? Because there is such great
10:08potential, such a great capacity for
10:10transformation, that there are these
10:11challenges, obviously, right? But these
10:15are more than fundamental challenges.
10:18We were, I was listening to you before
10:20starting the presentation, but I was
10:22thinking that we’ve had these several
10:24, many conversations with the Ministry
10:26of Health, Conas, CONASEMS, anyway,
10:28with all these partners about
10:30adolescent health. And then a
10:33reflection came that adolescent health
10:36can promote this new moment even for
10:39the SUS, right, because adolescence is
10:42just that, right? It keeps breaking
10:46boundaries, challenging things, saying:
10:48"Look, it's good, but not that good; we
10:50want more, we want better, it needs to
10:52improve here." So, I think this moment
10:56of adolescent health is also a time to
11:01I think, build and challenge, in a very
11:04adolescent way, an even better SUS,
11:06including for the adolescent years,
11:08right? So, uh, it's really great to be
11:10here. And if the goal was 70, you're
11:13doubling that goal, right? Because
11:15this is way up there. Congratulations,
11:19everyone. Uh, I'm going to share a
11:21presentation that I think just provides
11:23, you know, sometimes it's good to
11:25follow along visually. Ah, I'll try to
11:27be brief so we have more time for
11:29exchanges, right? And as Marine also
11:31mentioned about these, these, these
11:33themes here. Let me just find my
11:37presentation here. I already clicked it
11:41. Wait, hold on. It's not appearing for
11:56me here. Hold on, I think I'll have to
11:58go full screen, then. Just a minute,
12:04everyone. The usual things here. Done.
12:24Can you see my presentation now? Yes,
12:27yes. But it's not in presentation mode.
12:30Now it is, now it is.
12:34So, I think the first thing is to
12:36locate where this adolescent health
12:39part is, right, within the seal, we
12:41managed, I'll put this first, to place
12:44it with some focus, with more focus
12:46within systemic result one, right,
12:49which is health and nutrition. And then
12:52among the activities, there is activity
12:541.4. which is supporting the
12:57implementation of actions, services,
12:59and initiatives aimed at the
13:00comprehensive and integrated health of
13:02adolescents. And the document is a copy
13:05of this operational plan. Since we are
13:08adolescents and stay or still feel a
13:10bit like adolescents and keep thinking,
13:13uh, you know, about names, we said: "
13:15Wow, every time we talk about it, it
13:17will have to be the Municipal
13:19Operational Plan for Adolescent Health.
13:21" And we have affectionately called it
13:24"pompom." It's the health pompom. And
13:28this is the deliverable, uh, for
13:30systemic result one. It is one of the
13:32activities that must be submitted on
13:34the platform, on the PCJ, by 1/14. So
13:39that's it. So we usually call it
13:41affectionately, right, the health
13:43pompom. And, well, we kept talking. And
13:47, you know, Sert, L, Graça, so many
13:50people here, were super important in
13:52this building process. They were even
13:55here in Brasilia with us during the
13:56construction of this plan proposal.
14:00It's about how we could support the
14:01municipalities so that it would be the
14:03municipality's own plan, and not a plan
14:05that is sometimes more generic, you
14:07know, just with some information or
14:08other. How do we support the
14:11construction of this municipal plan? So
14:14, we saw that this plan would need to
14:17have data from their own municipality
14:19as a mandatory component, and it must
14:22include listening to adolescents. And
14:26so we challenge the municipalities a
14:28bit to conduct this listening, and are
14:30challenged back saying: "Look, how do
14:33we do it? Propose a model, you know, a
14:36guide, a starting point, and we'll
14:39figure out how we do it here." So,
14:43pragmatically, this delivery, which is
14:46the Municipal Operational Plan, must be
14:49submitted on the PCJ platform by
14:51December 14th. And it has some
14:55components, you know, that we are
14:57talking about, which are the essential,
14:59mandatory components: the
15:01municipality's data, not just general
15:03data, the listening of adolescents, you
15:05know, this record, and the
15:07prioritization of actions based on the
15:09data and the listening, right? And a
15:13final moment that we have called
15:15participatory validation, you know,
15:17that beyond listening to adolescents,
15:19we have to go back to them and tell
15:21them how this listening actually
15:23influenced, impacted, and was indeed
15:25heard by the management. So that's it.
15:30And in this, we were building a
15:32schedule throughout this year of
15:34support for partners and municipalities
15:37in the construction of this plan. So,
15:41in June, we did a live stream
15:42presenting the plan. Sônia Venanço,
15:46who is the national coordinator of
15:48child and adolescent health, sorry,
15:50from the Ministry of Health, was with
15:52us and explained what the proposal was
15:54for the whole year. In July, we made it
15:58available to partners. I hope the
16:00municipalities received it. I can't see
16:02you, everyone. I'm sharing my entire
16:04screen. So, if anyone wants to speak to
16:06me, you'll have to say so because I
16:07won't be able to see you. But we can
16:10clear up this doubt later. For each
16:13municipality, we generated data here in
16:16Brasilia for four indicators for all
16:19municipalities. It was one PDF per
16:22municipality, so there were 2,277 PDFs
16:27generated, where we have the
16:28municipality's data, and this was made
16:31available to partners and to the
16:33municipalities. We expect to continue
16:35next. And then we anticipate this third
16:39moment, which is where we are now,
16:41which is planning and listening to
16:43adolescents. And for this, as I
16:47mentioned, we received feedback from
16:49municipal partners saying: "Look,
16:51create some material, some support
16:53material on how to listen, how to do
16:55this safely for adolescents, and how to
16:58do it in a careful, qualified way." So,
17:01we are going to show you this moment.
17:04And we are planning for October or
17:06November this moment we are calling the
17:09validation of priorities, which is what
17:11? I’ve seen my data, I’ve listened
17:15to the adolescents, what is the
17:16priority? Because adolescence is a
17:18whole world, right? Will I prioritize
17:20mental health? Will I prioritize sexual
17:22and reproductive health? Will I
17:24prioritize teenage pregnancy? Will I
17:27prioritize immunization, nutrition,
17:29prevention? And promotion of parenting
17:32culture, violence prevention; anyway,
17:35for prioritization based on your
17:37municipality's data and this listening
17:39process. And then for the final stretch
17:43, we'll hold our Q&A sessions, perform
17:45reviews, and submit on the platform by
17:47the 14th. Well, for moment two, which
17:52is the data phase, each municipality,
17:55as I said, I hope has received it. If
17:59you haven't received it, I know it's
18:02easy to submit your data for four
18:05indicators, four pieces of information:
18:08your teenage pregnancy data, HPV
18:10vaccination coverage, how referrals
18:16happen in cases of reported violence,
18:18and the percentage of adolescents who
18:21are overweight or obese. Later, if you
18:25want, I can even show you how this PDF
18:27turned out, but it's quite interesting
18:29because it has a summary sheet for each
18:31municipality with these four data
18:33points, as well as some historical
18:35graphs, right? Oh, is teenage pregnancy
18:37in my municipality going up? Is it
18:40going down? Is HPV vaccination coverage
18:42also going up or down in recent years?
18:45Whenever possible, we included a
18:48breakdown by race. So, is it higher
18:52among Black or Indigenous populations?
18:56Right? The data we have also, whenever
18:58possible, we made this differentiation.
19:01Oh, the gender data, right? When, for
19:04example, regarding HPV, obesity, or the
19:06referral process itself, does this
19:07happen more with girls or boys? So,
19:10whenever data was available in the
19:12system, we performed these breakdowns,
19:14also understanding that there are
19:16various adolescences, right? It's not
19:19just adolescence or the adolescent;
19:21there is the male adolescent, the
19:22female adolescent, the adolescent in an
19:24urban context, a rural context, an
19:26indigenous context, a quilombola
19:28context. So, we tried as much as the
19:31information systems allowed to generate
19:34this data. So, repeating myself here, I
19:37know I'm being very repetitive, but I
19:39want to reinforce this. If you, if your
19:42municipality hasn't received this data
19:44yet, it is available. So, each
19:47municipality has its own PDF with its
19:49data on pregnancy, HPV coverage,
19:52violence notification referrals, and
19:54overweight.
19:57Samia, just to collaborate, because
19:58people are mentioning in the chat, we
20:00have already pointed out in the
20:01communication groups that the data is
20:03on the PCJ, in the systemic result area
20:05, right? One, the data is available
20:07there, as Samia is showing on the slide
20:09.
20:09Exactly. I was going to say, if you
20:11haven't accessed it yet, it's there on
20:12the PCJ. Thank you, Lália. And, ah, so
20:16this is the link, I can make this
20:18presentation available later. But it's
20:21there on the PCJ in that location,
20:23right? Classroom. Inside there, under
20:27systemic results, you'll have nutrition
20:30rooms, data, poms, reports, overviews,
20:33and inside those, the states, right?
20:36Then you go by alphabetical order, Acre
20:38, Alagoas, and so on. You click on the
20:41state, then you click on the
20:43municipality, and inside there will be
20:45the PDF for your city. So it's on the
20:48PCJ, and I know that CERT can provide
20:51support if you need any help finding
20:53this data, but it's there, that's the
20:55way to find the data. Well, and now we
21:00are at this third moment that we have
21:03been calling listening to adolescents.
21:07I think those of us who have been
21:09working with adolescents, who have been
21:11bitten by the bug—or rather, truly
21:13engaged—of being with adolescents,
21:15know there's no way to do anything for
21:17adolescents without adolescents, right?
21:20So, it is fundamental that we have
21:23adolescents involved in the
21:25construction of their own demands,
21:28their needs, and how they also indicate
21:31that these needs can be met. And so,
21:35for this, we created a guide that I
21:37imagine is also circulating. It should
21:40be available on the PCJ in the coming
21:42days, as there is a little internal
21:45time needed for the technologies to be
21:47ready. Uh, but this guide already
21:51exists, and it's a guide for
21:53participatory listening to adolescents
21:55within the logic of comprehensive and
21:57integrated health. Well, re-mapping, I
22:02imagine you've already had access to
22:04this; we made a practical guide for
22:07municipalities on building the POMS,
22:09which is the one with this beautiful
22:11boy's face here, which I also imagine
22:14is circulating. And in there, it has
22:17all this information I brought, the
22:19moments, the timing, what is needed.
22:21And I just wanted to show you that the
22:23listening part is here, right? Where we
22:26are, you are here, so we know the
22:28proposal, you received the baseline for
22:30your municipality, and if you haven't,
22:32you can access it now through the PCJ.
22:35And we
22:37Sami, just give me a minute. I think it
22:39would be worth it before we get into
22:41the listening part. Eulália is already
22:44ready to show the PDF as you were
22:47mentioning. I think it would be worth
22:49it.
22:50Let me just. It's because I can't see
22:51you. Let me just stop sharing now for
22:54you.
22:54Okay. Okay. Just so that before we move
22:58on to the listening guide, I can direct
23:01you on where we see the plans or, sorry
23:04, the baseline data. Please, Eulália.
23:07Okay, let me just
23:09to show it on the PCJ. Actually, the
23:12coordinators are very efficient;
23:14they've already put the link in the
23:15chat. They are quick.
23:18And when you go in there, mine is a
23:20little different from yours because we
23:23have the three states to access. It's
23:25that I'm in Alagoas, but if you look
23:27here at systemic result one, here are
23:30the POMS data, and here you have the
23:32panorama report, right? It will open,
23:35and here there is, we are only seeing
23:43the PCJ now
23:45here, isn't that right? Click on the
23:46panorama report and it will open
23:48this. The panorama will open. And here
23:50you have all the cities. Page, we are
23:53not seeing the other cities.
23:56Oh, it doesn't open
23:57no. We are frozen on the PCJ because I
24:01think you shared the PCJ screen. Now it
24:03worked. Now it worked.
24:06Here we have all the cities. So you
24:09click on your municipality, open it,
24:11download the PDF, and it will have all
24:14the information on the four indicators
24:16I mentioned.
24:18Could you open one just so we can show
24:20how it's structured? Eulália, thank
24:23you. Look, we have here come birth,
24:32health, nutrition, and protection data,
24:34and data separated by municipality,
24:37look, it's very complete. And one of
24:43the things that is quite interesting
24:45for you to see is that you will see
24:47both the 2025 snapshot, which is where
24:50we use this information, and you can
24:52also see the time series for some
24:54indicators. This gives you information
25:00like, look, this time series is
25:02increasing, so these are actions we
25:05need to focus on; this one is
25:08decreasing, so let's see what good
25:11practices we are doing that led to this
25:14result. So, this material is a very
25:19useful instrument for you to use in
25:22your daily work, but especially now in
25:26the development of adolescent health
25:30plans. This part of looking at the data
25:34is what we call here at UNICEF, you
25:37know, evidence-based management or
25:39data-based management, because, based
25:42on the data, we reflect, set actions,
25:45and determine which activities would
25:47impact each of these four indicators,
25:50initially set out. Please, Lelôia,
25:54scroll back up to the top, I
25:55accidentally closed it here, just a
25:57minute,
25:58okay? I think also, just an observation
26:04: while Lal is opening it, these data
26:07are from information systems, so they
26:09are not confidential data, nor are they
26:12data that UNICEF generated. They are
26:15data from the Ministry of Health's
26:17information system, which are available
26:18, right? They are open data, and we
26:21just organized them by municipality.
26:24And that's what I was showing there,
26:25Sami, that all the sources are right
26:27below, right? The municipality can even
26:30look at its own territory.
26:33Can you make it a little bigger? I
26:35don't know if it's me because I'm
26:36without glasses and can't see well, but
26:38maybe increase it a little. It's really
26:40small. That's better, right?
26:43That's perfect. So now, for example,
26:45here in the municipality, which one is
26:48this?
26:48Água Branca.
26:49Uh, Água Branca in Alagoas. So we...
26:53Água Branca is here; I don't think we
26:55are exposing Água Branca, we are just
26:57using you as an example, because after
26:59all, it's the first one in the roll
27:01call, Alagoas and Água Branca, right?
27:05So it has...So here, for example, the
27:08adolescent pregnancy indicator is 14.9
27:11in 2025, but further down you can see
27:14its time series. The same thing for HPV
27:17immunization. And then, uh, you can
27:21also see it broken down by age group
27:23and by boys and girls for nutrition
27:26regarding the percentage of adolescents
27:28who are overweight. And finally, just
27:32go back there, look, in the four
27:35quadrants that I, uh, here is the issue
27:38of referrals to the Child Protective
27:40Services. So, these are cases of
27:44violence reported in the municipality,
27:46and here is the percentage of cases
27:48that were referred to the Child
27:50Protective Services. So these are the
27:54four indicators that you will now have
27:56in hand to reflect on, think about, and
27:58propose actions. Now, Aulália, let's
28:01go further down, please, to look at the
28:07historical series. So here, for example
28:11, is the historical series for Água
28:13Branca regarding births to mothers
28:15under 20 years old. You can scroll down
28:18, please. Notice there's a decline,
28:22right? There was a decline in '23, it
28:25increased in '24, and it didn't manage,
28:28you know, to decline further in 2025.
28:30There we go. For Água Branca, it might
28:32be interesting to think about why,
28:34right, because they had already
28:36achieved a reduction in adolescent
28:38pregnancy in '23, but it started to
28:40rise again. What could it be? What are
28:42the challenges posed here? The next one
28:45, you can keep going, Lália. I wanted
28:47to show the immunization one, even to
28:49clarify, because it can raise a lot of
28:51questions. Let's go. Uh, here this
28:55graph, oops, this bar one.
28:57This immunization. That's it.
28:58Exactly. This bar one here. Uh, it is
29:01showing immunization by age group and
29:05by boys and girls. So, look, the
29:08lighter blue part, uh, is the girls
29:11immunized, and the dark part is the
29:14boys immunized according to the
29:16vaccine's age range, which is 9 to 14.
29:21So, look there, at 9 years old, boys
29:24and girls stay there, right, in 2025
29:26with 60%coverage. Uh, at 10 years old,
29:31the girls start to stand out, right? In
29:342025, boys are at 60%. 11-year-old boys
29:39and girls are at 71%and 69%. At 12
29:42years old, right, there is this
29:44differentiation. At 13 years old, even
29:48more so. And at 14 years old, it
29:49becomes more pronounced. So, Água
29:52Branca has an immunization percentage
29:54of over 100%for its girls because, very
29:57likely, Água Branca receives people
29:59from other, uh, other municipalities to
30:02get immunized. But all these girls, in
30:06theory, right, were immunized in Água
30:09Branca, whereas the boys are there in
30:11the 63%range. So this is also something
30:16for you to reflect on when building
30:18your operational plans. You can move on
30:20a bit more because now I’m going to
30:22talk about the Guardianship Council.
30:26And here you will see the entire
30:27historical series for immunization. Oh,
30:29sorry, for for nutrition. Nutrition.
30:31Look, me, a nutritionist, and not
30:33wearing my hat. Look at that, my lab
30:36coat. Here it is regarding excess
30:39weight. So, we see that the issue of
30:42excess weight, right, for boys and
30:45girls is around 23%. But I wanted to
30:49make a comment here. We are not asking
30:52for increased coverage for adolescents.
30:54That is not our focus. You remember
31:00very well that as an indicator for
31:03UNICEF, right? Food and nutrition
31:06surveillance, weight and height of
31:08children up to 10 years old. So
31:10adolescents are not part of this. But
31:14as you have heard me say a few times,
31:17the greater the coverage, the more
31:19reliable these data are, because what
31:22have we noticed, right? Uh, high high
31:27percentages of excess weight, because
31:30very very likely there is a measurement
31:32bias there, meaning only those
31:34adolescents with excess weight or
31:37obesity are being evaluated. The others
31:40are not being entered into the system.
31:42So our goal here is to address excess
31:45weight and obesity. But I wanted to
31:48sound an alert here for you that it
31:50will also be important to increase
31:53weight and height, measuring the weight
31:56and height of adolescents in
31:58information systems. It is not a
32:00mandatory task from UNICEF. I will say
32:03it again so I’m not looked at badly
32:05here by you. Oh, UNICEF asked for one
32:08more thing. We are not asking. I am
32:11just saying that for this type of
32:13indicator, it can be quite useful to
32:15think of actions that increase coverage
32:17so that you have more realistic data on
32:20excess weight, but it doesn't prevent
32:22you from, right, taking actions and
32:24thinking of activities focused on the
32:27issue of excess weight. Now yes,
32:30Eulália, please, now the referral to
32:32the Guardianship Council, which is the
32:34violence notifications. So, what do we
32:37see here? You can just stop here. We
32:40had two cases notified in Água Branca,
32:43right, of situations of violence
32:45against children and adolescents or,
32:47sorry, against adolescents. And so what
32:51did we see, that only one of them, half
32:53, right, 50%, was referred to the
32:55Guardianship Council. The practice of
32:59referring cases to the Child Protective
33:02Services should be a guideline, a
33:04protocol; meaning, if there has been a
33:07violation of a child's rights, the
33:09Child Protective Services is the entity
33:12, the body responsible for being the
33:14guardian of the Statute of the Child
33:17and Adolescent, and of the human rights
33:20regulations regarding children and
33:22adolescents. So, what we hope for in
33:26this regard is that municipalities also
33:29look at their data, and reflect on how
33:32this empowerment of health
33:34professionals to make the notification
33:37has been going, and for this
33:39notification to, in fact, follow the
33:41communication flow to the Child
33:44Protective Services. So, having said
33:48that, you will then access your
33:51instruments. We are also very available
33:55to clarify things that may not have
33:57been very clear, right? So, through
34:00Lalia, Eulalia always lets me know as
34:03well. So, whatever information is more
34:06complex, we are fully available. And,
34:08at the end, on the last page, besides
34:11this part that Oláia is showing, which
34:15is where each of the indicators is, and
34:18from which information systems they
34:21were taken, here we have a summary;
34:24this small table on the last page is a
34:27summary of all the indicators. So, if
34:30you don't want to keep looking at the
34:32historical series, if you get confused,
34:34or have any difficulty at all, focus
34:35here. So, we have information on birth,
34:39immunization, nutrition, and the issue
34:42of protection. So, all the most
34:45important indicators were aggregated
34:49here in this single table view. And
34:54this, as I already mentioned, is a tool
34:57you have in your hands today to think
34:59about your operational plan. Ready, we
35:04can continue here with the presentation
35:07of the listening guide. And so, Sami,
35:11can you continue sharing, please? Hi,
35:15dear. There's a cutie there with Sâmia
35:18. Someone special who didn't go to
35:21school today because they're not
35:22feeling very well, everyone. Real life,
35:25just real life.
35:26But you can go ahead, Aline.
35:28Could you go back to sharing the
35:30presentation so we can continue with
35:33your plans?
35:34Yes. On it.
35:36Aline, while Sha puts up the
35:37presentation, there's an interesting
35:38question here in the chat from Thaísa
35:40who says: "Do we need to
35:41cross-reference, like, compare these
35:42data with the data in the municipality
35:44to be able to use it for the fund?""
35:46Look, We don't require any data
35:51verification, unless you indicate, you
35:53know, that there is a major discrepancy
35:56in any information, right? But as
36:00mentioned, these are all public data.
36:03So, it would be important to see what
36:06kind of discrepancy this is, because in
36:09fact, let's suppose, your teenage
36:12pregnancy rate is in the public system,
36:15right, in this SINASC data, at 20%, and
36:18you tell me it's 5%, then something is
36:21off. We don't ask for this verification
36:24, but it would be important for you to
36:26just check if there is any information
36:28that stands out significantly. Then you
36:31can communicate with Lália and say:"
36:33Look, this is very discrepant, but
36:36small differences, look, it's 14 and
36:38mine is 15, it's 15, mine is 17, you
36:41know? Small things like that. "I think
36:44there is a possible margin there
36:46regarding the extraction method, you
36:49know, the filters used, but for very
36:52glaring things I would ask you to talk
36:54to us, but for small variations, I
36:57think it's totally reasonable for that
37:00to happen. Is that okay? Shall we
37:04proceed? So, now let's get to the
37:05famous listening of adolescents, right?
37:09So, at some points, in some
37:11municipalities, I had the opportunity
37:14to talk about this, and some
37:17municipalities were saying:" Oh, 2025,
37:232025 is the baseline, but if you look
37:25at the PDFs, there is a historical
37:26series. "So you will also look at the
37:30levels, you know, over the course of
37:32the years, how it behaved.
37:36Participatory listening cannot be
37:39confused with the protected listening
37:43law. I heard people in some places
37:46making a bit of this confusion. So,
37:49there is the protected listening law,
37:51which is to protect children and
37:53adolescents who are victims of violence
37:55. So, there are places that even have
37:59special rooms, lilac rooms inside the
38:02units for this. So, it is a qualified
38:06listening process, a listening process
38:08very directed toward issues of violence
38:10. What we are talking about here is
38:12participatory listening, that is,
38:14listening to adolescents to think about
38:17their, understand their issues, their
38:20demands, in order to think about public
38:22policies. So it is a way of promoting
38:26popular participation, right, starting
38:28from listening to these boys and girls.
38:32Next, please. So, our consultant who
38:40developed this material and took great
38:44care to draft it based on the
38:46experiences and realities of the
38:49municipalities included a very
38:52interesting quote that I want to read
38:55to you:" Allow me to speak, not my
38:58scars, "which is a line by Emicida. It
39:02is, in fact, a moment for public
39:05municipal management to rethink how it
39:08has been creating public policies,
39:11starting by listening to adolescents,
39:14based on what they bring, not replacing
39:18their voices, not assuming what they
39:21think, not assuming what their
39:23challenges are, but rather bringing
39:26this out very openly from them. Next,
39:31please. So, what we are discussing
39:34regarding active listening is closely
39:36related to the pillars of comprehensive
39:39and integrated health within the SUS,
39:41right? So, within the adolescent health
39:45guidelines—we still don't have a
39:47national adolescent health policy,
39:50which is a major bottleneck—that
39:52won't be an impediment for us to carry
39:54out adolescent health actions, which
39:56consist of seven pillars, right? The
40:00first of them is immunization. So,
40:02immunization and prevention as
40:06strategies to avoid vaccine-preventable
40:10diseases. The second pillar is food and
40:13nutrition, thinking about the entire
40:16aspect of food and nutritional
40:17surveillance and food and nutritional
40:19security. The third pillar is sexual
40:22and reproductive rights. And we have to
40:25think about this; it’s a topic that
40:28has been the target of a lot of fake
40:31news and a lot of prejudice. And as
40:35health professionals, as public health
40:38advocates that we are, as human rights
40:40defenders that we are, we need to look
40:43at the issue of sexual and reproductive
40:45rights of adolescents without taboos
40:48and without false moralisms. This is
40:51very important to consider, right?
40:53Regarding the guarantee of sex
40:55education, the prevention of sexually
40:57transmitted infections, and especially
41:00the issue of access to contraceptive
41:02methods and the question of consent, we
41:05have a series of issues to work on
41:07within this pillar, and we need to face
41:09the subject of sexuality with great
41:12seriousness as a society. The fourth
41:14point, the fourth pillar, is mental
41:16health and well-being. So, anyone who
41:19works with adolescents, anyone who even
41:21minimally talks to adolescents in their
41:24daily life, knows about the worsening
41:27of mental health issues that are being
41:29experienced today by adolescents, right
41:32? And this impacts their life projects,
41:36impacts their motivation, impacts, in
41:37short, a series of issues, and that is
41:39what has been brought up with great
41:41force. And mainly considering, right,
41:45the perspective of indigenous
41:48adolescences, quilombola adolescences,
41:51gypsy adolescences, traditional
41:54communities, because, uh, the life
41:57project is very much linked to issues,
42:00right, of belonging, of community, of,
42:03uh, the the own, uh, paths that this
42:07adolescent has. So, uh, it is very
42:10important that we look at, right, the
42:12issue of mental health. The fifth, the
42:15prevention of violence. So, uh, the
42:18issue of sexuality, of LGBTQIA +
42:21adolescence, the issue of digital
42:23violence. We have the data from the
42:28National School Health Survey that was
42:30released this year, showing how
42:32bullying, how, uh, bullying over the
42:35internet, through applications, right?
42:39Hypersexualization is indeed a real
42:42fact, uh, of violence against
42:45adolescents. So, we also need to think
42:49about actions to prevent violence
42:51within this axis. Then the sixth axis
42:54is youth participation, which dialogues
42:56very easily with the issue of the" poms
42:58, "right? the listening, right, that we
43:02are addressing here, which dialogues
43:04with the" nucas, "with the councils,
43:06and also with the issue of volunteering
43:08. I see two hands raised now. I don't
43:10know how to proceed. If I should open
43:12it up,
43:12maybe at the end, Aline. I think
43:14interaction is better at the end.
43:16That's fine. And we have the seventh
43:19axis, which is health promotion and the
43:21life project, right, which is as a
43:23human right, meaning, thinking about
43:26dreams, about the future, and so on.
43:28Next, please. So, health is recognized
43:35as a right. So, we all here know that
43:39this is set out in our Constitution, it
43:42is in the Child and Adolescent Statute,
43:44and the State here, uh, represented
43:47here by you, right, who are part of the
43:50municipal management as this, uh, this
43:52federated entity responsible for
43:55carrying this out. So, what does this
43:58listening need to contain? Who should
44:00perform this listening? This listening
44:03is a responsibility of the Health
44:05Secretariat, of the health agent. So
44:08the health agent needs to conduct these
44:12listening activities. And the listening
44:16needs to be, as we always say by adding
44:18an adjective, qualified. We need to
44:20show respect, right? We need to avoid
44:22making judgments. And there are huge,
44:25right? uh, many sources of judgment
44:29regarding adolescents. I remember
44:32reading somewhere that a teenager once
44:34asked:" Mom, why is it normal not to
44:37like teenagers? "So, we also need to
44:40understand this rejection that some
44:43people face regarding this generational
44:45challenge with adolescents. We must
44:49listen without judgment and provide a
44:51respectful environment, maintaining the
44:53privacy and confidentiality of what is
44:56being said. We have already experienced
44:59, during this journey of the seal and
45:01systemic result one, situations that
45:04can expose teenagers. So, when we bring
45:06up this subject, people say," Oh, I
45:08want to tell you about a teenager who
45:10went through this, that, and the other.
45:11"Therefore, these are delicate matters;
45:14the information shared must be handled
45:16with great care. So, if a teenager
45:20discloses a situation of violence,
45:23abuse, or a mental health issue, we
45:25must maintain the privacy and
45:28confidentiality of that information.
45:32And here, as health agents, we need to
45:36turn this discourse into action that
45:39also addresses other entities and other
45:42public policies. Integral health—
45:47physical, mental, social, and cultural
45:49—ensuring that services have better
45:52access to responsible follow-up and
45:54active participation. Next, please.
46:01The next step is listening, as I’ve
46:04been saying, to build better public
46:08policies that are more connected to
46:11reality, to the territory, and to more
46:15responsive services. What does that
46:18mean? If the service is provided with
46:22more care and addresses the real needs
46:26of that public, it creates a stronger
46:29bond and culminates in greater civic
46:32participation. Next, please. Well, as I
46:39had already mentioned, the Municipal
46:42Health Department is responsible for
46:44this, but we have a very important
46:47figure in the municipality, which is
46:49the adolescent health mobilizer. So,
46:53they can indeed be invited to these
46:55moments as a co-facilitator for these
46:57activities. Prioritize thinking about
47:01the NUCAs. NUCAs are local, right? They
47:05are already established groups that
47:07contain these teenagers who are the
47:10target of this action. But you don't
47:14need to focus only on the NUCAs. So, if
47:17you have other associations or other
47:20forms of adolescent organization in the
47:24municipality, use those spaces and
47:26dialogue with them to broaden the
47:29listening process; it needs to be quite
47:32inclusive. So, if in my NUCA, if my
47:37municipality has a Quilombola community
47:39, but there isn't one in my NUCA, it
47:42becomes very complex for us to validate
47:45this plan if we haven't heard, right,
47:47other contexts, other realities. Next,
47:51please. So here we, sorry, excuse me, I
47:59just wanted to interact a little bit
48:01with you here. It’s Flávio, right?
48:03Good morning, everyone. Focal point
48:05here for adolescent participation at
48:07Acert. I think you touched on a crucial
48:10point, which will be very important for
48:12conducting these hearings in the
48:13municipalities and for the work we will
48:15carry out from now on, which is also
48:17the integration of the NUCAs into this
48:19methodology of listening. So, we
48:22understand that this listening process
48:24has as its target audience the
48:26adolescents of the municipality as a
48:28whole, represented in their plurality,
48:30in their diversity. And we also
48:33understand that there is a group within
48:35the municipality, engaged for at least
48:37a year and a half, if counting from
48:39this edition, but we know there is a
48:41whole legacy of participation built in
48:42your territories; and it is a group
48:44that is precisely directly linked to
48:46the theme of comprehensive adolescent
48:48health, even having this as a component
48:50of their planning, right? So, we really
48:54intend to convey to you how strategic
48:57it is to ensure the participation of
48:59these NUCA adolescents and the
49:01conduction of this listening process
49:04with their participation, which doesn't
49:06have to be exclusively with the NUCA,
49:09right? Actually, the more adolescents,
49:12the better, because more adolescents
49:14are being heard, but we know there is a
49:17strategic position for the adolescents,
49:19the mobilizers, who can even act as
49:21co-facilitators. I think it is crucial
49:24for the execution of this listening
49:26process to have a participatory and
49:28free environment, right? An environment
49:30that doesn't seem too cold, that
49:32doesn't seem too distant from their
49:34reality, which also involves the
49:36language that will be used and
49:38everything else. So, I wanted to talk
49:42here with the municipalities, with the
49:43articulators and mobilizers present,
49:45that we will, that this part of this
49:47delivery needs to be carried out
49:48closely with the participation of
49:50adolescents. And we actually have this
49:53material prepared by UNICEF,
49:55specifically for the listening process,
49:57which we haven't released yet because
49:58it needs a little adjustment, but as
50:00soon as it's ready, we will put it in
50:02the adolescent mobilizer groups as well
50:04. We intend to have a specific moment,
50:07an open room dedicated solely to
50:09listening to adolescents, and we are
50:11counting on your mobilization to talk
50:14with the organizers, right, to make
50:16them understand how we will gather the
50:18best contributions from adolescents in
50:20this process regarding comprehensive
50:22health, which will cover not only the
50:24obstacles to this well-being, but also
50:27the health service itself: how
50:28receptive it is to adolescents, whether
50:31these units are friendly, whether
50:34adolescents know how to access them,
50:36and what access to therapy is like, for
50:38example, within the municipalities. So,
50:42as always, it is time to exercise this
50:44intersectorality, and we will make
50:46ourselves available to all
50:47municipalities to work on adolescent
50:49participation within this.
50:53Fábio, thank you very much. I am very
50:57happy to hear you and understand how
50:59much this material arrives at such a
51:02fertile moment, right, for you as well.
51:06And I am here, totally available to
51:08support you with whatever you need in
51:11these next steps. Thank you, okay?
51:13By the way, it is excellent material,
51:15folks! You will see, it is super
51:17complete; we had another listening
51:19experience in a different area, and I
51:21think we have already accumulated the
51:24lessons from that experience and now
51:26arrive with the opportunity to make
51:28adolescent listening shine even more
51:30within the municipalities. So,
51:32congratulations to you as well for the
51:34material that was produced here.
51:35Oh, thank you, thank you so much.
51:38Please, the next one, so we can get to
51:41the listening methodology, right? So,
51:44how do we form this group of
51:48adolescents? The recommendation is that
51:51there be 10 to 16 adolescents,
51:54preferably between the ages of 12 and
51:5619, ensuring diversity, as I have
51:59already mentioned, in gender, race,
52:01territory, socioeconomic context,
52:03inclusion of people with disabilities,
52:06and groups that are historically
52:08excluded in the municipality.
52:11Participation must always be voluntary,
52:13so there is no obligation. The
52:15adolescent will be there because they
52:18were invited, encouraged, and
52:20stimulated to fulfill their role as a
52:23citizen, but it is a totally voluntary
52:26participation and it must be exclusive
52:29to adolescents, with a very restricted
52:32presence of adults, in the sense of not
52:35inhibiting the adolescents '
52:37participation. Therefore, a facilitator
52:40will be important, a health mobilizer
52:43or another person in health with more
52:45experience in dialogue with adolescents
52:47, and the adolescent mobilizer can also
52:50be there as a co-facilitator. All of
52:53this must be very, uh, customized based
52:55on the municipality. So there is no
52:58rule on how this facilitation has to be
53:01. The important, the only rule must be
53:03that it is a health professional, right
53:05? It should be a health tool, but also
53:09with care not to have a
53:13spectacularization of the listening
53:15process. So, oh, bring filming, let's
53:18do this, that, and so on. It is
53:20necessary to also respect this moment
53:23and the adolescents' privacy. Uh, and
53:26also think about strategies that expand
53:28access. For example, is doing it in the
53:31city center the best location, or can
53:33we talk to the Department of Education
53:36to hold it at some point in a school or
53:39in a more remote area? All of this will
53:42have to be based a lot on your
53:44experience and the depth of
53:46understanding you have of the territory
53:49. Next, please. So we make a
53:54proposition which is the following:
53:56there are two ways to conduct this
53:58workshop. An essential workshop, which
54:02is what we need to discuss, which lasts
54:052 hours and has a whole step-by-step
54:07guide you will receive on how it should
54:10be conducted. Now we have an extended
54:13workshop. This extended workshop is
54:17longer, it lasts 3 hours, and it allows
54:20for a deeper dive into all these, uh,
54:23themes we will discuss. So, here it is,
54:29we have already prepared a structure
54:32for you on how to conduct this workshop
54:34: a reception, a welcome dynamic,
54:37agreements to strengthen interaction,
54:39how this integration will take place,
54:42and a warm-up regarding the questions.
54:47Uh, then we have the issue of the
54:49health canvas, which is nothing more
54:52than a large information panel where we
54:55have questions for each of those axes,
54:57and the adolescents are very free and
55:00available to answer those questions.
55:04And we have a core element within these
55:06workshops, which is the" Adolescent
55:08Charter. "We experienced in the
55:10systemic result workshops the
55:12experiences of adolescents building
55:14charters. We found this very
55:17interesting and wanted this to continue
55:18now not only at the state level, but at
55:20the municipal level as well. So, what
55:23does this Adolescent Charter need to
55:25have? It needs to be a political
55:28document built by this collective of
55:30adolescents who will propose
55:32reflections and recommendations, and it
55:34must be delivered to the municipal
55:36administration. And, based on this
55:39document, also including everything
55:41that was thought of within this great
55:44health canvas, which are these axes of
55:47the plans and of integrated
55:49comprehensive health, which must be
55:51validated, right, must be received by
55:54those who are leading the construction
55:57of the operational plans, so that this
56:00information is included in the plan
56:02that will be delivered there on
56:04December 14th, right, at the PCJ. Next
56:08one, please. Uh, and so, right, I'm
56:12going to be repetitive about this
56:14because I think this is a very
56:15important topic, right? Confidentiality
56:18, right? So, it is necessary that the
56:21statements be recorded without
56:23identification, without names, without
56:26images to preserve the privacy of the
56:29adolescent who is sharing information.
56:32Every recording must be consented to.
56:36So, uh, try, right, to make this pact,
56:38right, if you are going to make a
56:41recording before the workshop, at the
56:43end, avoid these recordings during,
56:46like, filming records. So as not to
56:49collect the adolescents 'statements. I
56:51think we have to be very careful with
56:54all of this, right, to preserve privacy
56:57and the limits of secrecy, right? So,
57:01given, this is very important for us to
57:03talk about, so in situations of
57:05violence or risk, the team must indeed,
57:07right, follow the protection network
57:09flows. So, if someone during the
57:13workshop mentions that they are a
57:15victim of violence, that they suffer
57:17aggression or other situations, right,
57:20that put that situation at, that
57:22adolescent at risk, this needs to be
57:24addressed within the municipality's
57:26protocols. Next. And so, I think I'll
57:32finish on this slide, right, so we also
57:35have time to listen to you, and that
57:38the workshop, right, the listening
57:40doesn't just end at the workshop. We
57:44listen, systematize it in the health
57:47canvas, in the adolescents' letter, we
57:49provide feedback, validate this
57:52information, and we take action and
57:54monitor. It is necessary that the
57:58adolescents recognize within the
57:59operational plan, right, the actions
58:01that they proposed. And our
58:04recommendation is that at least one of
58:06the activities, of the actions foreseen
58:09in the POMBs, comes from the
58:10adolescents, is a demand from the
58:13adolescents, because this is
58:15effectively validating, right, social
58:17participation and addressing what has
58:19been produced, right, in a very
58:21collective and civic way. Uh, and so I
58:25don't know if you want to make any
58:27closing remarks on this listening part,
58:30if I failed to mention anything, if you
58:32want to add anything.
58:41I think we still have a few more. Yeah,
58:44Hold on, sorry, I have a thousand
58:46screens here trying to map everything
58:48out,
58:49but I just wanted to mention that next
58:52week, on the 15th, the adolescent
58:54participation team will host a live
58:57stream about this movement called Ocupa
59:00Saúde (Occupy Health). So, it's an
59:05action that is part of this
59:06intersectoral relationship—I think it
59:09was Flávio, or Fábio, who mentioned
59:12earlier—that the adolescent area is
59:14carrying out several actions, and now,
59:17mid-September into October, it will be
59:19the moment for adolescents to occupy
59:22basic health units and other health
59:24services in this Ocupa Saúde movement.
59:29So there will be a live stream next
59:30week, and we will share the cards once
59:32we receive them from the adolescent
59:34team. The focus is on the NUCAs and how
59:37they will do this, but for those in
59:39health, if you'd like to follow along,
59:41you are also very welcome. And, well,
59:44welcome to everyone. And September 21st
59:47is Adolescent Health Day, two weeks
59:49from now. So we also see this as a good
59:54excuse to create that activation, that
59:56buzz, that conversation with the
59:58adolescents, and for the activities
1:00:00within the NUCAs, especially from the
1:00:02perspective of the seal, to be
1:00:04participating. And then, following that
1:00:07, they have a stamping part. So the
1:00:09NUCAs get a stamp called" Ocupa Saúde,
1:00:11"meaning that the NUCA has also carried
1:00:13out a health action. So, it also
1:00:16highlights how we are truly working
1:00:19hand-in-hand with the NUCAs and the
1:00:22adolescent participation team to
1:00:25strengthen this action. I thought,
1:00:30Aline, about showing the guide very
1:00:33quickly,
1:00:35because I think it would be interesting
1:00:37to see, because sometimes we wonder,
1:00:38will I be able to get this presentation
1:00:40? But I will share the image of the
1:00:42guide. I think it works. It reassures
1:00:45everyone that some interesting things
1:00:48are coming. Hold on, let me just here.
1:00:56Ready. Can you see it here? It appeared
1:00:59.
1:00:59Yes.
1:01:00Okay. So, this guide is already
1:01:02finished. We had a little review, but I
1:01:06imagine it might have already
1:01:08circulated in some networks and some
1:01:10places, but it is very detailed. I know
1:01:14that when we look at an 88-page guide,
1:01:16it might be a bit overwhelming, but
1:01:19it's the opposite; it's meant to
1:01:21provide plenty of support, so you can
1:01:23use it according to your needs. So this
1:01:28guide starts by presenting the need for
1:01:31it, and then it goes through these
1:01:33fundamental principles. Why do we say"
1:01:36adolescences "in the plural? What is
1:01:38integral and integrated health? Ah, the
1:01:42Listening Law, the General Data
1:01:43Protection Law, which Aline just went
1:01:45over, and the Child and Adolescent
1:01:47Statute. So there is all this
1:01:49introduction we have been building,
1:01:51about health as a right. And then we
1:01:54arrive at the methodology. So here in
1:01:57the methodology, there is a
1:01:59step-by-step on how to carry out this
1:02:01listening process, the foundation, and
1:02:04this model that Aline presented, the
1:02:07workshop format, which has both
1:02:09versions, detailed with suggested times
1:02:12. Then there is a sequence of cards,
1:02:17which are these sub-themes, and that's
1:02:19it: you can print them, copy them, or
1:02:21use them as a base, but in this more
1:02:23didactic way. And then there is all
1:02:26this explanation. How to prepare for
1:02:29the listening session, what needs to be
1:02:31highlighted, and then all the
1:02:33facilitation tips. I'm going through
1:02:36this quickly, just so you can keep
1:02:37track of what's inside. So there are
1:02:39these cards, how we talk more, listen
1:02:42less, and what that means. There are
1:02:46also several suggestions for activities
1:02:48, from welcoming and integration
1:02:51dynamics—there are several here—to
1:02:53a second round of thematic warm-up
1:02:56activities that go directly into the
1:02:59health topic. A health card deck was
1:03:02also created, which is another tool you
1:03:04can print or reproduce in another way.
1:03:08Then comes the Health Canvas, which is
1:03:11this central activity, where we have a
1:03:14specific model and support cards. I
1:03:17wanted to show you, this here is the
1:03:18canvas. So here is how the themes,
1:03:21which are the main axes, look today,
1:03:23and we also included a free topic,
1:03:24knowing that sometimes that's the case.
1:03:27We have the themes from the Ministry of
1:03:30Health, but the adolescents can bring
1:03:33up topics more specific to their own
1:03:35reality. And each of these themes has
1:03:39its own axes. And here is the
1:03:42adolescents 'letter with two possible
1:03:46models, right? The letter for an
1:03:49extended workshop and the letter for an
1:03:52essential workshop, in case time is
1:03:55tighter. And finally, support material,
1:03:59for in case you encounter sensitive
1:04:01moments and need to activate this
1:04:03network, and also I think for us as
1:04:06professionals, especially health
1:04:08professionals, where we seek more
1:04:10information and support. So, there are
1:04:13several topics here, right? And where
1:04:16are the support networks available
1:04:18today? And then a lot of movie tips,
1:04:23the Ministry of Health guidelines,
1:04:25links to the handbooks, and so on. And
1:04:29so this is the guide we wanted to share
1:04:34with you, which is ready. If you
1:04:37haven't received it, you will receive
1:04:39it shortly. That's it. Let me stop
1:04:42sharing here. Was I sharing? I was,
1:04:44right? Okay. Let me
1:04:45I was. Yes, you were. So, just to echo
1:04:50what Sâmia mentioned. September is the
1:04:55perfect month, the guide couldn't have
1:04:56come at a better time. It’s a month
1:04:58when we have these adolescent health
1:05:01celebrations. We are working hard on
1:05:04the perspective that will be presented
1:05:06on the 15th, in more depth, regarding
1:05:09the" Occupy Health "initiative, where
1:05:11we want this movement from the NUCAS,
1:05:13right? Looking for health units,
1:05:17wanting more information, and asking
1:05:20you to open up the units as well. Think
1:05:24of actions, talk to the NUCAS to plan
1:05:26actions for this" Occupy Health ". A
1:05:28very beautiful and cool moment for the
1:05:31adolescents.
1:05:34Aline and Sâmia, Tatiana is also here
1:05:37with us, she is the coordinator for
1:05:39child and adolescent health here in the
1:05:42state of Paraíba. She even posted here
1:05:46in the chat. I would like to invite
1:05:50Tati, Tian here, for her to speak with
1:05:53us. Can you hear us, Tati? Is your
1:05:57microphone unmuted? Just unmute it.
1:06:03Just open it. We'll see in a moment.
1:06:17You just need to turn on your
1:06:18microphone.
1:06:30Hello, everyone. Good morning.
1:06:34Good morning.
1:06:36Can you hear me?
1:06:37Yes. Office.
1:06:40Hello, good morning.
1:06:47Can you hear me?
1:06:50Yes, we can hear you. You can speak
1:06:52again.
1:06:58Oh, yes. So, everyone, I am currently
1:07:01in the child and adolescent health
1:07:03coordination office at the secretariat
1:07:12and it is a huge pleasure to
1:07:14participate here with you in this, this
1:07:16live, which is so important, bringing
1:07:19news about FOME. uh, it’s a document
1:07:24that will uh better guide, right, the
1:07:26managers, the municipalities, and, well
1:07:29, the states. And for us, this document
1:07:33is very important. So, I just want to
1:07:36give a brief report on what we are
1:07:37already doing here in the state of
1:07:38Paraíba, right? Here, since March of
1:07:41this year, we have carried out Tatiana,
1:07:53we can't hear you. There's a, the
1:07:55internet, I think the internet is
1:07:57cutting off your speech. Yeah, I think
1:08:18we can't hear her, right? Is it frozen
1:08:21for you guys too, right? The audio, the
1:08:22quality.
1:08:23Yes. try to get in touch with her here.
1:08:34Let me just try to close and get in
1:08:36touch with her and we'll proceed. I
1:08:44think we can continue. I have to talk
1:08:45to her
1:08:48here. I think so. Sure. I think on our
1:08:52part, we are now just in these final
1:08:55minutes here to hear what the questions
1:08:58might be, right?
1:09:01I'd like to acknowledge and also thank
1:09:03the presence of the CESAL team from
1:09:04Maceió, the state health department,
1:09:06who is also here with us. It's
1:09:12beautiful today, you know? of
1:09:14representation. It was highly
1:09:17anticipated. Let me take a look here to
1:09:21start raising, uh, uh, opening people's
1:09:23microphones. We have Renato first, uh,
1:09:26the Health in Schools program from
1:09:28Maceió, is also here with us. Thank
1:09:31you for being here. We have Renato, who
1:09:34is from Rio Largo. Just a moment,
1:09:36Renato, I'll open your microphone for
1:09:37your question. It's open, Renato. Right
1:09:50, Lara. Two quick minutes. Morning,
1:10:01everyone. Uh, Eulália, in our case,
1:10:07our our plan has already been delivered
1:10:10, right, to UNICEF, as soon as the
1:10:13state approved it. I already put it on
1:10:17the PCJ. And so, uh, it's one of the
1:10:21questions I have, because, at this
1:10:24moment of approval, when it went to
1:10:26approve the plan, it it went through
1:10:28all the departments and we actually
1:10:30held a moment with the Municipal
1:10:32Council for the Rights of Children and
1:10:35Adolescents, which includes civil
1:10:37society, and also includes the basic
1:10:39policy departments. And I wanted to see
1:10:43because I saw that there has to be the
1:10:45participation of adolescents, right?
1:10:48And so the NUCA mobilizer went, the
1:10:50education mobilizer. And we tried our
1:10:53best to bring the network together so
1:10:56that this plan could be discussed and
1:10:58approved in the best way. Naturally,
1:11:01thinking about the adolescent's
1:11:03perspective. Would there be any more
1:11:09guidance from UNICEF? I can, I can
1:11:13answer, Renato, how good that you have
1:11:15already anticipated this, and did all
1:11:17this articulation movement.
1:11:19Congratulations. What is your
1:11:20municipality, Renato? Rio Largo.
1:11:23Rio Largo. Congratulations to Rio Largo
1:11:25. For having already advanced this
1:11:28condition. Now, I would like to ask you
1:11:31, actually to recommend, that you
1:11:34practice listening to adolescents,
1:11:37including making adjustments to the
1:11:40plan based on what you heard from them.
1:11:44Listening to government entities is
1:11:45essential. This is part of the plan,
1:11:49but I would suggest that you revisit
1:11:51your plan based on the baseline. See if
1:11:55what was presented in the Rio Largo
1:11:57baseline aligns with the plan that was
1:12:00built. And I strongly recommend that
1:12:03you make this effort to listen to the
1:12:06adolescents. This is a very timely move
1:12:09that does not invalidate the work you
1:12:12have done previously. On the contrary,
1:12:15it only adds to it. And so, just as I
1:12:19make this recommendation to Renato, I
1:12:20make it to all the municipalities that
1:12:22have also already created their plans
1:12:24and uploaded them to the PCJ, that they
1:12:26facilitate the listening of adolescents
1:12:28. And then, with this adolescent input,
1:12:32look at the plan through another lens,
1:12:34wearing these new glasses, which are
1:12:37the glasses of listening to adolescents
1:12:39, and see if there is room for any
1:12:41adjustment or modification, as I think
1:12:43there is still time. I think this is
1:12:47the great innovation that UNICEF is
1:12:49pushing, which is that beyond building
1:12:51a management plan, it is a plan that
1:12:53utilizes popular participation. So that
1:12:56is the invitation I extend to you. I
1:12:59think Rio Largo only has more to add to
1:13:01the work it is doing.
1:13:03Right? Uh, when we did this, before we
1:13:06even sent it to CESAL, for CESAL to
1:13:08approve our plan, we had a session with
1:13:11the adolescents in the unified registry
1:13:13. And one of their questions was
1:13:17exactly that, we left it very open for
1:13:19them to say how they wanted to be
1:13:21treated in the health unit, what they
1:13:24thought, you know, of our healthcare
1:13:26here in the municipality of Rio Largo.
1:13:30And there were exactly those points, ah
1:13:32, no, sometimes I want to go to the UBS
1:13:34and I am a girl, but sometimes I don't
1:13:36want to go in with my mother as a
1:13:38companion. I want to have my right to
1:13:41speak to the nurse alone, as the
1:13:42teenagers put it, right? This is
1:13:45something we started to see. We also
1:13:49need service, a, a differentiated look
1:13:52for LGBT, QIA + people. So, we’ve
1:13:57already spoken with the primary care
1:13:59coordinator, with IT, telling her:"
1:14:02Look, Ticiane, see if you can provide
1:14:04training for the staff, look at the
1:14:06reality our adolescents are presenting,
1:14:09because there’s no way we can create
1:14:11public policy if we don't listen to the
1:14:14adolescents. "" There’s no way we can
1:14:18create any type of public policy,
1:14:20regardless of the policy, without first
1:14:22listening to the children and
1:14:23adolescents. "So, our focus here in Rio
1:14:26Largo, and especially that of the
1:14:28Municipal Council for the Rights of
1:14:30Children and Adolescents, is always to
1:14:32provide this youth leadership, this
1:14:34voice, this opportunity, and this
1:14:35representation for the adolescent.
1:14:38Uh-huh. That's what we brought to the
1:14:42discussion of the plan, because as he
1:14:43is also attending classes, we wrote
1:14:45down all his points and brought them to
1:14:47the council meeting.
1:14:51Renato, I think, just listening to you,
1:14:53it seems good to hear from you, because
1:14:55you were already working on the plan
1:14:57before, you’re already looking to
1:14:59approve the plan, you know, you're
1:15:01already ahead of the game, if we think
1:15:03about it. I was thinking about the
1:15:05record, because sometimes we make a
1:15:07plan and it almost becomes bureaucratic
1:15:09material, you know, which is the end of
1:15:10the story. So, perhaps, if you could, I
1:15:14think in this PCJ submission, include
1:15:16this listening experience, or, if you
1:15:19want to use the material from the
1:15:21listening guide and take advantage of
1:15:23this relationship with the NUCAS, this
1:15:26heated moment now in September, and
1:15:28then put the plan there and include
1:15:30this attachment about what this
1:15:32listening was, what came of it, and
1:15:34whether this actually influenced the
1:15:37review of the plan for 2026, or 2027 in
1:15:39this case, if it was reviewed, it would
1:15:42be, I think, very interesting, right? I
1:15:45think you already have a good
1:15:46foundation, and so how can you further
1:15:48qualify this foundation? So, I wanted
1:15:50to give this slightly practical
1:15:52suggestion of an attachment with a
1:15:54report of this history and if, by
1:15:56looking at the data and listening to
1:15:58the adolescents, you see it as a
1:16:00priority area, for example, for 2027.
1:16:04Yes, thank you. Thank you, Renato, and
1:16:10congratulations to Rio Largo. Folks,
1:16:12I'm going to, it breaks my heart, but I
1:16:15have a conversation now that I'm going
1:16:18to, uh, Guys, I lost my train of
1:16:22thought, I'll be moderating one
1:16:23starting at 10:30 and I only have 3
1:16:25more minutes here with you. So, I'll
1:16:28take this opportunity to excuse myself,
1:16:30apologize because I won't be able to
1:16:33stay long, but I will finish listening
1:16:35to the last question. And I'm always
1:16:39available to SEERT, right, and to all
1:16:41of you here so we can build things
1:16:43collectively, okay? So, a big hug and
1:16:46thank you for today's time.
1:16:49Thank you, Aline. Thank you very much.
1:16:51Aline is already off. Now we have SIA
1:16:53as well. Jacleía, my dear, it's your
1:16:56turn.
1:17:00Good morning, how are you all doing?
1:17:04Good morning, all good? Other than the
1:17:07flu, all is well. Um, I had to step out
1:17:11of the meeting for a bit, but my
1:17:13question is just whether, based on
1:17:16these data and this plan that you
1:17:18presented, we can execute everything.
1:17:22Uh, I was approached by the health team
1:17:25, who are part of the seal,
1:17:27specifically for us to hold an
1:17:29integrated forum for adolescents. I
1:17:32wanted to know if this is feasible
1:17:33within the context of carrying out the
1:17:37formulation of this plan.
1:17:41Wouldn't that be amazing, right? The
1:17:44plan is just that, it's the initial
1:17:46seed, but if it turns into a forum from
1:17:49this, it would be incredible. I also
1:17:52think about the possibility of
1:17:54continuity, right? I don't know, how
1:17:57often this forum would happen, who the
1:17:59participants are, I think it would be
1:18:00wonderful.
1:18:02It wouldn't be the first forum in the
1:18:03municipality on this issue of
1:18:05integrated adolescent health. And since
1:18:08municipalities have to create this
1:18:10integrated health plan as a UNICEF goal
1:18:13, I think it would be interesting for
1:18:15us to hold the forum first, and then
1:18:18create the plan based on that. What do
1:18:22you say? Can you give me some direction
1:18:24? No, that's wonderful. Uh, I'm
1:18:27thinking about two things, one is how
1:18:29the forum can be this moment, even to
1:18:31give visibility to this agenda which
1:18:33sometimes, often, right, is kind of
1:18:35hidden away. Sometimes we deal with
1:18:38health as if health were just children,
1:18:40pregnant women, and the elderly, right?
1:18:42We skip over a part of that
1:18:45stage of life. So, I think it's
1:18:47fundamental. My point would be, if
1:18:50during the forum you decide to listen
1:18:53to the adolescents, it's good to be
1:18:55careful with the format,
1:18:59isn't it? Then I think it would be a
1:19:02different format in context, like
1:19:04prioritizing, uh, mainly their
1:19:05sensitivity, this part where they are
1:19:08very repressed. Anyway, we just had,
1:19:11I'm the youth coordinator here in the
1:19:13municipality as well, and we just had
1:19:15youth week. So the priority was to talk
1:19:19about sex education with the health
1:19:21team as a whole and bring them into
1:19:23this approach so they could clear up
1:19:24doubts, since there's that issue of
1:19:26being embarrassed in front of parents,
1:19:28which the colleague from another
1:19:30municipality mentioned, about asking
1:19:31questions and such. Then the
1:19:35coordinator of the Health at School
1:19:37program said:" Hey, how about we hold a
1:19:39forum? "So I said:" I need to consult
1:19:43my experts from Certo and UIP. "So I
1:19:45already thought it’s possible to
1:19:47connect one thing to the other. I think
1:19:49it’s very interesting.
1:19:49No, I think it’s definitely possible.
1:19:51I would just suggest being careful
1:19:52during the listening session, because
1:19:53that's it, right? For example, in the
1:19:54guide, when you receive it later,
1:19:55you'll see, right? Sometimes it seems
1:19:58obvious, but we get excited and have a
1:20:00session with more adults than
1:20:01adolescents, and obviously that
1:20:03inhibits the adolescent. So, right? We
1:20:06have these precautions: regarding the
1:20:08number of people, the safe space, the
1:20:11themes, how we warm up before getting
1:20:13to the topic, for example, right? Our
1:20:16proposal is for it to become a letter,
1:20:18right? A letter that goes to the
1:20:20municipality, where this letter doesn't
1:20:21have the adolescent's name so they
1:20:23don't feel exposed, but rather it is
1:20:25from the adolescents. So I think that
1:20:27caution is good, I think the Forum is a
1:20:29great idea, just take care so that
1:20:31during the listening, those ethical
1:20:34protection safeguards for adolescents
1:20:36are upheld, and obviously, keep a
1:20:38record of it. So I think it will be, it
1:20:41will be incredible. I hope it continues
1:20:43afterwards. There are the next forums,
1:20:45right?
1:20:45I hope so. The seal is already so much.
1:20:48Uh, okay then. I will coordinate
1:20:50everything properly with the health
1:20:51staff. I have a meeting with them soon,
1:20:54and then we will be doing this very
1:20:56carefully with all the technical
1:20:58support from C. Oh, how wonderful. Oh,
1:21:05Sâmia, before opening the floor to
1:21:07Sônia, I think it’s quite important
1:21:09to address some questions from our PSE
1:21:11partners from Maceió here in the chat,
1:21:13where they ask, right, if for this
1:21:15listening session there is a minimum
1:21:17number of adolescents per municipality,
1:21:19if it can be done in stages in the
1:21:21school environment with the health team
1:21:24, uh, how can this methodology work?
1:21:27Is that right? So, we are suggesting
1:21:29from 10 to 16 adolescents, thinking
1:21:31about a minimum and a maximum. Well, we
1:21:35know that having few adolescents
1:21:36sometimes inhibits more than having
1:21:38many. So, having a group that is too
1:21:40small isn't ideal, either. So, we are
1:21:43in this range of 10 to 16. Sometimes
1:21:45there are eight, sometimes 18. That's
1:21:47fine, but in this range, the
1:21:49relationship with the PSE is super
1:21:51valuable. I think if the municipality
1:21:55already has this relationship well
1:21:57established, sometimes even the contact
1:21:59person is from the PSE, so working in
1:22:01this health and education partnership
1:22:03works really well. It can be in the
1:22:06school environment, it can be at the
1:22:08basic health unit, or it can be in
1:22:10another shared space, right? There is
1:22:12no limit on the space, it doesn't have
1:22:13to be here or there. The only thing we
1:22:17ask again, and I think I'm always
1:22:19reinforcing this, is that the people
1:22:22who will conduct the activity have
1:22:25these principles of adolescent
1:22:28protection regarding confidentiality,
1:22:31privacy, exposure, and referrals in
1:22:34cases of, you know, reporting cases of
1:22:37violence or more serious issues. So,
1:22:40preparation is very important. That is
1:22:43the highlight I would give. It can be
1:22:44done with the PSE, wonderful. Will you
1:22:46do it in partnership with the Nuca
1:22:48adolescent participation mobilizer?
1:22:50Wonderful. But, prepare together to do
1:22:53this and emphasize how to ensure the
1:22:57protection of adolescents. And, well,
1:23:00Aline mentioned this in her
1:23:02presentation, but we get excited and
1:23:04take a bunch of photos and things,
1:23:05check with the adolescent first.
1:23:08Sometimes we see an image and think it
1:23:09looks great, but the adolescent says:"
1:23:11Wow, I look horrible, I don't want that
1:23:12image used. "Then it goes to the city's
1:23:14website and that, you know, causes a
1:23:17problem. So I am bringing up very
1:23:19specific examples, but I think it is
1:23:21this care in preparation, including for
1:23:24the professionals who will be listening
1:23:26, and the PSE is wonderful for doing
1:23:29this. And there is just one last
1:23:34question to open up to Sonia, which is
1:23:36the validity of the plan. What is the
1:23:38suggested duration?
1:23:40Yes. So, it will be...we don't have a
1:23:44way to mandate the approval of the plan
1:23:47, that would be wonderful, right? But
1:23:51we do have the requirement that the
1:23:53plan be submitted. So the validity of
1:23:57the plan will be an accomplishment.
1:24:00Then, if you manage to move on to the
1:24:02next stage, which is approving this
1:24:04plan at the city hall, then you will
1:24:05follow your own bureaucratic procedures
1:24:08. So, we don't have a minimum duration
1:24:11period. Obviously, we suggest it be at
1:24:13least for the current term of office,
1:24:15right? That the current administration
1:24:18can commit to this plan. That is the
1:24:22minimum, right, that the current
1:24:24administration commits, but it is not a
1:24:26condition for submission on the seal
1:24:28platform, right? What we are
1:24:31responsible for approving and
1:24:33monitoring is the submission of the
1:24:34plan; the timing and the approval
1:24:36remain with the city government. Thank
1:24:41you, Sânia. Sônia, dear, your
1:24:43microphone is unmuted.
1:24:46Good morning, smart people. It is
1:24:48always good to learn from you. It will
1:24:50be very quick. We already had a meeting
1:24:52with the seal staff, right? The
1:24:54committee that works on the education
1:24:57part of NUCA formulated, and we had the
1:24:59idea of making Google Forms. The form
1:25:04is from the municipal health council,
1:25:06which I also participate in, with
1:25:09several questions about various axes
1:25:11for adolescents, differently for the
1:25:13councilors, and differently for health
1:25:15professionals. We are also thinking of
1:25:19doing it with education professionals.
1:25:23This response will not have
1:25:24identification, okay, of their names,
1:25:26just more or less the age. Not even an
1:25:29exact age; let's suppose they are 10
1:25:32years old, we will put 10 to 12 so as
1:25:35not to be identified, so that they feel
1:25:38more comfortable speaking about certain
1:25:41, uh, situations. It is not a proposal
1:25:44form, but it is for identifying how
1:25:46they see health across various axes. I
1:25:50don't know if you understand, we have
1:25:52already created this form. I wanted to
1:25:54know if it can also be done this way as
1:25:55a situational diagnosis in the
1:25:57municipality, right? We have already
1:26:00scheduled a meeting with NUCA, together
1:26:02with the NUCA coordinator, to show what
1:26:04the plan is and to coordinate with
1:26:05other schools. Some meetings have
1:26:08already been scheduled for us to show
1:26:10what the plan is and that they need to
1:26:12participate, and how they will make the
1:26:13proposal. And now all that's missing is
1:26:17to schedule this moment that we hadn't
1:26:20attended, right, this movement. So now
1:26:24we are going to coordinate how this
1:26:26in-person stage will be, but there are
1:26:28already meetings scheduled. So I would
1:26:32like to know if there is any problem
1:26:34with us doing this form online, which
1:26:36can even, for example...We will do it
1:26:38both physically and for them to answer
1:26:40on paper, and we will leave an envelope
1:26:42in each school classroom, which they
1:26:44put inside the envelope; no one will
1:26:46know who responded. And also, we'll do
1:26:50it online for those who have a cell
1:26:52phone, want to answer on their phone,
1:26:55and the phone can be lent to another
1:26:57student to answer, for those who want
1:26:59to answer virtually. Uh, I'd like to
1:27:03know if there would be any problem,
1:27:05because I think it makes it easier for
1:27:07them to answer without worrying about
1:27:10appearing in person. There's also that
1:27:13issue, you understand?
1:27:16So, Sonia, I think that as a complement
1:27:18, it's fantastic, right? You open this
1:27:22form, this new data channel so that
1:27:24they, both the adolescents and the
1:27:26management, as you said there are
1:27:29several, can express themselves and, in
1:27:31a way, without identification, they can
1:27:34provide their contributions. Uh, my
1:27:37only warning is that this does not
1:27:39replace the listening sessions. So, I
1:27:41think by maintaining that, maintaining
1:27:43the listening in this relationship, you
1:27:45mentioned the relationship with the
1:27:47NUCAs, now you are going to receive the
1:27:49guide. So, do the health canvas, do the
1:27:52letter from the adolescents to the
1:27:55municipality. So, I think it's
1:27:58wonderful. I think it will be one more
1:27:59source of information you're having
1:28:01there, so just don't stop doing the
1:28:02listening, okay? This does not replace
1:28:04the listening.
1:28:05Thank you.
1:28:06Exactly. Uh, I also just wanted to add
1:28:08something. I was going to talk
1:28:10precisely about not replacing the
1:28:11listening, but I also saw that you said
1:28:13you're going to meet with the NUCA
1:28:14adolescents. I also think an important
1:28:17distinction is that the adolescents in
1:28:19the core can and should plan actions,
1:28:21interventions, led by them within the
1:28:22theme of comprehensive health, but the
1:28:24listening is something that will be
1:28:26organized by the municipality with the
1:28:28participation of the adolescents, you
1:28:30see? So a NUCA action on the topic of
1:28:33health is not equivalent to, nor does
1:28:34it replace, this listening that needs
1:28:36to be organized based on the guide that
1:28:39will be made available. Just for you to
1:28:41keep that in mind.
1:28:42Thank you. I understand. But I think we
1:28:44need to show them what the plan is, how
1:28:46it works, what needs to be done so that
1:28:48they participate in the other meetings.
1:28:52I would like to take the group to all
1:28:53the other meetings to participate. I
1:28:56think it's important.
1:28:57Yes. And that they arrive well-prepared
1:28:58, right? At the time of the listening.
1:29:05To close, we have immunization from
1:29:08Sumé. Your microphone is already
1:29:10enabled.
1:29:15Good morning, everyone. My name is
1:29:17Victor Hugo, I am the immunization
1:29:19coordinator for the municipality here
1:29:22in Sumé, in Paraíba, and I am also an
1:29:25R1 coordinator, right? And I have many
1:29:29questions, uh, and I even started
1:29:32writing down several here, because I
1:29:34don't have much access to this part. uh
1:29:40of the seal as a whole, right? I was
1:29:43very focused on the immunization part
1:29:44and so on. Then this year I discovered
1:29:47these other things, that health in the
1:29:49UNICEF Seal isn't just immunization,
1:29:51right? There are other areas. So I'm a
1:29:55little lost, I'm trying to get in touch
1:29:57with the staff, with the coordinators,
1:29:59right, from social assistance and such,
1:30:01to see how we're going to do some
1:30:02things. But, uh, regarding the creation
1:30:06of this plan, first, uh, I had access
1:30:09to a material called the PONS model.
1:30:12It's in Word, I downloaded it, and so
1:30:14on, so we could have an idea here of
1:30:15how it's done. And then, uh, I heard
1:30:19you, Samel, also talking about activity
1:30:21logs in the PCJ. I've already had
1:30:23access to the PCJ, I already understood
1:30:25more or less how it works there, to
1:30:27register. Uh, and so I wanted to know,
1:30:31uh, is the base, the plan, uh, going to
1:30:34be done, uh, modified within this PONS
1:30:37model? So, the plan is what we...in the
1:30:41PONS model it's listed as the expected
1:30:43results of the cycle. It's an
1:30:45operational framework.
1:30:51It's muted, Sam. Your microphone.
1:30:53Hi, sorry, I was here talking. Exactly.
1:30:56Uh, I think your question makes a lot
1:30:57more sense. Since we divided it into
1:30:58moments, it seems like each moment
1:31:00requires submitting something, right,
1:31:02on the platform. But that's not it.
1:31:04There is only one submission that has
1:31:07to happen by 12/14, right? And then
1:31:11Lália can help me with exactly where,
1:31:13right, Lália? Since you know the PCJ
1:31:15well, much better than I do. So, uh,
1:31:18the submission is just one, it's a
1:31:20single plan by 12/14. What we have been
1:31:25requesting, because that's how we're
1:31:27going to evaluate it, is that the plan
1:31:30has these essential components: that it
1:31:32has municipal data, that it has the
1:31:34record of listening to adolescents, and
1:31:37that it has a prioritization. And so,
1:31:40to help some municipalities, well, most
1:31:42of them that we could, we provided this
1:31:44plan template which is that Word
1:31:46document you downloaded. So, because,
1:31:49you know? Oh, I have to build a plan.
1:31:51What does that mean? So, in that Word
1:31:53document you downloaded, you can even
1:31:54add the link here later if you want. It
1:31:57goes, like: phase one, it's like:" ah,
1:31:58I have the data, I'll go there and
1:31:59write that my adolescent pregnancy data
1:32:01is like this, that immunization is like
1:32:02that, "boom. Ah, regarding the
1:32:06listening session that’s in the
1:32:07adolescents' letter, we formed a group,
1:32:09so many adolescents participated, and
1:32:10we heard these priorities. But the plan
1:32:13can't stop there, right? It needs to be
1:32:15a plan, an action plan. And then
1:32:18there's this table at the end, which is
1:32:20what you found in that document, that
1:32:21goes on to say," ah, so we’re going
1:32:23to prioritize mental health, we’re
1:32:24going to prioritize sexual and
1:32:26reproductive health. "What does it mean
1:32:28to prioritize that? What action am I
1:32:30going to take, right? A colleague said,
1:32:32" Oh, I’m going to keep the forum
1:32:33active, I’m going to carry out a PSE
1:32:35action. "Then you will describe the
1:32:37action there. We put nine or 10
1:32:40examples in the SEM there. Do they have
1:32:43to be those? They don't. Each
1:32:45municipality will have its own priority
1:32:47, but those were just ideas. The idea
1:32:50was a Word document that you can edit,
1:32:51you know, grab the document, write here
1:32:53, copy, paste, take the information
1:32:55from there. So, it's from that
1:32:58perspective, it became more...
1:33:01it became clear, I understood. I was
1:33:04actually going to ask if, for example,
1:33:06every municipality had to, regardless
1:33:09of its context in the results, if it
1:33:12had to aim the plan toward those seven
1:33:15axes of the SUS integrated health
1:33:17system. Because here, I’ve already
1:33:21taken a look at the results and I saw
1:33:23that our HPV coverage is high, so I was
1:33:26already wondering if it's already...
1:33:28what are we going to do if it's already
1:33:30good, you know? But I already
1:33:33understood that we will direct it
1:33:35toward where we feel most vulnerable
1:33:37within this context of health focused
1:33:39on the adolescent, right? Then other
1:33:42things I heard you talking about were
1:33:44also regarding the appropriate
1:33:46professionals to participate in this
1:33:48listening session. When I went to talk
1:33:51to the social assistance staff to go to
1:33:54the Nuca—sorry—I’m the one who
1:33:56will go, right, as a representative,
1:33:57since I’m the guy who is, anyway,
1:33:59inside this UNICEF thing, and so on. Uh
1:34:03, as the coordinator, I can, uh, listen
1:34:06to what they have to say, or actually,
1:34:08I, uh, thought about this listening
1:34:11moment, but also, as my colleague said,
1:34:14taking a questionnaire for them, uh, to
1:34:16, uh, fill out, right, so that they
1:34:19don't feel, uh, identified by that
1:34:21answer. For example, since it's a small
1:34:24town, you always have to think like, oh
1:34:26, I know they heard me saying that, you
1:34:28know? So, uh, I can bring a
1:34:31questionnaire that doesn't identify
1:34:33which teenager is responding, with
1:34:35questions like, what do you think about
1:34:37the municipality's healthcare? Uh, what
1:34:41do you think about the service at the
1:34:42units, right? Things of that nature.
1:34:44And regarding the professional, at this
1:34:47moment of listening, do I, for example,
1:34:49have to bring a psychologist or
1:34:51something similar to provide support if
1:34:54these, uh, more sensitive moments you
1:34:56mentioned arise, such as teenagers who
1:34:58are victims of sexual violence and
1:35:00things like that?
1:35:05Let's see. I think, uh, those are
1:35:07several questions in one, and, uh, I
1:35:09think going back to the previous
1:35:11comment, prioritize. You don't need to
1:35:14have an action for each of the seven
1:35:16axes; if you want, focus on one axis,
1:35:18focus on two. That's wonderful. That's
1:35:20your municipality's need. Uh, regarding
1:35:24the listening process itself, uh, you
1:35:27will receive a guide, and the guide is
1:35:29quite detailed, already detailing how
1:35:32to prepare, which is the most important
1:35:35part. So, in this preparation, for
1:35:38example, about the questionnaire I'm
1:35:40bringing, the health canvas, you will
1:35:42see it there; it's basically the
1:35:43questionnaire you're talking about,
1:35:45which is: what is health to me, what is
1:35:47my priority in health? It already has
1:35:50all those questions. So, I think my
1:35:51suggestion would be to take a look as
1:35:53soon as you receive it and see if that
1:35:55material answers your needs. And
1:35:57there's another issue you mentioned,
1:35:59which is the sensitivity of a small
1:36:01town where the teenager is afraid to
1:36:04speak because everyone will know it was
1:36:06them. And that has a lot to do with
1:36:08this preparation. For example, it's
1:36:10very common, uh, to have a letter from
1:36:12teenagers to the municipality, and
1:36:14everyone signs it because, you know,
1:36:15it's a way to show appreciation. In
1:36:17this case, it's the opposite. We don't
1:36:19want the teenagers to sign it. We don't
1:36:22want the teenagers to be identified.
1:36:24The signature of this letter is"
1:36:26teenagers from the city, "right? So,
1:36:30it's not the other way around, is it?
1:36:32There’s nothing in the preparation
1:36:33that isn't there. And then, when you
1:36:36start the group, it's essential that
1:36:38this is made explicit to them, right?
1:36:40And to them as well. Look, there won't
1:36:42be any identification, you don't need
1:36:44to put your names anywhere, okay? This
1:36:47is a moment, uh, that the municipality
1:36:49will receive the city's adolescents. So
1:36:52I think that should also be highlighted
1:36:54. If even then you say," No, I’d
1:36:55still like to use the questionnaire. "
1:36:56Wonderful. Then you can customize it as
1:36:59you go, but don't let the questionnaire
1:37:01replace the listening process,
1:37:02otherwise, everyone just stays in their
1:37:04own bubble, they write their answers,
1:37:06and no one discusses them, you know? So
1:37:09I think the material will really help
1:37:12with that.
1:37:14Right. I appreciate the answer. It
1:37:17cleared up a lot, but I really hadn't
1:37:19thought about skipping the listening
1:37:20part. I think the discussion among them
1:37:23is quite necessary. I think it’s very
1:37:25interesting because it sparks ideas,
1:37:26right? Actually, I’ve even been
1:37:28thinking about the discussion first,
1:37:30then the questionnaire, but I didn't
1:37:32want to bring that up until you
1:37:34presented it to me, you know? Day. I'm
1:37:36feeling a bit anxious, kind of
1:37:38desperate, not knowing how I'm going to
1:37:39manage to resolve this. And I think
1:37:42regarding your last question about the
1:37:44professionals, you don't need to have a
1:37:46psychologist in that circle, you don't
1:37:48need a highly specialized professional,
1:37:51if that's not our expectation. The
1:37:54expectation is that you have
1:37:56professionals who prepare together,
1:37:58right, on these ethical principles of
1:38:01confidentiality, secrecy, and
1:38:03protecting and caring for adolescents
1:38:05in that sense. So you don't need a
1:38:09specialized professional.
1:38:11Right? Uh, I just have one last doubt
1:38:13and one last question. The doubt is
1:38:15regarding the letter from the
1:38:17adolescents you mentioned; I saw it at
1:38:19one point in the presentation, but
1:38:20hearing you now, I remembered to ask
1:38:22how it will be done, if there is
1:38:24already a ready-made template we will
1:38:26adapt, or if we are going to create a
1:38:28letter from scratch. What would be the
1:38:31content of this letter? There is
1:38:33already a ready-made template. Actually
1:38:35, there are two templates, because
1:38:37since we made two workshop proposals,
1:38:39we talked about the essential workshop,
1:38:41which is a 1-hour-and-30-minute
1:38:43workshop, if I'm not mistaken, and the
1:38:45extended workshop, which is a 3-hour
1:38:47workshop. And then for each of these
1:38:51workshops, we included a suggestion, a
1:38:53letter template, in the guide. And then
1:38:55you just start the sentence and
1:38:57complete it, you know? Obviously, you
1:38:59can say, no, for my municipality I want
1:39:01to add this point, I want to remove
1:39:02this here. Obviously, the municipality
1:39:04has the autonomy for that, but there
1:39:06are already two models there,
1:39:08right? Uh, when you mentioned the
1:39:11submission, right, and the issue of the
1:39:13records, that we will make just one
1:39:14record, right, basically there. And
1:39:16then inside this record is where I will
1:39:19put everything at once. For example, I
1:39:21read somewhere in one of these
1:39:23documents that there has to be minutes
1:39:25of this NUCA meeting and that, uh,
1:39:27there are some others that, for example
1:39:29, require a photo, something like that,
1:39:30right, a description of how it went.
1:39:33And then inside this record I will put
1:39:35all of that. For example, one document
1:39:38with the minutes, another document with
1:39:40the operational results, then the
1:39:42letter document, then some photos. It's
1:39:45just one record contain-Uh, we request
1:39:48some record, you don't need to include
1:39:51all of them, right? So, that's it. Ah,
1:39:53the municipality made the letter, great
1:39:55, the letter is already a record, right
1:39:57? Ah, no, I want to, I have minutes, I
1:39:59included the details, I put them there
1:40:01as an attachment, I have the photos and
1:40:03I agreed with the adolescents that I
1:40:04will share the photos, I put them as a
1:40:06record. So you don't have to register
1:40:08everything there, it's just like, you
1:40:10just need to ensure it was done, right?
1:40:12So, in that sense,
1:40:14okay? I appreciate it a lot. you know?
1:40:19Uh, folks, we will need to end the live
1:40:21stream at 11 o'clock sharp, because we
1:40:22have actually already gone over by half
1:40:24an hour. Samia has a schedule, we also
1:40:26have a schedule. Uh, Débora and
1:40:29Estefânia, who just raised her hand,
1:40:32can you leave your question in the chat
1:40:35so we can answer it or ask the question
1:40:38more quickly so we can cover it?
1:40:43Débora, uh, I think your microphone is
1:40:45already open, okay, Carla?
1:40:50I'm opening it, just a moment,
1:40:52okay? But for you to Yes, just so we
1:40:56can finish.
1:41:01It's open, it's enabled, Débora.
1:41:10Hi, everyone. Good morning.
1:41:12Hi, Débora. Good morning. Hey, I know
1:41:14I spoke right at the very end, I joined
1:41:17much later, right, a bit late, but I
1:41:19would like to know if I am doing it the
1:41:21right way. Uh, I started with a meeting
1:41:26with some municipal departments, like
1:41:29health, social services, and culture,
1:41:32in an intersectoral way, to discuss
1:41:35current data, what the teenage
1:41:37pregnancy rate is like here,
1:41:40vaccination coverage, and everything
1:41:43related to adolescents, so we can start
1:41:46planning the operational plan for
1:41:49adolescent health. Uh, and so I wanted
1:41:53to know if I'm really doing it the
1:41:55right way, because I'm also a bit lost.
1:41:58It's all very new, I believe everyone
1:42:00is feeling the same way. I picked up
1:42:04the guide, but I couldn't really find
1:42:05the right direction from it, you know?
1:42:10But I got started; we brought all the
1:42:12municipal departments together to
1:42:14discuss what we can do for our
1:42:15adolescents in the municipality. And
1:42:19then I started presenting what the
1:42:21teenage pregnancy coverage is like, the
1:42:23vaccination coverage, and the number of
1:42:25young people participating in NUCA here
1:42:27in the municipality. And so I wanted to
1:42:31know if I'm doing this correctly. And
1:42:34then we will start developing the
1:42:36actions that can be taken for these
1:42:37adolescents here in the municipality,
1:42:39right? With each department. I decided
1:42:42to sit down with each department. On
1:42:44Monday, I'll be sitting down with the
1:42:46health department, then afterwards with
1:42:48social services, and then with culture,
1:42:51right? Because I believe we can be more
1:42:54productive this way, by sitting down
1:42:57with each department to see what
1:42:59actions we can develop and include in
1:43:01this operational plan. So I would like
1:43:04to know if I'm doing it right, because
1:43:08I saw there that there's a little table
1:43:11, right? And we have to include what
1:43:14action will be developed, who will be
1:43:16responsible for developing that action,
1:43:17and the timeframe, right? And I wanted
1:43:22to know if it's really like that,
1:43:24because my bottleneck here, for example
1:43:26, is teenage pregnancy. Then we'll see,
1:43:30we already have a municipal plan that
1:43:32was developed for adolescents here in
1:43:34the municipality. And we are going to
1:43:37sit down with the PSE team, primary
1:43:39care, and immunization staff to see
1:43:41what we can do specifically for these
1:43:43adolescents. And so I wanted to know if
1:43:46that's the way to go.
1:43:47Listening to you, I think this
1:43:49intersectoral starting point is
1:43:51wonderful, isn't it? Oh, for sure. This
1:43:54is indeed the way. I think my very
1:43:56pragmatic suggestion is obviously to
1:43:59continue. It's great that you're
1:44:01managing to secure these partnerships
1:44:02with other departments throughout this
1:44:04process. Plan your listening session
1:44:06there. Perhaps involving the mobilizers
1:44:09could be very interesting. Take the
1:44:11guide, plan it with them, listen, and
1:44:13see who else from other departments
1:44:15wants to participate, taking care that
1:44:16you don't end up with 10 adults and
1:44:18five adolescents, right? Because
1:44:20sometimes everyone wants to join in, so
1:44:21keep an eye on that too. Oh, and the
1:44:24next step is the prioritization phase.
1:44:28So my final suggestion for you is to
1:44:30continue with this one-on-one approach,
1:44:32seeing what everyone prioritizes based
1:44:35on the data, but by October or November
1:44:37, try to sit down with everyone and
1:44:39what they’ve brought so you can
1:44:41decide on the priority. And then
1:44:45prioritize together, as a municipality,
1:44:48what the municipality's priority will
1:44:50be, and that's it. Will it be
1:44:52adolescent pregnancy, will it be
1:44:53another theme, and what will each
1:44:55department, for example, be responsible
1:44:57for?
1:44:58Right? Regarding this listening session
1:45:00, can I do it just with the Nuca
1:45:02members, or do I need to include the
1:45:04schools as well?
1:45:04I want to
1:45:05It can be just Nuca or some schools, it
1:45:08doesn't matter. Just try to keep to
1:45:10that limit of 10 to 16. We had a
1:45:13question in the chat, I'll take this
1:45:14opportunity. People asked if it was 10
1:45:16to 16 adolescents per school or for the
1:45:19entire municipality. We are asking for
1:45:22one per municipality. If you want to
1:45:25hold more than one session, that's fine
1:45:27, but we are requesting one listening
1:45:30session per municipality.
1:45:34Right. Thank you,
1:45:41everyone. Let's wrap things up, shall
1:45:44we? And, as well said by Humberto in
1:45:48the chat, today's live stream was
1:45:50excellent, Sam. Thank you so much for
1:45:54your availability, this whole
1:45:56partnership with UNICEF, and this very
1:45:58didactic way of accompanying and
1:46:00explaining things; I think it makes a
1:46:03huge difference in ensuring this
1:46:05reaches the territories efficiently. We
1:46:09are very grateful for your presence. We
1:46:11hope to count on you many more times.
1:46:13There's a long way to go until December
1:46:1514th and we look forward to having you
1:46:18with us on several other occasions,
1:46:20okay? Oh,
1:46:21we will certainly meet again. I'm
1:46:23already hoping to be invited in person,
1:46:25right? Because you keep calling me only
1:46:27for online meetings. From now on, I
1:46:30want in-person meetings. No, but I also
1:46:32want to say thank you, right? It's so
1:46:34good to see this group so engaged in
1:46:36this topic, which is so passionate and
1:46:38also so important. I also wanted to
1:46:41highlight Juliana, our great partner
1:46:43from UNICEF, who couldn't be with us
1:46:45today, but she left everything
1:46:47organized and ready for us to be here,
1:46:49and I know she might watch the live
1:46:51stream later, and you'll be in contact
1:46:53with her too. So I also wanted to make
1:46:56that mention, right? And thank you very
1:46:59much, and count on me. As you said,
1:47:00Lália, there's still a long way to go
1:47:02until the 14th. There's still a second
1:47:04chance afterwards, right, where there's
1:47:05still a possibility.
1:47:06Exactly. Ju is always with us. Thank
1:47:10you so much, especially for
1:47:11coordinating the presence of the state
1:47:13coordinators, Ju does that with a lot
1:47:15of excellence. So, we have Paraíba
1:47:18with us here, Alagoas too, and
1:47:20Pernambuco. We are very grateful that
1:47:22this coordination happens in the
1:47:24territories, right? There's a lot of
1:47:26work involved, and we thank each and
1:47:29every one of you present here, the
1:47:31folks from CESAL, PSE Maceió, and the
1:47:33health coordination from Paraíba and
1:47:35Pernambuco as well. Thank you very much
1:47:39for the presence of each and every one
1:47:41of you, as well as our dear colleagues
1:47:44who are with us every day, the
1:47:45articulators and mobilizers from these
1:47:48three states that ACER supports, as the
1:47:50Recife office, with great affection,
1:47:52together with each one of you. Folks,
1:47:56the live stream will be recorded. Soon,
1:47:58it will be uploaded to the groups for
1:47:59you as well, along with all the
1:48:01material that Sâmia sent. We had
1:48:04already made the guides available in
1:48:06the group; only the adolescent guide
1:48:07was going to be uploaded after this
1:48:09live stream, but we'll go ahead and
1:48:11post the general announcement with all
1:48:13the links clearly specified for you in
1:48:15the mobilizer and articulator groups,
1:48:16okay? Kisses, hugs, and see you next
1:48:20time. Thanks a lot. Good morning to you
1:48:22all.
1:48:22Bye, bye. See you next time.

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