Andrea Fachel Leal

Federal University of Rio Grande do Sul - UFRGS

Av. Bento Gonçalves, 9500 - Instituto de Filosofia e Ciências Humanas
Departamento de Sociologia - Prédio 43311 sala 106 A1
Porto Alegre, RS

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I have been working in the field of an Anthropology of Policy. I am currently a professor at the Public Policy School and of the Sociology Department of the Federal University of Rio Grande do Sul (UFRGS), Brazil, where I am also a researcher and professor of both the Post-Graduate Epidemiology Program and the Post-Graduate Sociology Program. I also have experience in the fields of Medical Anthropology and Applied Anthropology. My current research projects are on the implementantion of the Maria da Penha Law in Brazil (gender violence) and on HIV-AIDS (gender and AIDS, morbi-mortality, international cooperation).

Leal, Andréa Fachel. Avaliação de implementação do Projeto Piloto DEBIBrasil : relatório / Implementation Evaluation of the Pilot DEBI Brazil Project : Final Report. Porto Alegre: Universidade Federal do Rio Grande do Sul, 2012.
Abstract: Evaluation report on the implementation of the DEBI Brazil Pilot Project by the Brazilian National HIV AIDS Department / Ministry of Health, carried out with the support of CDC and Fiocruz.
Gomes Romeu, Leal Andréa Fachel, Knauth Daniela, Silva Geórgia Sibele Nogueira da. Meanings attributed to policy directed to Men's Health. 2012 Oct ; 17 (10): 2589-2596.
Abstract: This study analyzed the meanings given to the Brazilian National Men's Health Policy (PNAISH) by those involved in its implementation to find out how a policy formulated at national level is reflected in local contexts. In five cities, from each macro region of the country, a set of 6 narratives and 21 semi-structured interviews were held with health managers and professionals; the information on the Policy was developed according to the Meaning Interpretation Method. The Policy is generally perceived as positive. Among the meanings given, it is emphasized that the policy is seen, by some, as a comprehensive care that guides actions to address men as a whole in Primary Care; then again, others perceived it as a reduction to urological problems. The policy was also perceived as something vague, which does not detail how to proceed to take men to the services and to better assist them, or something episodic, being the policy reduced to the accomplishment of specific events rather than ongoing actions in everyday services. The different meanings guide practices and actions, which may signal the effective and continued engagement of the professional with the policy, being a key element for its monitoring and evaluation. Key words: Men's health, Health policy, Public Health Policies, Gender and health, Qualitative research, Brazil
KNAUTH, Daniela Riva, LEAL, Andrea Fachel Leal, PILECCO, Flavia, SEFFNER, Fernando, TEIXEIRA, Ana Maria Borges. Staying awake: truck drivers' vulnerability in Rio Grande do Sul, Southern Brazil. Rev. Saúde Pública [online]. 2012, vol.46, n.5, pp. 886-893. ISSN 0034-8910
Abstract: OBJECTIVE: To analyze factors as1sociated with the use of stimulants by truck drivers to stay awake. METHODS: A survey with 854 drivers was carried out at eight truck stops (seven gas stations and one border patrol post) located at five cities in the State of Rio Grande do Sul (Southern Brazil) in 2006. The outcome "amphetamine use" was categorized as "yes" or "no". Poisson regression analysis with robust variance was conducted in order to select variables that would be included in the model, which was composed of variables regarding socioeconomic and demographic characteristics, information on profession and on alcohol consumption. RESULTS: Amphetamine was used by 12.4% of truck drivers in order to stay awake, either by itself or together with other substances (coffee, guaraná powder, energy drinks, snorted cocaine). Amphetamine was the most cited substance by those who consumed something to stay awake. Consumption of alcoholic drinks was mentioned by more than 70% of the interviewees. Among those who declared drinking alcohol, 45.1% reported drinking at least once a week. Once a week. Amphetamine use was associated with younger age, higher income, longer trips, and alcohol use. CONCLUSIONS: Truck drivers' higher income implies increased workloads, which can result in physical and emotional stress, with consequent use of stimulants, as a temporary solution. The reduction in abusive consumption of alcohol and in the use of illicit substance, like amphetamines, by truck drivers depends not only on policies addressing prevention and treatment for drug abuse, but also on integrated policies ensuring better working and health conditions. Descriptors: Transportation. Occupational Risks. Amphetamine. Men's Health. Occupational Health. Health Surveys.
LEAL, Andréa Fachel; FIGUEIREDO, Wagner dos Santos and NOGUEIRA-DA-SILVA, Geórgia Sibele. Charting the Brazilian Comprehensive Healthcare Policy for Men (PNAISH), from its formulation through to its implementation in local public health services. Ciênc. saúde coletiva [online]. 2012, vol.17, n.10, pp. 2607-2616. ISSN 1413-8123.
Abstract: The scope of this article is to see how the Brazilian Comprehensive Healthcare Policy for Men (PNAISH) has been implemented in the Unified Health System, from the standpoint of health professionals. A case study, involving five cases (each from a different macro region of Brazil) conducted using ethnographic techniques of data collection charted the progress of PNAISH implementation based on an anthropological approach using Lipsky's idea of street-level bureaucracy. PNAISH is contextualized in historical terms with national and international documents. Acknowledging the inevitable gap between the formulation and the implementation of any policy, an attempt is made to see how this gap has evolved by analyzing the transition of PNAISH into city Action Plans (PAs). It was revealed that the implementing agents had little knowledge of PNAISH, of the local health care network for men, of the techniques required to meet men's specific needs and of the concept of gender. It faced institutional obstacles, such as lack of an organizational structure, of a consolidated healthcare network – where the user receives services with different degrees of complexity within the system – and resources in general, especially human resources. Key words: Men's health, Healthcare policy, Public healthcare policy, Anthropology, Qualitative research, Brazil
LEAL, Andrea Fachel. "No peito e na raça" - a construção da vulnerabilidade de caminhoneiros: um estudo antropológico de políticas públicas para HIV/AIDS no sul do Brasil. Thesis (PhD). Universidade Federal do Rio Grande do Sul, Instituto de Filosofia e Ciências Humanas, Programa de Pós Graduação em Antropologia Social, Porto Alegre (Brazil). 2008.
Abstract: The main goal of this study, in the field of the Anthropology of Policy, was to analyze the social construction of the AIDS vulnerability of truck drivers in the South of Brazil, examining the national HIV/AIDS prevention policies. The discourse of three social actors were analyzed using the Medical Anthropology framework: (i) the national gonvernmental AIDS agency, (ii) the Non Governmental Organizations supported by the National AIDS Program to execute prevention projects targeting truck drivers, and (iii) the truck drivers themselves, passing through Rio Grande do Sul state. Three important themes traverse this study: (i) globalization (and the global/local relations), (ii) the identity of a social group or a community, and (iii) the construction of a sexual culture. To understand the social construction of the truck drivers’ vulnerability, I followed the route that this idea went through different institutions and levels. Beginning at international intergovernmental agencies such as the World Health Organization, the United Nations AIDS Program (UNAIDS) and the World Bank, the course followed through the analysis of scientific research on the theme, and finally the national AIDS agency’s discourse. The route finally came to how NGOs seize and use the idea that truck drivers are a vulnerable group, ending with how the truckers themselves perceive their vulnerability to HIV, AIDS and sexually transmitted infections. The study was limited in scope by the action of NGOs who had developed publicly funded projects targeting truck drivers. Methodologically, the study collected and analyzed data of different origins, types and qualities. Official documents, grey literature, scientific papers on truckers and HIV/AIDS, as well as NGO project proposals were studied. Data collection also involved an ethnography and a survey (N=854) of truck drivers. Both qualitative and quantitative studies of truckers were developed in Rio Grande do Sul, southernmost state of Brazil, in the cities of Porto Alegre, Gravataí, Canoas, Rio Grande and Chuí. Truckers are immersed in a social network, both in the truck stops (fuel stations and customs) and in their places of origin (where family relations prevail). The social universe of the truckstops is not a simply a transitory place: there are rules of conduct, leaderships, social spaces which are symbolic and geographically marked, and a number of persons who maintain diverse relations amongst themselves for a long time. Truck drivers did mention inconsistent use of condoms, specially with regular or fixed partners, that certainly increases their vulnerability to HIV and sexually transmitted infections. However, inconsistent condom use, and the availability of commercial sex workers, is not exclusive to truckers or truck stops. Emphasis is given to the programmatic or institucional vulnerability of truck drivers.

Substantive Focus:
Governance SECONDARY
Health Policy PRIMARY
Social Policy

Theoretical Focus:
Agenda-Setting, Adoption, and Implementation SECONDARY
Policy Analysis and Evaluation PRIMARY