Health at School Program: advances, difficulties and challenges in health promotion in schools in Brazil

Abstract

Brazil has gone through an extensive historical journey until the institutionalization of a national program to work in the school environment. The realization of this study is justified by the need to analyze how health promotion has been carried out within the country's schools, allowing a reflection on the effectiveness of the activities carried out until then, as well as supporting the execution of the next actions by the management and by health professionals under this program. It aimed to identify advances, difficulties and challenges for health promotion in Brazilian schools after the implementation of the School Health Program (PSE). This is an integrative literature review, carried out in the Scientific Electronic Library Online (Scielo), Google Scholar and Virtual Health Library (BVS) databases, to answer the guiding question: what studies bring about the advances, difficulties, and challenges for health promotion in Brazilian schools after PSE implementation? The searches took place in October 2021, with the descriptors “health promotion”, “school health service”, and “Brazil”. A total of 511 articles were identified, of which 16 were selected according to eligibility criteria, evaluated for methodological rigor and level of evidence. The 16 articles presented level of evidence VI. Advances were identified in the path of health promotion, such as the approximation of the school-family bond and the health unit and the multiprofessional action in the agreed activities. However, it was pointed out as difficulties and challenges overload and accumulation of activities by professionals, lack of material inputs, inadequate infrastructure, weaknesses of intersectoral bonds and fragmented actions focused on disease prevention.