In every country, health and prevention “come down” from the authorities responsible for this mission by way of planners, local authorities, and peer educators until it reaches the target population. International and national systems function on the premise of a top-down transmission, with little room for integrating local information that might provide a better understanding of the implementation process. This analysis is based on an empirical evaluative research of HIV/AIDS prevention projects with sex workers in a remote area of northern Brazil. It illustrates how nursing sociopolitical analysis can reveal how political interests can have perverse effects by contaminating the group's internal relations and with established partnerships, thereby weakening the impact of prevention programs. These effects can seriously affect community relations and social practices, far beyond the technical division of work and political hierarchies in the sociosanitary network.
Brandão, C. R. (1985). Pesquisa participante[Participatory research]. São Paulo, Brazil: Brasiliense.
2.
Brandão, C. R. (2002). A educação popular na escola cidada[People's education in citizenship training school]. Petrópolis, Brazil: Editora Vozes.
3.
Callon, M. , Law, J., & Rip, A. (1986). Mapping the dynamics of science and technology: Sociology of science in the real world. London: Macmillan.
4.
Campbell, D. T. (1989). The experimenting society. In E. S. Overman (Ed.), Methodology and epistemology for social science (pp. 504-523). Chicago: University of Chicago Press. (Original work published 1971)
5.
Campbell, D. T. (1989). Can we be scientific in applied social science? In E. S. Overman (Ed.), Methodology and epistemology for social science(pp. 315-335). Chicago: University of Chicago Press. (Original work published 1984)
6.
Campbell, D. T. (1989). Science's social system of validity-enhancing collective belief change and the problems of the social sciences. In E. S. Overman (Ed.), Methodology and epistemology for social science(pp. 504-523). Chicago: University of Chicago Press. (Original work published 1986)
7.
Casanova, P. G. (2002). Os conflitos ideológicos e a cooperação em ciências sociais [The ideological conflicts and cooperation in social sciences]. In P. G. Casanova (Ed.), Exploração, colonialismo e luta pela democracia na América Latina [Exploitation, colonialism and fight for democracy in Latin America] (pp. 265-290). Petrópolis, Brazil: Editora Vozes.
8.
Centre for the Sociology of Organizations. (2005). Le laboratoire [The laboratory]. Paris: Author. Retrieved September 7, 2005, from http://www.cso.edu
9.
Cronbach, L. J. (1989). Ninety-five theses for reforming programme evaluation. In G. F. Madaus, M. S. Scriven, & D. L. Stufflebeam (Eds.), Evaluation models.Viewpoints in educational and human services evaluation (pp. 405-412). Boston: Kluwer-Nijhoff.
10.
Crozier, M. (1980). Actors and systems: The politics of collective action. Chicago: University of Chicago Press.
11.
Daudelin, G. , & Vissandjée, B. (1998). L'empowerment comme technique d'intervention dans le domine de la santé: Réflexion sur une panacée[Empowerment as technical intervention in health field: Reflection about a panacea]. Montréal, Canada: Centre d'Excellence pour la Santé des Femmes.
12.
Demo, P. (2000). Conhecimento moderno.Sobre ética e intervenção do conhecimento [Modern knowledge. About ethic and intervention of knowledge]. Petrópolis, Brazil: Editora Vozes.
13.
Demo, P. (2001). Participação é conquista [Participation is a conquest] (5th ed.). São Paulo, Brazil: Cortez Editora.
14.
Denis, J. L. , & Champagne, F. (1990). L'analyse de l'implantation: modèles et methods [Analysis of implantation: models and methods]. The Canadian Journal of Program Evaluation, 5, 47-67.
15.
Detienne, M. , & Vernant, J. P. (1991). Cunning Intelligence in Greek culture and society (J. Lloyd, Trans.). Chicago: University of Chicago Press.
16.
Dewey, J. (1930). The quest for certainty: A study of the relation of knowledge and action. London: Allen and Unwin.
17.
Dewey, J. (1991). How we think. New York: Prometheus Books.
18.
Fals-Borda, O. (1992). La ciencia y el pueblo: Nuevas reflexiónes [The science and the people: New thoughts]. In M. C. Salazar (Ed.), La investigación-acción participativa.Inicios y desarrollos [The participatory action research. Beginnings and developments] (pp. 63-84). Buenos Aires, Argentina: Humanitas. (Original work published in 1980)
19.
Farmer, P. (1999). Infections and inequalities: The modern plagues. Berkeley: University of California Press.
20.
Farmer, P. (2003). Pathologies of power.Health, human rights, and the new war on the poor. Berkeley: University of California Press.
21.
Fassin, D. (2000). Comment faire de la santé publique avec des mots: Une rhétorique à l'oeuvre [How to make public health with words: A rhetoric in movement]. Ruptures, Revue Transdisciplinaire en Santé, 4(1), 58-78.
22.
Freire, P. (1974). Education for critical consciousness. New York: Continuum.
23.
Friedberg, E. (1996). Local orders: Dynamics of organized action. Greenwich, CT: JAI Press.
24.
Friedberg, E. (Ed.). (2001). De Taylor à aujourd'hui.L'histoire de la théorie des organizations [From Taylor to present. The history of theory of organizations] [DVD-Rom]. The Series of Cooperation, Decision, Leadership, Negotiation. Paris: Banlieues Media Editions. Retrieved from http://www.banlieues-media.com/home.asp
25.
Friedberg, E. (Ed.). (2005). Decision making [DVD-Rom]. The Series of Organization. Paris: Banlieues Media Editions. Retrieved from http://www.banlieues-media.com/home.asp
26.
Health Canada. (2000). Guide to project evaluation: A participatory approach. Retrieved August 16, 2004, from http://www.hc-sc.gc.ca/hppb/phdd/resources/guide
27.
House, E. R. , & Howe, K. R. (1999). Values in evaluation and social research. Thousand Oaks, CA: Sage.
28.
Interinstitutional Commission for the Control and Prevention of STDs of the State of Amazonas [Comissão interinstitucional de controle e prevenção das Doenças sexualmente transmissíveis e AIDS]. (2003). Plano Interinstitucinal das DST e AIDS no Estado do Amazonas[Interinstitutional plan for STD and AIDS in the state of Amazonas]. Manaus, Brazil: Amazonas.
29.
International Development Research Centre. (n.d.). The guiding principles of IDRCs. Retrieved September 11, 2005, from http://web.idrc.ca/en/ev-26266-201-1-DO_TOPIC.html
30.
International Institute for Sustainable Development. (1999). Participatory research for sustainable livelihoods: A guide for field projects on adaptive strategies. Retrieved September 21, 2005, from: http://www.iisd.org/casl/CASLGuide/GuideBook-home.htm
31.
Jalbert, Y. , Pinault, L., Renaud, G., & Zúñiga, R. (1997). Epsilon.A self-evaluation guide for community organizations (D. Buckley-Couvrette, Trans.). Montreal, Canada: Coalition des Organismes de Lutte Contre le Sida (COCQ-Sida).
32.
Kushner, S. (2000). Personalizing evaluation. London: Sage.
33.
Lalande, A. (1960). Vocabulaire technique et critique de la philosophie [The technical and critical vocabulary of philosophy]. Paris: Presses Universitaires de France.
34.
Laperrière, H. (2004). L'évaluation de l'action préventive en contexte d'imprévisibilité.Les enjeux d'un projet de prévention des HIV/AIDS par les pairs, Amazonas, Brésil [Evaluation of preventive action in a context of unpredictability. Challenges of a HIV/AIDS prevention project with peers]. Unpublished master's thesis, Faculty of Nursing Sciences, University of Montreal, Canada.
35.
Laperrière, H. , Benzaken, A. S., & Zúñiga, R. (2004, October 14). Les déterminants sociopolitiques dans l'action conjointe à paliers multiples.Les interlocuteurs dans un projet de prévention des MTS/VIH/Sida[Sociopolitical determinants in multiple level of collective action. The interlocutors in a STD/AIDS prevention project]. Paper presented at the Second International Conference on local and regional health programmes, Quebec. Abstract retrieved September 20, 2005, from http://colloquequebec2004.com/Search.aspx?params=id=2,rawinput=Laperri%E8re
36.
Latour, B. (1988). Science in action. Cambridge, MA: Harvard University Press.
37.
Latour, B. (1999). Pandora's hope.Essays on the reality of science studies. Cambridge, MA: Harvard University Press.
38.
Mark, M. M. , Henry, G. T., & Julnes, G. (1998). A realist theory of evaluation practice. New Direction for Evaluation, 78, 3-32.
39.
Mark, M. M. , Henry, G. T., & Julnes, G. (2000). Understanding social betterment and the role of values in evaluation. In M. M. Mark & G. Julnes (Eds.), Evaluation.An integrated framework for understanding, guiding, and improving public and nonprofit policies and programs(pp. 18-48). San Francisco: Jossey-Bass.
40.
Massé, R. (1999). La santé publique comme nouvelle moralité [Public health as a new morality]. In P. Fortin, M. Beaulieu, B. Boulianne, M. Dumais, R. Massé, P. P. Parent, et al. (Eds.), La réforme de la santé au Québec [Health reform in Quebec] (pp. 155-174). Quebec City, Canada: Éditions Fides.
41.
Mendel, G. (1998). L'acte est une aventure.Du sujet métaphysique au sujet de l'actepouvoir [The act is an adventure. From metaphysic subject to power act of subject]. Paris: La découverte.
42.
Mercado, F. , Springett, J., Kierans, C., Laperrière, H., & Zúñiga, R. (2003, December). First world participatory evaluation to health aid programmes in Latin America.A critical perspective. Paper presented at the UKES Conferences, Cardiff, United Kingdom.
43.
Moura, H. A., & Moreira, M. M. (2001, July). A população da região norte: Processos de ocupação e de urbanização recentes [The northern region population: Recent process of occupation and urbanization]. Retrieved on July 20, 2003, from www.fundaj.gov.br/tpd/112.htm
44.
Pawson, R. , & Tilley, N. (1997). Realistic evaluation. London: Sage.
45.
Petersen, A. , & Lupton, D. (1996). The new public health: A new morality? In A. Petersen & D. Lupton, The new public health.Health and self in the age or risk (pp. 1-26). London: Sage.
46.
Pluye, P. , Potvin, L., & Denis, J.-L. (2004). Making public health programs last: Conceptualizing sustainability. Evaluation and Program Planning, 27, 121-133.
47.
Rahman, A. , & Fals-Borda, O. (1992). La situación actual y las perspectivas de la IAP en el mundo [The present situation and perspectives of PAR in the world]. In M. C. Salazar (Ed.), La Investigación-Acción Participativa.Inicios y desarrollos [The participatory-action research. Beginnings and developments] (pp. 205-226). Buenos Aires, Argentina: Humanitas.
48.
Scriven, M. (1972). Pros and cons of goal-free evaluation. Evaluation Comment, 3(4).
49.
Scriven, M. (1991). Evaluation thesaurus. Newbury Park, CA: Sage.
50.
Scriven, M. (2004). Reflections. In M. C. Alkin (Ed.), Evaluation roots. Tracing theorists' views and influences (pp. 183-185). Thousand Oaks, CA: Sage.
51.
Stavenhagen, R. (1981). Decolonializing applied social sciences. In R. Stavenhagen (Ed.), Between underdevelopment and revolution.A Latin American perspective, (pp. 179-201). New Delhi, India: Abhinav Publications.
52.
Tremblay, M. (1999). Une démocratie en santé: Utopie ou réalité? [A democracy in health: Utopia or reality?]. In P. Fortin, M. Beaulieu, B. Boulianne, M. Dumais, R. Massé, P. P. Parent, et al. (Eds.), La réforme de la santé au Québec [Health reform in Quebec] (pp. 76-131). Quebec City, Canada: Editions Fides.
53.
United Nations Development Programme. (1996). Participatory evaluation in programmes involving governance decentralisation: A methodological note. Management Development and Governance Division. Retrieved August 20, 2004, from http://magnet.undp.org/docs/dec/evaluate.htm
54.
USAID. (1996). Performance monitoring and evaluation tips. Center for Development Information and Evaluation. Retrieved August 15, 2005, from www.usaid.gov/pubs/usaid_eval/pdf_docs/pnaby233.pdf
55.
Vasconcelos, E. M. (1998). Educação Popular em tempos de democracia e pos-modernidade: Uma visão a partir do setor saúde [People's education in times of democracy and postmodernity: A vision from the public field]. In M. V. Costa (Ed.), Educação popular hoje [People's education today] (pp. 63-95). São Paulo, Brazil: Edições Loyola.
56.
Vasconcelos, E. M. (2002). Educação Popular e pesquisa-ação como instrumentos de reorientação da prática médica [People's education and action-research as tools for medical practice reorientation]. In E. P. Gonsalves (Ed.), Educação e grupos populares: Temas (re)correntes[People's education and groups: (Re)current themes] (pp. 99-116). Campinas, Brazil: Alinea Editora.
57.
World Health Organization . (1986). Ottawa charter for health promotion. Ottawa: Canadian Association of Public Health.
58.
Zúñiga, R. , & Laperrière, H. (in press). A Avaliação comunitária: Conflitos verticales e ambiguidades metodológicas [Community evaluation: Vertical conflicts and methodological ambiguities]. In F. Mercado & M. L. Bosi (Eds.), Avaliação de programas e serviços de saúde: Enfoques emergentes [Program and health services evaluation: Emerging perspectives]. Petrópolis, Brazil: Editora Vozes.
