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A BRIEF REVIEW


The idea of the CEDROS Network arose from a group of dentists worried about the growth of specialists within the oral health field, both at the individual and at the community levels, with the almost total abandon of the generalism. This phenomenon is observed in several areas of contemporaneous society, and requires the re-establishment of the balance. Specialism is manifested by means of disciplines at universities, at specialized scientific societies, and also by means of increasing specialties in the dental practice. Specialism cannot be avoided and is even necessary for the development of science and technology. However, we believe it must be followed by a movement crossing horizontally the vertical lines represented by the specialties. This is one of the reasons for the creation of NETWORKS as one of the megatrends of contemporary society.

The CEDROS, acronym resulting from the Portuguese translation of "Network for Cooperation in Studies and Development of Dental Resources for the Health Sector", was initially discussed in a meeting held in 1988, attended by teachers and health managers from several Brazilian states, aiming at the creation of a network based on a holistic view of Dentistry, and which allowed the union of minds and efforts around common ideas. These ideas are represented in the circle of Figure 1. We can see the action scope of the CEDROS Network in five major areas:

· epidemiological area;

· preventive area;

· curative-restorative technologies;

· development of human resources for oral health;

· improvement of technologies and policies to develop local health systems.

These five major areas were divided into twelve minor areas, represented in Figure 2. The intention was to start from the population needs with an epidemiological basis, through successive stages of development of preventive, curative, restorative methods and formation of human resources to reach the dental component of the health system and to contribute to the formulation of policies for oral health which are suitable to our reality and based on proved experiences.

Some basic characteristics of the Network were established:

· Holistic Aspect, having as a principle the concept that the whole is larger than the sum of the parts, thus explaining the option of the Network by the global focus of the problems, distant from the common trend of specialization of the health professions;

· Concern with Development, the research being always oriented to application to the oral health problems;

· Valuation of the human resources, which is antagonist to present trend of overestimating material resources created by manufacturers, who want them to be continuously renewed;

· Integration of the concepts of prevention and cure, prevention here meaning the basic element of any oral health program;

· Emphasis on cost/effectiveness when planning and evaluating oral health programs;

· Concern with equality and social justice, social responsibility of the professionals;

· Multidisciplinary focus of the problems through joint work with professionals of different areas, viewing the oral health problems of the individuals and community.

This meeting was followed by another one, in September 1989, as part of the schedule of the Congress of the Network of Projects for School-Services Integration (IDA Network), held at the University of the State of Rio de Janeiro (UERJ).

During the following months, there were discussions in Geneva with Dr. David Barmes, Chief of the Oral Health Section of the World Health Organization (WHO), with Dr. George Gillespie, of the Pan American Health Association (PAHO), and with Dr. Ariel Gómez, Executive Secretary of the Organization of Dental Schools, Faculties and Departments (OFEDO), related to the Union of Latin American Universities (UDUAL). At the same time, the Kellogg Foundation was contacted for support both to the CEDROS Network and to other similar efforts in Latin America, by means of OFEDO. These discussions led to the support of the Kellogg Foundation in June 90, thus allowing the beginning of activities.

OFEDO has also received support from the Kellogg Foundation for a three-year project named OFEDO/Networks Project, whose ideas were similar to those of CEDROS Network. The Network based its work on individual in leadership interacting voluntarily for a common goal, rather than on institutions. At the same time, it established important work relations with other networks within Brazil and around the world, as represented in the illustration below. At first the development of the Network was planned to take place in several Brazilian states or groups of states. The Rio de Janeiro and São Paulo poles were then created. As time went by, in an attempt to accelerate the implantation and to pass rapidly to the Network action program, it was decided to start the concomitant organization of Working Groups, according to the work lines of the network.

A second request for specific support from the Kellogg Foundation was elaborated in December 1991, and approved by the Foundation for the year of 1992. This resource, together with the one provided by the OFEDO/Networks Project, has made possible the continuity of the project up to present.


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