Apoio institucional em saúde: desafios para democratização na atenção básica

It was aimed to analyze one of dimensions of the Basic Attention offered by in primary care team by the municipal administrations of Brazilian cities that have joined Access Improvement Programme and Quality of Primary Care (PMAQ-AB in portuguese). Owned descriptive exploratory, by qualitative and...

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Autor principal: Melo, Lygia Maria de Figueiredo
Outros Autores: Rocha, Paulo de Medeiros
Formato: doctoralThesis
Idioma:por
Publicado em: Universidade Federal do Rio Grande do Norte
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Endereço do item:https://repositorio.ufrn.br/jspui/handle/123456789/20410
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id ri-123456789-20410
record_format dspace
institution Repositório Institucional
collection RI - UFRN
language por
topic Gestão em saúde
Apoio institucional
Atenção básica
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
spellingShingle Gestão em saúde
Apoio institucional
Atenção básica
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA
Melo, Lygia Maria de Figueiredo
Apoio institucional em saúde: desafios para democratização na atenção básica
description It was aimed to analyze one of dimensions of the Basic Attention offered by in primary care team by the municipal administrations of Brazilian cities that have joined Access Improvement Programme and Quality of Primary Care (PMAQ-AB in portuguese). Owned descriptive exploratory, by qualitative and quantitative approaches to data analysis. Data collection took place between February-October 2014 by two sample groups, the first one consisting of respondents of module II corresponding to 2941 teams of 23 capitals that have joined the program and the second one by 22 managers of Primary Care Brazilian cities that responded to the module IV (on line). In quantitative phase variables were analyzed using descriptive statistics, using IBM SPSS Statistics Software 20 and organized and grouped results in three dimensions: characteristics of Institutional Support; Institutional Sketchpad the work process and support teams to manage and plan work processes. In qualitative phase, it was analyzed general guidelines for the Institutional Support in the municipal, as described by the municipal manager in online form. For organization and categorization of qualitative data was used Atlas ti.7.1, and as a method of interpretation, content analysis. From the conception of support as a democratizing tool, it was proceeded to approach concepts Support Paideia (Campos), power relations (Foucault) and institutional analysis (Lourau). It was defined following categories of analysis: Category 1 - Dimension administration and planning work processes by subcategories: Support for organization of work process of teams; Support planning, monitoring and evaluation; Support the actions of teams; Support for the strengthening of health care networks and intersectoral actions and organizational and administrative structure of support in the city. Category 2 - Dimension Policy by following subcategories: Support for participative process management and stimulation of social control; Support the building of democratic relations, cooperatives and dialogical; Support for actions related to PMAQ; description of Institutional Support using the same wording of official documents of health ministry. Category 3 - Pedagogical dimension formed by Subcategory: formation and training of professionals and managers. It was observed that Institutional Support is a reality in context of Primary Care in Brazil, but it was found that in both actions supported as the guidelines proposed by managements is evident in a normalizing and trace this process. There was a positive evaluation by teams Sketchpad Institutional, although these professionals find themselves overwhelmed when exercising that function by excessive number of teams under their responsibility, demonstrating the need for a design that takes into account how to operate the Support function. In Brazilian cities were observed weaknesses in a position to manage the processes for institutionalization of support, the conclusion was that managements and management teams in Primary Care need to be supported in conducting this process. It is proposed thus deepening the theme and when other PMAQ-AB cycles tooccur be made adequacy of instruments used in external evaluation concerning the importance Institutional Support in order to advance the appreciation of uniqueness of support, especially regard to co-management as a collective and democratic process.
author2 Rocha, Paulo de Medeiros
author_facet Rocha, Paulo de Medeiros
Melo, Lygia Maria de Figueiredo
format doctoralThesis
author Melo, Lygia Maria de Figueiredo
author_sort Melo, Lygia Maria de Figueiredo
title Apoio institucional em saúde: desafios para democratização na atenção básica
title_short Apoio institucional em saúde: desafios para democratização na atenção básica
title_full Apoio institucional em saúde: desafios para democratização na atenção básica
title_fullStr Apoio institucional em saúde: desafios para democratização na atenção básica
title_full_unstemmed Apoio institucional em saúde: desafios para democratização na atenção básica
title_sort apoio institucional em saúde: desafios para democratização na atenção básica
publisher Universidade Federal do Rio Grande do Norte
publishDate 2016
url https://repositorio.ufrn.br/jspui/handle/123456789/20410
work_keys_str_mv AT melolygiamariadefigueiredo apoioinstitucionalemsaudedesafiosparademocratizacaonaatencaobasica
_version_ 1773964759219044352
spelling ri-123456789-204102017-11-03T17:28:58Z Apoio institucional em saúde: desafios para democratização na atenção básica Melo, Lygia Maria de Figueiredo Rocha, Paulo de Medeiros http://lattes.cnpq.br/3580862965931971 http://lattes.cnpq.br/3633596483807678 Amorim, Ana Karenina de Melo Arraes http://lattes.cnpq.br/9847082748841264 Vasconcelos, Cipriano Maia de http://lattes.cnpq.br/6561196586776281 Almeida, Ana Mattos Brito de http://lattes.cnpq.br/4899711651204481 Righi, Liane Beatriz http://lattes.cnpq.br/5575942071914661 Gestão em saúde Apoio institucional Atenção básica CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA It was aimed to analyze one of dimensions of the Basic Attention offered by in primary care team by the municipal administrations of Brazilian cities that have joined Access Improvement Programme and Quality of Primary Care (PMAQ-AB in portuguese). Owned descriptive exploratory, by qualitative and quantitative approaches to data analysis. Data collection took place between February-October 2014 by two sample groups, the first one consisting of respondents of module II corresponding to 2941 teams of 23 capitals that have joined the program and the second one by 22 managers of Primary Care Brazilian cities that responded to the module IV (on line). In quantitative phase variables were analyzed using descriptive statistics, using IBM SPSS Statistics Software 20 and organized and grouped results in three dimensions: characteristics of Institutional Support; Institutional Sketchpad the work process and support teams to manage and plan work processes. In qualitative phase, it was analyzed general guidelines for the Institutional Support in the municipal, as described by the municipal manager in online form. For organization and categorization of qualitative data was used Atlas ti.7.1, and as a method of interpretation, content analysis. From the conception of support as a democratizing tool, it was proceeded to approach concepts Support Paideia (Campos), power relations (Foucault) and institutional analysis (Lourau). It was defined following categories of analysis: Category 1 - Dimension administration and planning work processes by subcategories: Support for organization of work process of teams; Support planning, monitoring and evaluation; Support the actions of teams; Support for the strengthening of health care networks and intersectoral actions and organizational and administrative structure of support in the city. Category 2 - Dimension Policy by following subcategories: Support for participative process management and stimulation of social control; Support the building of democratic relations, cooperatives and dialogical; Support for actions related to PMAQ; description of Institutional Support using the same wording of official documents of health ministry. Category 3 - Pedagogical dimension formed by Subcategory: formation and training of professionals and managers. It was observed that Institutional Support is a reality in context of Primary Care in Brazil, but it was found that in both actions supported as the guidelines proposed by managements is evident in a normalizing and trace this process. There was a positive evaluation by teams Sketchpad Institutional, although these professionals find themselves overwhelmed when exercising that function by excessive number of teams under their responsibility, demonstrating the need for a design that takes into account how to operate the Support function. In Brazilian cities were observed weaknesses in a position to manage the processes for institutionalization of support, the conclusion was that managements and management teams in Primary Care need to be supported in conducting this process. It is proposed thus deepening the theme and when other PMAQ-AB cycles tooccur be made adequacy of instruments used in external evaluation concerning the importance Institutional Support in order to advance the appreciation of uniqueness of support, especially regard to co-management as a collective and democratic process. Objetivou-se analisar o Apoio Institucional na Atenção Básica ofertado às equipes pelas gestões municipais das capitais brasileiras que aderiram ao Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB). Possuiu caráter exploratório descritivo, com abordagens qualitativa e quantitativa para análise dos dados. A coleta de dados foi realizada no período de fevereiro a outubro de 2014 com dois grupos amostrais, sendo o primeiro composto pelos respondentes do módulo II que correspondeu a 2941 equipes, das 23 capitais que aderiram ao Programa e o segundo por 22 gestores da Atenção Básica das capitais brasileiras que responderam ao módulo IV (on line). Na fase quantitativa as variáveis foram analisadas através da estatística descritiva, com uso do Software IBM SPSS Statistics 20 e os resultados organizados e agrupados em três dimensões: características do Apoio Institucional; processo de trabalho do Apoiador Institucional e Apoio às equipes para administrar e planejar processos de trabalho. Na fase qualitativa, analisaram-se as diretrizes gerais para o Apoio Institucional no município, descritos pelo gestor municipal no formulário on line. Para organização e categorização dos dados qualitativos foi utilizado o Atlas ti.7.1, e como método de interpretação, a análise de conteúdo. A partir da concepção do Apoio como ferramenta democratizante, procedeu-se a aproximação de conceitos do Apoio Paideia (Campos), das relações de poder (Foucault) e da análise institucional (Lourau). Elencou- se as seguintes categorias de análise: Categoria 1- Dimensão administração e planejamento de processos de trabalho com as Subcategorias: Apoio à organização do processo de trabalho das equipes; Apoio ao planejamento, monitoramento e avaliação; Apoio às ações das equipes; Apoio ao fortalecimento das redes de atenção à saúde e ações intersetoriais e estrutura organizacional e administrativa do Apoio no município. Categoria 2- Dimensão Política com as Subcategorias: Apoio aos processos participativos de gestão e estímulo ao controle social; Apoio a construção de relações democráticas, cooperativas e dialógicas; Apoio às ações vinculadas ao PMAQ; descrição do Apoio Institucional utilizando a mesma redação dos documentos oficiais do MS. Categoria 3- Dimensão Pedagógica com a Subcategoria: processos de formação e qualificação de profissionais e gestores. Observou-se que o Apoio Institucional é uma realidade no contexto da Atenção Básica no Brasil, porém identificou-se que, tanto nas ações apoiadas quanto nas diretrizes propostas pelas gestões evidencia-se um traço normalizador e burocrático nesse processo. Houve avaliação positiva pelas equipes do Apoiador Institucional, embora esses profissionais encontrem-se sobrecarregados no exercício dessa função pelo número excessivo de equipes sob sua responsabilidade, evidenciando-se a necessidade de um dimensionamento que leve em consideração o modo de operar a função Apoio. Nas capitais brasileiras observaram-se fragilidades nas condições de gerir os processos para a institucionalização do Apoio, inferindo-se que as gestões e equipes de gestão da Atenção Básica precisam ser apoiadas na condução desse processo. Propõe-se, assim, o aprofundamento da temática e que nos outros ciclos do PMAQ-AB haja adequação dos instrumentos utilizados na avaliação externa, referente à dimensão Apoio Institucional, a fim de avançar na valorização das singularidades do Apoio, principalmente, no tocante à cogestão enquanto processo coletivo e democrático. 2016-05-06T20:18:53Z 2016-05-06T20:18:53Z 2015-08-03 doctoralThesis MELO, Lygia Maria de Figueiredo. Apoio institucional em saúde: desafios para democratização na atenção básica. 2015. 171f. Tese (Doutorado em Saúde Coletiva) - Centro de Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, 2015. https://repositorio.ufrn.br/jspui/handle/123456789/20410 por Acesso Aberto application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM SAÚDE COLETIVA