A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações do UFSM |
Texto Completo: | http://repositorio.ufsm.br/handle/1/16629 |
Resumo: | This research is about the implementation of public health policies, with a specific look at the National Basic Care Policy (NBCP), starting with the research problem "How can implementation actions affect the effectiveness of the Family Health Strategy in the municipality of Santa Maria/RS?". Based on this questioning, this work aims to analyze the factors that affect the effectiveness in the implementation of the Family Health Strategy (FHS) in Santa Maria/RS. The FHS is the main service of NBCP and includes a reorientation in the work model, seeking prevention and health promotion, increasing care towards the individual, and also the family and community, being also considered managerial to the other levels of health care. The choice for this municipality occurred due to some specifications found in the implementation of the FHS, which began in 2004, when the municipality joined Proesf (Expansion and consolidation of FHS Project) and in 2015 there were only 16 teams of FHS implemented, representing a coverage of 22.94% of the municipal territory. In addition, the process of implementing the FHS in this municipality went through periods of discontinuity and rupture according to the policy proposal. The design of this research, of mixed approach, predominantly qualitative, with an analytical inductive logic base method, starts from the theoretical recognition of the object, based on the concepts of public policies, implementation and effectiveness. It builds a historical-political clipping of public health policies in Brazil, starting from the Brazilian Sanitary Reform, up to the NBCP and in the empirical field analyzes the process of implementing the FHS in Santa Maria, through analysis of documents produced over the 13 years of this service. Semi-structured interviews were performed with health counselors and Community Health Agents (CHA), in addition to direct observation in the FHS teams implemented do far. The results point at many weaknesses along the implementation, regarding the planning of the territorialisation of the FHS teams, the compliance with work guidelines established in the public policy, the practices of professionals in the community, and the institutional support for professionals to carry out their activities. Nevertheless it is also possible to perceive specific changes in the communities assisted by the policy, in what refers to a change of habits of the users concerning the health care. The research made possible to perceive the "State in action" (SOUZA, 2006) in the work practices of the CHA that implement the FHS, and the existence of a service that exercises the coming and going of health care in the social context in which it is inserted. |
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2019-05-23T19:29:21Z2019-05-23T19:29:21Z2018-02-26http://repositorio.ufsm.br/handle/1/16629This research is about the implementation of public health policies, with a specific look at the National Basic Care Policy (NBCP), starting with the research problem "How can implementation actions affect the effectiveness of the Family Health Strategy in the municipality of Santa Maria/RS?". Based on this questioning, this work aims to analyze the factors that affect the effectiveness in the implementation of the Family Health Strategy (FHS) in Santa Maria/RS. The FHS is the main service of NBCP and includes a reorientation in the work model, seeking prevention and health promotion, increasing care towards the individual, and also the family and community, being also considered managerial to the other levels of health care. The choice for this municipality occurred due to some specifications found in the implementation of the FHS, which began in 2004, when the municipality joined Proesf (Expansion and consolidation of FHS Project) and in 2015 there were only 16 teams of FHS implemented, representing a coverage of 22.94% of the municipal territory. In addition, the process of implementing the FHS in this municipality went through periods of discontinuity and rupture according to the policy proposal. The design of this research, of mixed approach, predominantly qualitative, with an analytical inductive logic base method, starts from the theoretical recognition of the object, based on the concepts of public policies, implementation and effectiveness. It builds a historical-political clipping of public health policies in Brazil, starting from the Brazilian Sanitary Reform, up to the NBCP and in the empirical field analyzes the process of implementing the FHS in Santa Maria, through analysis of documents produced over the 13 years of this service. Semi-structured interviews were performed with health counselors and Community Health Agents (CHA), in addition to direct observation in the FHS teams implemented do far. The results point at many weaknesses along the implementation, regarding the planning of the territorialisation of the FHS teams, the compliance with work guidelines established in the public policy, the practices of professionals in the community, and the institutional support for professionals to carry out their activities. Nevertheless it is also possible to perceive specific changes in the communities assisted by the policy, in what refers to a change of habits of the users concerning the health care. The research made possible to perceive the "State in action" (SOUZA, 2006) in the work practices of the CHA that implement the FHS, and the existence of a service that exercises the coming and going of health care in the social context in which it is inserted.Esta pesquisa versa sobre a implementação de políticas públicas de saúde, com olhar específico para a Política Nacional de Atenção Básica (PNAB). Parte do problema de pesquisa “Como as ações realizadas na implementação podem afetar a efetividade da Estratégia de Saúde da Família, no município de Santa Maria/RS?”. A partir deste questionamento, a pesquisa tem o objetivo de analisar os fatores que afetam a efetividade na implementação da Estratégia de Saúde da Família (ESF) em Santa Maria/RS. A ESF é o principal serviço da PNAB e compreende uma reorientação no modelo de trabalho, buscando a prevenção e promoção a saúde, ampliando o cuidado sobre o indivíduo, família e comunidade, sendo considerada gerencial aos demais níveis de atenção a saúde. A escolha por este município ocorreu devido a algumas especificidades encontradas na implementação da ESF, que iniciou em 2004, quando o município aderiu ao Proesf (Projeto de Expansão e consolidação da ESF) e em 2015 existiam apenas 16 equipes de ESFs implementadas, representando uma cobertura municipal de 22,94% do território, além disso, o processo de implementação da ESF neste município passou por períodos de descontinuidade e ruptura com a proposta da política. O delineamento desta pesquisa, de abordagem mista, predominantemente qualitativa, com método de base lógica indutivo analítico, parte do reconhecimento teórico do objeto, a partir dos conceitos de políticas públicas, implementação e efetividade, constrói um recorte histórico-político das políticas públicas de saúde no Brasil, partindo da Reforma Sanitária Brasileira, até a PNAB e no campo empírico analisa o processo de implementação da ESF em Santa Maria, por meio de análise de documentos produzidos ao longo dos 13 anos de funcionamento deste serviço, entrevistas-semiestruturadas com conselheiros de saúde e Agentes Comunitários de Saúde (ACS), além de observação direta nas equipes de ESF implementadas. Os resultados apontam para uma implementação com muitas fragilidades, no que diz respeito ao planejamento da territorialização das equipes de ESF, ao cumprimento de diretrizes de trabalho estabelecidas na política pública, a práticas dos profissionais na comunidade e ao suporte institucional para os profissionais exercerem suas atividades, porém também, é possível perceber mudanças pontuais nas comunidades assistidas pela política, no que se refere a uma mudança de hábitos dos usuários com o cuidado a saúde. A pesquisa possibilitou perceber o “Estado em ação” (SOUZA, 2006), nas práticas de trabalho dos ACS que implementam a ESF e na existência de um serviço que exerce o ir e vir do cuidado a saúde no contexto social em que está inserido.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESporUniversidade Federal de Santa MariaCentro de Ciências Sociais e HumanasPrograma de Pós-Graduação em Ciências SociaisUFSMBrasilSociologiaAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessPolíticas públicasImplementaçãoEfetividadeSaúde da famíliaPublic policiesImplementationEffectivenessFamily healthCNPQ::CIENCIAS HUMANAS::SOCIOLOGIAA política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RSPublic policy of control and care: is there effectiveness in the implementation of the family health strategy in Santa Maria?info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisCampos, Rosana Soareshttp://lattes.cnpq.br/3832191347253241Cunha, Patricia Rodrigues Chaves dahttp://lattes.cnpq.br/4371769396775499Siqueira, Monalisa Dias dehttp://lattes.cnpq.br/0994530332510835http://lattes.cnpq.br/0230328717212950Martins, Maique Berlote700200000009600b1b72c93-c80e-4129-9d4c-5bead784f9d963546d1e-0b8d-4347-8fa1-e245d01f57156a713dc2-6a18-4487-bee1-3f8b3d73d06984844ecf-dda1-4774-a543-37ab5fcff3a8reponame:Biblioteca Digital de Teses e Dissertações do UFSMinstname:Universidade Federal de Santa Maria (UFSM)instacron:UFSMORIGINALDIS_PPGCS_2018_MARTINS_MAIQUE.pdfDIS_PPGCS_2018_MARTINS_MAIQUE.pdfDissertação de Mestradoapplication/pdf1818830http://repositorio.ufsm.br/bitstream/1/16629/1/DIS_PPGCS_2018_MARTINS_MAIQUE.pdfcf154534e7a84fe91a481b0536781734MD51CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; 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dc.title.por.fl_str_mv |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
dc.title.alternative.eng.fl_str_mv |
Public policy of control and care: is there effectiveness in the implementation of the family health strategy in Santa Maria? |
title |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
spellingShingle |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS Martins, Maique Berlote Políticas públicas Implementação Efetividade Saúde da família Public policies Implementation Effectiveness Family health CNPQ::CIENCIAS HUMANAS::SOCIOLOGIA |
title_short |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
title_full |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
title_fullStr |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
title_full_unstemmed |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
title_sort |
A política pública do controle e do cuidado: há efetividade na implementação da estratégia de saúde da família em Santa Maria/RS |
author |
Martins, Maique Berlote |
author_facet |
Martins, Maique Berlote |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Campos, Rosana Soares |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/3832191347253241 |
dc.contributor.referee1.fl_str_mv |
Cunha, Patricia Rodrigues Chaves da |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/4371769396775499 |
dc.contributor.referee2.fl_str_mv |
Siqueira, Monalisa Dias de |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/0994530332510835 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/0230328717212950 |
dc.contributor.author.fl_str_mv |
Martins, Maique Berlote |
contributor_str_mv |
Campos, Rosana Soares Cunha, Patricia Rodrigues Chaves da Siqueira, Monalisa Dias de |
dc.subject.por.fl_str_mv |
Políticas públicas Implementação Efetividade Saúde da família |
topic |
Políticas públicas Implementação Efetividade Saúde da família Public policies Implementation Effectiveness Family health CNPQ::CIENCIAS HUMANAS::SOCIOLOGIA |
dc.subject.eng.fl_str_mv |
Public policies Implementation Effectiveness Family health |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS HUMANAS::SOCIOLOGIA |
description |
This research is about the implementation of public health policies, with a specific look at the National Basic Care Policy (NBCP), starting with the research problem "How can implementation actions affect the effectiveness of the Family Health Strategy in the municipality of Santa Maria/RS?". Based on this questioning, this work aims to analyze the factors that affect the effectiveness in the implementation of the Family Health Strategy (FHS) in Santa Maria/RS. The FHS is the main service of NBCP and includes a reorientation in the work model, seeking prevention and health promotion, increasing care towards the individual, and also the family and community, being also considered managerial to the other levels of health care. The choice for this municipality occurred due to some specifications found in the implementation of the FHS, which began in 2004, when the municipality joined Proesf (Expansion and consolidation of FHS Project) and in 2015 there were only 16 teams of FHS implemented, representing a coverage of 22.94% of the municipal territory. In addition, the process of implementing the FHS in this municipality went through periods of discontinuity and rupture according to the policy proposal. The design of this research, of mixed approach, predominantly qualitative, with an analytical inductive logic base method, starts from the theoretical recognition of the object, based on the concepts of public policies, implementation and effectiveness. It builds a historical-political clipping of public health policies in Brazil, starting from the Brazilian Sanitary Reform, up to the NBCP and in the empirical field analyzes the process of implementing the FHS in Santa Maria, through analysis of documents produced over the 13 years of this service. Semi-structured interviews were performed with health counselors and Community Health Agents (CHA), in addition to direct observation in the FHS teams implemented do far. The results point at many weaknesses along the implementation, regarding the planning of the territorialisation of the FHS teams, the compliance with work guidelines established in the public policy, the practices of professionals in the community, and the institutional support for professionals to carry out their activities. Nevertheless it is also possible to perceive specific changes in the communities assisted by the policy, in what refers to a change of habits of the users concerning the health care. The research made possible to perceive the "State in action" (SOUZA, 2006) in the work practices of the CHA that implement the FHS, and the existence of a service that exercises the coming and going of health care in the social context in which it is inserted. |
publishDate |
2018 |
dc.date.issued.fl_str_mv |
2018-02-26 |
dc.date.accessioned.fl_str_mv |
2019-05-23T19:29:21Z |
dc.date.available.fl_str_mv |
2019-05-23T19:29:21Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://repositorio.ufsm.br/handle/1/16629 |
url |
http://repositorio.ufsm.br/handle/1/16629 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.cnpq.fl_str_mv |
700200000009 |
dc.relation.confidence.fl_str_mv |
600 |
dc.relation.authority.fl_str_mv |
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dc.rights.driver.fl_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/ |
eu_rights_str_mv |
openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências Sociais e Humanas |
dc.publisher.program.fl_str_mv |
Programa de Pós-Graduação em Ciências Sociais |
dc.publisher.initials.fl_str_mv |
UFSM |
dc.publisher.country.fl_str_mv |
Brasil |
dc.publisher.department.fl_str_mv |
Sociologia |
publisher.none.fl_str_mv |
Universidade Federal de Santa Maria Centro de Ciências Sociais e Humanas |
dc.source.none.fl_str_mv |
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