Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Tipo de documento: | Tese |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UFPB |
Texto Completo: | https://repositorio.ufpb.br/jspui/handle/123456789/11800 |
Resumo: | This thesis deals with State-society relations through the "implementation" of a public health policy entitled Programa Mais Médicos (PMM). It emphasizes one of the elements of the policy that was the process of distribution of Brazilian and foreign physicians in Brazil and especially in Paraíba. My goal was to understand the processes of elaboration and implementation of a policy, considering the local dynamics of its implementation. The research process looks at politics in a given political and historical period, from the initial tensions that favor the formulation of the “Programa Mais Médicos”, to the policy developments after the change of government in the year 2016. Paraíba was chosen as the territory of observation because of the expressive coverage of Basic Attention, by the family health tradition, by the creation of instruments that favored the "implementation" of the policy at local and national level and by the approach of the researcher with the implementing actors. In order to be able to observe and analyze the multiplicity of phenomena coming from the field of research, a cartography was constructed, in the sense of Deleuze and Guattari, that aims to follow processes in movement. This movement means the relations between the various actors participating in the Programa Mais Médicos, such as physicians, supervisors, tutors, municipal and state managers, representatives of the ministries of health and education, workers of the Primary Care teams and users of the public health system. One of the fundamental elements of this cartography was the problematization of the insertion of the researcher with the actors, with the need for movements of distance and approach with the field of research to guarantee the objectivation of the phenomena observed. By means of the research process, it was possible to observe the reactions against the politics from the "official medical movement", which produced political facts and disseminated ideologies regarding the program, especially opposing changes in professional training and access to medical residences. In addition, it discusses the tactics to disqualify foreign professionals, especially Cuban doctors, by assigning to them what can be called outsiders, in the logic of Elias and Scotson. During the field work, the differences between the professional practices of Brazilian and Cuban physicians drew attention, with the observation of a greater involvement with the attendances and health team by the latter. In addition, observing the distribution of the professionals in the state, it was possible to perceive that in some regions, characterized as being more difficult to reach or those farther away from the large urban centers, it was only possible to guarantee medical assistance from the "cooperados" which may allow you to create a care vacuum if the program is finished. For the "implementation" of the PMM in the state, it was fundamental the relationship between actors that already had an approach before the program, in social and political movements, characterizing a group of militant actors in favor of the health system and the qualification of Basic Attention. |
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Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política públicaPrograma mais médicosAnálise de políticas públicasCartografiaMedical doctors programPublic policy analysisCartographyCNPQ::CIENCIAS HUMANAS::SOCIOLOGIAThis thesis deals with State-society relations through the "implementation" of a public health policy entitled Programa Mais Médicos (PMM). It emphasizes one of the elements of the policy that was the process of distribution of Brazilian and foreign physicians in Brazil and especially in Paraíba. My goal was to understand the processes of elaboration and implementation of a policy, considering the local dynamics of its implementation. The research process looks at politics in a given political and historical period, from the initial tensions that favor the formulation of the “Programa Mais Médicos”, to the policy developments after the change of government in the year 2016. Paraíba was chosen as the territory of observation because of the expressive coverage of Basic Attention, by the family health tradition, by the creation of instruments that favored the "implementation" of the policy at local and national level and by the approach of the researcher with the implementing actors. In order to be able to observe and analyze the multiplicity of phenomena coming from the field of research, a cartography was constructed, in the sense of Deleuze and Guattari, that aims to follow processes in movement. This movement means the relations between the various actors participating in the Programa Mais Médicos, such as physicians, supervisors, tutors, municipal and state managers, representatives of the ministries of health and education, workers of the Primary Care teams and users of the public health system. One of the fundamental elements of this cartography was the problematization of the insertion of the researcher with the actors, with the need for movements of distance and approach with the field of research to guarantee the objectivation of the phenomena observed. By means of the research process, it was possible to observe the reactions against the politics from the "official medical movement", which produced political facts and disseminated ideologies regarding the program, especially opposing changes in professional training and access to medical residences. In addition, it discusses the tactics to disqualify foreign professionals, especially Cuban doctors, by assigning to them what can be called outsiders, in the logic of Elias and Scotson. During the field work, the differences between the professional practices of Brazilian and Cuban physicians drew attention, with the observation of a greater involvement with the attendances and health team by the latter. In addition, observing the distribution of the professionals in the state, it was possible to perceive that in some regions, characterized as being more difficult to reach or those farther away from the large urban centers, it was only possible to guarantee medical assistance from the "cooperados" which may allow you to create a care vacuum if the program is finished. For the "implementation" of the PMM in the state, it was fundamental the relationship between actors that already had an approach before the program, in social and political movements, characterizing a group of militant actors in favor of the health system and the qualification of Basic Attention.NenhumaEsta tese trata das relações Estado-sociedade através da implementação de uma política pública de saúde intitulada Programa Mais Médicos (PMM). Enfatiza-se um dos elementos da política que foi o processo de distribuição de médicos brasileiros e estrangeiros no Brasil e, especialmente, na Paraíba. Meu objetivo foi entender os processos de elaboração e implementação de uma política, considerando as dinâmicas locais de sua implantação. O processo de investigação observa a política em um determinado período político e histórico, desde as tensões iniciais que favorecerem a formulação do Programa Mais Médicos até os desdobramentos da política após a mudança de governo em 2016. A Paraíba foi escolhida como território de observação por causa da cobertura expressiva da Atenção Básica, pela tradição em Saúde da Família, pela criação de instrumentos que favoreceram a implementação da política no nível local e nacional e pela aproximação do pesquisador com os atores implementadores. Para conseguir observar e analisar a multiplicidade de fenômenos advindos do campo de pesquisa, foi construída uma cartografia, no sentido de Deleuze e Guattari, que visa acompanhar processos em movimento. O movimento referido significa as relações entre os diversos atores participantes do Programa Mais Médicos, como médicos, supervisores, tutores, gestores municipais e estaduais, representantes dos ministérios da saúde e da educação, trabalhadores das equipes de Atenção Básica e usuários do SUS. Um dos elementos fundamentais dessa cartografia foi a problematização da inserção do pesquisador entre os atores, com a necessidade de movimentos de afastamento e aproximação com o campo da pesquisa para garantir a objetivação dos fenômenos observados. Tecendo o processo de pesquisa, foi possível observar as reações contrárias ao Mais Médicos provenientes do movimento médico oficial, que produziu fatos políticos e difundiu ideologias sobre o programa, especialmente opondo-se às mudanças da formação profissional e as formas de acesso às residências médicas. Além disso, são discutidas as táticas para desqualificar os profissionais estrangeiros, especialmente os médicos cubanos, atribuindo a estes o que se pode chamar de outsider, na lógica de Elias e Scotson. Durante o trabalho de campo, chamou atenção as diferenças entre as práticas profissionais de médicos brasileiros e cubanos, tendo sido observado maior envolvimento com os atendimentos e equipe de saúde por parte dos segundos. Além disso, observando a distribuição dos profissionais no estado, percebeu-se que, em algumas regiões caracterizadas como de mais difícil acesso ou as mais distantes dos grandes centros urbanos, só foi possível garantir assistência médica a partir da atuação dos “cooperados”, o que poderá criar um vazio assistencial caso o programa acabe. Para a implementação do PMM no estado, foi fundamental a relação entre atores que já mantinham aproximação antes do Programa, em movimentos sociais e políticos, caracterizando um grupo de atores militantes em defesa do sistema de saúde e da qualificação da Atenção Básica.Universidade Federal da ParaíbaBrasilSociologiaPrograma de Pós-Graduação em SociologiaUFPBNeves, Ednalva Macielhttp://lattes.cnpq.br/7766410071856075Sassi, André Petraglia2018-09-26T20:32:40Z2018-09-262018-09-26T20:32:40Z2018-04-25info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesishttps://repositorio.ufpb.br/jspui/handle/123456789/11800porinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UFPBinstname:Universidade Federal da Paraíba (UFPB)instacron:UFPB2018-09-27T06:01:03Zoai:repositorio.ufpb.br:123456789/11800Biblioteca Digital de Teses e Dissertaçõeshttps://repositorio.ufpb.br/PUBhttp://tede.biblioteca.ufpb.br:8080/oai/requestdiretoria@ufpb.br|| diretoria@ufpb.bropendoar:2018-09-27T06:01:03Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB)false |
dc.title.none.fl_str_mv |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
title |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
spellingShingle |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública Sassi, André Petraglia Programa mais médicos Análise de políticas públicas Cartografia Medical doctors program Public policy analysis Cartography CNPQ::CIENCIAS HUMANAS::SOCIOLOGIA |
title_short |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
title_full |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
title_fullStr |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
title_full_unstemmed |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
title_sort |
Dinâmicas da implantação do programa mais médicos na Paraíba: contribuições sociológicas para a análise de uma política pública |
author |
Sassi, André Petraglia |
author_facet |
Sassi, André Petraglia |
author_role |
author |
dc.contributor.none.fl_str_mv |
Neves, Ednalva Maciel http://lattes.cnpq.br/7766410071856075 |
dc.contributor.author.fl_str_mv |
Sassi, André Petraglia |
dc.subject.por.fl_str_mv |
Programa mais médicos Análise de políticas públicas Cartografia Medical doctors program Public policy analysis Cartography CNPQ::CIENCIAS HUMANAS::SOCIOLOGIA |
topic |
Programa mais médicos Análise de políticas públicas Cartografia Medical doctors program Public policy analysis Cartography CNPQ::CIENCIAS HUMANAS::SOCIOLOGIA |
description |
This thesis deals with State-society relations through the "implementation" of a public health policy entitled Programa Mais Médicos (PMM). It emphasizes one of the elements of the policy that was the process of distribution of Brazilian and foreign physicians in Brazil and especially in Paraíba. My goal was to understand the processes of elaboration and implementation of a policy, considering the local dynamics of its implementation. The research process looks at politics in a given political and historical period, from the initial tensions that favor the formulation of the “Programa Mais Médicos”, to the policy developments after the change of government in the year 2016. Paraíba was chosen as the territory of observation because of the expressive coverage of Basic Attention, by the family health tradition, by the creation of instruments that favored the "implementation" of the policy at local and national level and by the approach of the researcher with the implementing actors. In order to be able to observe and analyze the multiplicity of phenomena coming from the field of research, a cartography was constructed, in the sense of Deleuze and Guattari, that aims to follow processes in movement. This movement means the relations between the various actors participating in the Programa Mais Médicos, such as physicians, supervisors, tutors, municipal and state managers, representatives of the ministries of health and education, workers of the Primary Care teams and users of the public health system. One of the fundamental elements of this cartography was the problematization of the insertion of the researcher with the actors, with the need for movements of distance and approach with the field of research to guarantee the objectivation of the phenomena observed. By means of the research process, it was possible to observe the reactions against the politics from the "official medical movement", which produced political facts and disseminated ideologies regarding the program, especially opposing changes in professional training and access to medical residences. In addition, it discusses the tactics to disqualify foreign professionals, especially Cuban doctors, by assigning to them what can be called outsiders, in the logic of Elias and Scotson. During the field work, the differences between the professional practices of Brazilian and Cuban physicians drew attention, with the observation of a greater involvement with the attendances and health team by the latter. In addition, observing the distribution of the professionals in the state, it was possible to perceive that in some regions, characterized as being more difficult to reach or those farther away from the large urban centers, it was only possible to guarantee medical assistance from the "cooperados" which may allow you to create a care vacuum if the program is finished. For the "implementation" of the PMM in the state, it was fundamental the relationship between actors that already had an approach before the program, in social and political movements, characterizing a group of militant actors in favor of the health system and the qualification of Basic Attention. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-09-26T20:32:40Z 2018-09-26 2018-09-26T20:32:40Z 2018-04-25 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/doctoralThesis |
format |
doctoralThesis |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufpb.br/jspui/handle/123456789/11800 |
url |
https://repositorio.ufpb.br/jspui/handle/123456789/11800 |
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por |
language |
por |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
dc.publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Sociologia Programa de Pós-Graduação em Sociologia UFPB |
publisher.none.fl_str_mv |
Universidade Federal da Paraíba Brasil Sociologia Programa de Pós-Graduação em Sociologia UFPB |
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reponame:Biblioteca Digital de Teses e Dissertações da UFPB instname:Universidade Federal da Paraíba (UFPB) instacron:UFPB |
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Universidade Federal da Paraíba (UFPB) |
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UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB |
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Biblioteca Digital de Teses e Dissertações da UFPB - Universidade Federal da Paraíba (UFPB) |
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diretoria@ufpb.br|| diretoria@ufpb.br |
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