Dinâmica da inovação na estratégia saúde na família

• Autor(a) principal: Lacerda, Katarina Leal Chaves
• Data de Publicação: 2020
• 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/123456789/20263
• topic: Inovação no setor público; Dinâmica da inovação; Estratégia saúde da família; Atenção primária à saúde; Public sector innovation; Dynamics of innovation; Family health strategy; Primary health care; CNPQ::CIENCIAS SOCIAIS APLICADAS::ADMINISTRACAO

This study aims to clarify how the dynamics of innovation occur in the Family Health Strategy (FHS). For this, based on the foundations of adaptive theory, the methodological strategy of a case study was adopted in the municipality of Campina Grande, located in the State of Paraíba. The research subjects were key informants of the Municipal Health Secretary, District Health Managers, in addition to health professionals from FHS teams in the city appointed by the managers. As data collection techniques, semi-structured interviews, focus groups, systematic direct observation and secondary data were used. The analysis was performed using the content analysis method, with the aid of the ATLAS.ti software. As results, the research showed the existence of fifteen innovations in the FHS of Campina Grande, among which three are present in all Basic Health Units (BHU) and the others are distributed in the BHU of the city. The most present type of innovation is the service type, with radical innovations, with a predominance of incremental innovations. The innovation process occurs according to stages foreseen in the literature. However, there is political and administrative autonomy for the ESF teams, in the BHUs, to develop and implement innovations. Of the twenty two determinants of innovation highlighted, the main ones are users' needs and understanding the demand of the public. Sociodemographic and economic characteristics, meeting government program requirements and population recognition are determinants that emerged from the analyzed case. Eleven barriers to innovation were identified, the most relevant being the limitation of resources, especially financial resources. Inadequate training was a barrier evidenced in the specific context of the study. Among the political, legal and physical actors involved in the dynamics of innovation, the ones that stand out the most are health professionals and managers (municipal and district). The user, despite not being an active actor in the process of elaborating and implementing innovation, is at the center of this dynamic. The partnership for carrying out innovations is more evident with the Ministry of Health and with higher education institutions located in the city. As for the results of innovation, managerial aspects are the most contemplated, followed by assistance and social aspects. The dynamics of innovation in the Family Health Strategy, based on the four dimensions analyzed (innovation, determinants and barriers, actors and results), was represented through a framework developed a priori, in the light of the theoretical link discussed, and improved a posteriori through empirical research. As a contribution of the research, the theoretical discussion about innovation in public health made it possible to understand that among the public administration management models, the principles of the New Public Service (NPS) are the ones that come closest to the reality in which innovations are developed and implemented in the FHS. In addition, the findings provide a clearer understanding of what the elements that involve the dynamics of innovation in the FHS are and how they behave, guiding managers and formulators of public health policies regarding the improvement of innovative processes.