Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2018-04-03T14:47:02Z No. of bitstreams: 1 GustavoAdolfoLealCosta_DISSERT.pdf: 9145007 bytes, checksum: 096b1a92a513994e4d22f82a35b800d6 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2018-04-10T19:45:43Z (GMT) No. of bitstreams: 1 GustavoAdolfoLealCosta_DISSERT.pdf: 9145007 bytes, checksum: 096b1a92a513994e4d22f82a35b800d6 (MD5) / Made available in DSpace on 2018-04-10T19:45:43Z (GMT). No. of bitstreams: 1 GustavoAdolfoLealCosta_DISSERT.pdf: 9145007 bytes, checksum: 096b1a92a513994e4d22f82a35b800d6 (MD5) Previous issue date: 2017-12-11 / O presente trabalho discorre sobre o procedimento contratual e as discuss?es que resultaram na assinatura do Contrato Organizativo de A??o P?blica Ensino-Sa?de (COAPES) nas 4? e 5? regi?es de sa?de do Rio Grande do Norte, visando viabilizar a estrutura??o de servi?os de sa?de em condi??es de ofertar campo de pr?tica suficiente e de qualidade aos cursos e resid?ncias da ?rea da sa?de, permitindo o fortalecimento da integra??o ensino-servi?o-comunidade. Utiliza-se da teoria de interpreta??o qualitativa, observando-se as posi??es ?ticas e pol?ticas dos diversos interessados no processo contratual, buscando, a partir delas, compreender de forma interpretativa as decis?es decorrentes da pr?pria natureza humana, norteadas a priori pelos interesses sociais, como tamb?m pol?ticos, e em que n?vel a mudan?a almejada foi alcan?ada. Promove-se an?lise das informa??es coletadas, dada atrav?s de uma revis?o integrativa da literatura, envolvendo um aprofundamento descritivo do COAPES e dos seus fundamentos; da an?lise de documentos e instrumentos, como atas de reuni?es, of?cios, portarias, decretos e leis; e da interpreta??o e discuss?o dos resultados, com a finalidade superveniente de gerar um produto que apresente relev?ncia para outras institui??es interessadas em iniciar o processo de contratualiza??o. Destaca-se durante o procedimento contratual a import?ncia da pactua??o, discuss?o e qualifica??o da inser??o de estudantes no territ?rio. Verifica-se na problematiza??o a n?o linearidade procedimental, em detrimento ? orienta??o em cartilhas do SUS, observando-se estagna??o com a mudan?a na gest?o administrativa durante e ap?s o per?odo de elei??es municipais. Torna-se poss?vel, ent?o, afirmar que o processo de produ??o do COAPES em estudo ainda precisa avan?ar enquanto um processo dial?gico com reconhecimento, comprometimento e participa??o dos atores envolvidos, numa constante busca pela qualifica??o do cuidado em sa?de de maneira integrada ao processo de forma??o em servi?o e de educa??o permanente da rede. / This paper explores the contractual procedure and the discussions that resulted in the signing of the Organizational Contract of Public Action for Teaching-Health (COAPES) in the 4th and 5th health regions of the state of Rio Grande do Norte, aiming to make possible the structuring of health services in conditions to offer sufficient field of practice and with quality to the courses and residencies of the health area, allowing the strengthening of the teaching-service-community integration. The qualitative theory of interpretation is used, observing the ethical and political positions of the various parts involved in the contractual process, seeking, from them, to understand in an interpretative way the decisions deriving from human nature, at first guided by social interests, as also political, and at what level the desired change was achieved. The analysis of the information collected is promoted through an integrative review of the literature, involving a descriptive deepening of the COAPES and its foundations; analysis of documents and instruments, such as minutes of meetings, letters, ordinances, decrees and laws; and the interpretation and discussion of the results, with the supervenient purpose of generating a product that presents relevance to other institutions interested in starting the process of contracting. The importance of the agreement, discussion and qualification of the insertion of students in the territory stands out during the contractual procedure. Procedural non-linearity is verified during the problematization, against the orientation present in the Unified Health System (SUS) guides, stagnating with the change in administrative management during and after the period of municipal elections. It is possible, then, to affirm that the COAPES production process under study still needs to progress as a dialogical process with recognition, commitment and participation of the involved actors, in a constant search for the qualification of health care in an integrated way to the process of in-service training and permanent education of the health network.