The relationship between the Socialist Unity Party [SED] and the medical intelligentsia in the German Democratic Republic [GDR] has often been described as one of the most problem-atic for the Republic‟s political vanguard. This thesis discusses this relationship for the two dec-ades after the erection of the Berlin Wall in 1961. With the inability of East German workers to leave for West Germany after this event, the GDR was able to enforce their programme of so-cialist development in a new way. Doctors, despite being crucial for this socialist society and its legitimacy, were not excluded from the state‟s radical new policies. However, as files from the former state security apparatus, party and trade union make obvious, doctors were very success-ful in preventing both the ideological conditioning of their community and state interference in the composition of the medical elite. With the examination of the every-day life of the medical intelligentsia, especially in East German hospitals, this thesis contributes to the discussion about the difference between the claims of the socialist party and the realities faced in the healthcare sector. There were a variety of complex reasons for the increasing distance between the state‟s claim and reality, many of which will be analysed in the course of this work. This analysis is, em-bedded in a historical approach, outlined mainly by Mary Fulbrook, which sets the micro-level in the context of the macro-level, considering the correlation between the claim and ideology of the SED, their communication, mechanisms and policies reaching the boundaries of the social con-glomerate of doctors, as well as their reactions, career aspirations and pre-conditions. For the seventies, a whole section is dedicated to exploring the reasons that the medical intelligentsia was one of the main-clients of so-called „human trafficking gangs‟, enabling insight into their situa-tion and the attitude towards the socialist state, which led them to „vote with their feet‟. This the-sis demonstrates, especially for the sixties and seventies, that there is still much potential for fur-ther research, in to the case of the most ideologically unreliable social group in the GDR: the medical intelligentsia.

The need for donor funding has increased significantly over the last decade. Without donor funding millions of people wouldn’t be alive today. Thanks either to research finding a cure, successful treatment, funds donated for food, aid toward building infrastructure, or giving people the opportunity to further their education. Donor funding thus facilitates a better future. A literature review was conducted to give background on the health sector and how these funds were distributed, ethical clearance, different types of reporting, the role project managers pays in a project and the sustainability of projects. Expenses in different countries were evaluated by gathering data from the internet, while two international funded projects are also used to state how funders divide their line items into different categories. The empirical study used a qualitative research approach by collecting and analysing data obtained from the MDG 2010 report and other freely available data on the web. The main findings from this thesis are: *The Millennium Development Goals (MDG’s) influence donor funding as it gives donors a guide towards funding needs. Donors are also influenced by their own preferences or what poses a burden to them individually. *The different types of reporting required for funding received, delay a project and the bureaucratic structures thereof are a hindrance. *Ethical clearance plays a fundamental role in the outcome of a project, as without ethical clearance a project cannot commence. *The objectives of a project play a critical role when applying for funding. This can change the focus of a project. *Expenses differ from country to country and funders need to take this into account when giving funding to recipient countries. *Project Managers and community involvement plays a critical role in ensuring sustainability of projects. THE SUSTAINABILITY OF DONOR FUNDED PROJECTS IN THE HEALTH SECTOR *The MDG’s are not on track and aid are focus on singular goals instead of multiple goals, to ensure an overall improved result. There is a major gap between needed funds and given funds. A single injection of funds will not be the solution to our health problem; different sectors need to collaborate together as we are facing a multi-dimensional problem. Trade and reform must also form part of this aid, ensuring a sustainable progression in the life’s of people. Donor funded projects may have a sustainable future, when taking in account the abovementioned findings. With the world trend in reporting changing rapidly, cost and management accountants as well as financial accountants and project managers have to equip them to adhere to the new way of reporting, namely integrated and sustainability reporting. South Africa is way behind and needs to catch up fast if they want to stay competitive in the “global donor funding market”. The limitations in this study were that not all expenses were evaluated and only 15 countries were looked at. An indebt look was taken into Africa with the empirical review, while Asia is also combating poor health issues. Some African countries like Sierra Leone and Zimbabwe did not have sufficient data to compare with other countries. From the research conducted, the following topics were identified that require further research: *Why are most projects in Third World countries not sustainable? *What plans are put into action to ensure that the MDG goals are reached? *Investigate what works for First World countries health systems and consider how that can be applied to Third World countries to ensure that they also get the best health care available. *Do donors take into account the different costs of countries when allocating funding to that specific country? *Establishing models to evaluate the sustainability of pilot projects and normal projects. *Establishing a model on how to distribute donor funds across different needs and not only one specific need. / MCom (Management Accountancy), North-West University, Vaal Triangle Campus, 2013

Community nursing services provide health care services in communities outside health care institutions. They are targeted at the sick people in their own home environments, especially providing disease prevention, health support and health care assistance. The goal of community health services is to improve the whole community health, especially of those people who are exposed to risky lifestyles and who are under risk of petting sick, or of dech, and to provide a specific care to them. The introductory part of my thesis contains the theory and elementary parts and types of the health care system in the CR as well as categorized structures and functions of the World Health Organization. It also includes the primary health care goals as well as the goals of the European Union and of the Czech Ministry of Health for the health care system development. In the second part the theory deals with the meaning of the community care, its foundations, the past and the present in the CR. It also describes the nurses´ job descriptions. In the course of the quantitative research I chose the technique of a questionnaire on the grounds of a stratified selection. It was made up by questions used in interviews with nurses. In the frame of qualitative research I chose a method used in interviews with workers in health insurance companies in which I used a guided interview. The goal of my thesis was to find out whether health care workers are aware of health care deficits. I asked for the workers´ opinions on the necessity of community care development in the CR. The goals of my work were reached. The research question was used to find out what the of health care insurance companies representatives´ opinions on the necessity of the community care in the CR are. On the grounds of the questionnaire it was found out that the representatives of health care insurance companies have a positive opinion on the necessity of the community care development in the CR. I did not prove the first hypothesis which stipulated that nurses working outside hospitál facilities do not feel any deficit in providing health care services referring to the provided care. The second hypothesis was proven stipulating that nurses working in hospital facilities can see the most serious deficit in the the fact that people lack their interest in their own health. The third hypothesis was proven, too. The health care workers´ opinions on the the necessity of the community care in the CR are positive.

Made available in DSpace on 2014-06-11T19:35:14Z (GMT). No. of bitstreams: 0 Previous issue date: 2003Bitstream added on 2014-06-13T18:46:44Z : No. of bitstreams: 1 lemos_crh_dr_fran.pdf: 250684 bytes, checksum: cd307edda8291bc4967635dc88de2f8d (MD5) / Este estudo teve por objetivo compreender, por meio da representação social sobre transplante cardíaco, o impacto social produzido no cotidiano dos pacientes que se submeteram a esta proposta terapêutica, no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Adotamos a metodologia qualitativa, entrevistando, com roteiro semi-estruturado, seis pacientes. Os dados obtidos e submetidos a análise de conteúdo possibilitaram identificar cinco eixos temáticos: da doação de órgãos ao órgão doado; as mudanças na vida; o suporte social, a finitude humana e a religiosidade. O estudo evidenciou que o transplante cardíaco foca a atenção do paciente na condição de estar vivo. A vida, propriamente dita, dá sentido ao seu cotidiano, as suas experiências e vivências. A necessidade de suportes para operacionalizar as aspirações dos pacientes, configurou-se como imprescindível. O suporte social viabiliza a sobrevivência, suprindo necessidades básicas materiais e afetivas. A possibilidade de manterem-se vivos está atrelada ao acesso imediato a um sistema de saúde. O suporte espiritual, caracterizado como energia vital, confere aos pacientes, o sentido da transcendência de uma vida de privações para uma vida divina e até mesmo eterna. A compreensão das pessoas deve ser a essência das ações na área da saúde. Esperamos que, este estudo contribua com os programas assistenciais e de educação em transplantes cardíacos, construídos a partir da ótica dos pacientes, tornando a aderência ao tratamento mais eficaz. / This study intended to understand, by the social representations of heart transplantation, what was the social impact it had on the everyday life of patients submitted to this therapeutic approach at the Instituto do Coração of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo. We adopted a qualitative methodology and interviewed six patients following a semi-structured script. The data collected and submitted to content analysis led to the identification of five key thematic issues: from organ donation to donated organ; changes in life; social support, human finitude and religiousness. The study evidenced that in heart transplantation the patients' focus of attention is at being alive. Life, per se, gives meaning to their everyday activities and experiences. The need to have support in coping with patients' aspirations proved to be indispensable. Social support enables survival, providing for material and affective basic needs. The possibility of staying alive is connected to immediate access to health care. Spiritual support, characterized as vital energy, conveys to patients the sense of transcendence, from a life of deprivation to a divine and even eternal life. People's understanding should be the core of healthcare actions. We sincerely hope that this study can contribute to other healthcare and educational programs in heart transplantation, building things from the patients' perspective and promoting greater treatment compliance.

Orientador: Noêmia Pereira Neves / Resumo: Este estudo teve por objetivo compreender, por meio da representação social sobre transplante cardíaco, o impacto social produzido no cotidiano dos pacientes que se submeteram a esta proposta terapêutica, no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Adotamos a metodologia qualitativa, entrevistando, com roteiro semi-estruturado, seis pacientes. Os dados obtidos e submetidos a análise de conteúdo possibilitaram identificar cinco eixos temáticos: da doação de órgãos ao órgão doado; as mudanças na vida; o suporte social, a finitude humana e a religiosidade. O estudo evidenciou que o transplante cardíaco foca a atenção do paciente na condição de estar vivo. A vida, propriamente dita, dá sentido ao seu cotidiano, as suas experiências e vivências. A necessidade de suportes para operacionalizar as aspirações dos pacientes, configurou-se como imprescindível. O suporte social viabiliza a sobrevivência, suprindo necessidades básicas materiais e afetivas. A possibilidade de manterem-se vivos está atrelada ao acesso imediato a um sistema de saúde. O suporte espiritual, caracterizado como energia vital, confere aos pacientes, o sentido da transcendência de uma vida de privações para uma vida divina e até mesmo eterna. A compreensão das pessoas deve ser a essência das ações na área da saúde. Esperamos que, este estudo contribua com os programas assistenciais e de educação em transplantes cardíacos, construídos a partir da ótica dos pacientes, tornando a aderência ao tratamento mais eficaz. / Abstract: This study intended to understand, by the social representations of heart transplantation, what was the social impact it had on the everyday life of patients submitted to this therapeutic approach at the Instituto do Coração of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo. We adopted a qualitative methodology and interviewed six patients following a semi-structured script. The data collected and submitted to content analysis led to the identification of five key thematic issues: from organ donation to donated organ; changes in life; social support, human finitude and religiousness. The study evidenced that in heart transplantation the patients' focus of attention is at being alive. Life, per se, gives meaning to their everyday activities and experiences. The need to have support in coping with patients' aspirations proved to be indispensable. Social support enables survival, providing for material and affective basic needs. The possibility of staying alive is connected to immediate access to health care. Spiritual support, characterized as vital energy, conveys to patients the sense of transcendence, from a life of deprivation to a divine and even eternal life. People's understanding should be the core of healthcare actions. We sincerely hope that this study can contribute to other healthcare and educational programs in heart transplantation, building things from the patients' perspective and promoting greater treatment compliance. / Doutor

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-10-17T10:02:47Z No. of bitstreams: 2 Dissertação - Amauri Oliveira Silva - 2017.pdf: 1918380 bytes, checksum: 75a3ed9843afb5adb0137c92f7f64a7b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-10-17T10:03:40Z (GMT) No. of bitstreams: 2 Dissertação - Amauri Oliveira Silva - 2017.pdf: 1918380 bytes, checksum: 75a3ed9843afb5adb0137c92f7f64a7b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-10-17T10:03:40Z (GMT). No. of bitstreams: 2 Dissertação - Amauri Oliveira Silva - 2017.pdf: 1918380 bytes, checksum: 75a3ed9843afb5adb0137c92f7f64a7b (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-08-18 / The work results from an investigation about how education in the Single Healthcare System (SUS - Sistema Único de Saúde) guides the actions of Health Promotion in the Health Gym Program (PAS – Programa Academia da Saúde). The objectives are: to analyse how the Health Gym Program consist in na element of Health promotion in SUS; identify, describe and ascertain their contituent links; perceive and examine the documents referring to bases of creation and structuring; execute the maping and description of the current conditions of the irimplementation in the country; and construe their theoretical bases, identifying their mediations with education. Trying to make a meticulous analysis, carefully and committed with the object, avoiding what was immediate, searching to understand its movement, essence, complexity, totality and history, was chosen the historical-dialetical materialism method. In it the analysis are guided by the knowlegde that what is put in the reality only can be understood without risk of reducionism through compreention of the materials relations that gave origins, observing in the object all its socio-historical dynamics, of the historical conditioning that influenced it. Contributing to the study, a documentary research of public health policies and ordinance was carried out on the program and a bibliographical research in database, magazines articles, Banks of theses and others. The results showed that the actions of the Health Program needs of educational practices based on the Collective Health paradigm, in order to not incurreproducing in the PAS health education activities based on the biomedical paradigm. The Health education from PAS has its fundamental theoretical bases based on popular education, fundamental in the process of consolidation of SUS. / O trabalho resulta de uma investigação sobre como a Educação no Sistema Único de Saúde (SUS) norteia as ações de Promoção da Saúde no Programa Academia da Saúde (PAS). Os objetivos são: analisar como o Programa Academia da Saúde constitui-se em elemento de Promoção e Educação em Saúde no SUS; identificar, descrever e averiguar os seus nexos constitutivos; compreender e examinar os documentos referentes às bases de sua criação e estruturação; realizar o mapeamento e a descrição das condições atuais de sua implementação no país; e analisar suas bases teóricas, identificando as suas mediações com a educação. Procurando analisar de forma minuciosa, cuidadosa e comprometida com o objeto, evitando o que estava posto no imediato, buscando compreender seu movimento, essência, complexidade, totalidade e história, optou-se pelo método do materialismo histórico-dialético. Nele, as análises são guiadas pelo entendimento de que, o que está posto na realidade só poderá ser compreendido, sem risco de reducionismo, por meio da compreensão das relações materiais que lhe deram origem, observando no objeto toda a sua dinâmica sócio-histórica, dos condicionantes históricos que o influenciam. Contribuindo com a pesquisa, foi realizada uma pesquisa documental de políticas públicas de saúde e portarias sobre o Programa e uma pesquisa bibliográfica em base de dados, artigos de revistas, banco de dissertações e teses, entre outros. Os resultados mostraram o quanto as ações de Promoção da Saúde carecem de práticas educativas pautadas no paradigma da Saúde Coletiva, para não incorrer de reproduzir no PAS atividades de educação sanitária pautadas no paradigma biomédico. A educação em Saúde do PAS tem suas bases teóricas fundamentadas na educação popular, fundamental no processo de consolidação do SUS.

Este trabalho tem por objeto examinar a atuação administrativa consensual, com enfoque na solução de conflitos sobre prestações materiais de saúde na esfera administrativa. A Constituição Federal de 1988 reconhece expressamente a saúde como direito fundamental de todos e determina ser dever do Estado garanti-lo, mediante políticas sociais e econômicas que visem à promoção, proteção e recuperação da saúde. Para alcançar os fins estatuídos pelo constituinte, diversas políticas públicas têm sido elaboradas e executadas. Porém, tendo em vista que grande parte da população não tem acesso às ações e serviços de saúde, o trabalho se propõe a indicar possíveis alternativas para enfrentar esta problemática brasileira. Para construir uma concepção dogmática adequada à compreensão do direito à saúde e de suas repercussões jurídicas, a dissertação analisa a teoria dos direitos fundamentais, explicitando as variadas funções que o direito à saúde pode exercer conforme o caso concreto. A função positiva do direito à saúde é destacada neste estudo, sobretudo, sua importância no Estado Social na promoção da igualdade material. Na sequência, o trabalho se dedica ao estudo do Sistema Único de Saúde (SUS), com base na estrutura delineada pela Constituição para conduzir a elaboração e a execução de políticas sanitárias. Em seguida, o tema da participação popular na Administração Pública é examinado como vetor do caráter Democrático do Estado, analisando seus pressupostos, instrumentos e, ainda, suas formas de expressão no âmbito do Sistema Único de Saúde (SUS). Por fim, o texto explora o modelo de Administração consensual no Brasil, especialmente no tocante à atividade de dirimir controvérsias na via administrativa, buscando identificar se, e em quais casos, esta atuação configura um autêntico módulo convencional. Feito o recorte temático proposto como linha de pesquisa, o trabalho examina instrumentos pró-consensuais institucionalizados para a solução de conflitos em matéria de saúde na via administrativa, apontando caminhos voltados à realização do direito fundamental à saúde e aos objetivos do Estado previstos na Constituição Federal. / This essay intends to examine the consensual administrative action, approaching to the conflict resolution regarding to medical supplies as well as healthcare services in the administrative process. The Federal Constitution of 1988 expressly recognizes health as a fundamental right and States guarantee duty, through social and economic policies, which has the propose of health promotion, protection and recovery. In order to realize the constitutional aims, a lot of public policies have been developed and implemented. However, considering that great amount of the population does not have access to healthcare actions and services, the study has the purpose of identifying possible alternatives to deal with this Brazilian issue. In order to develop an appropriate dogmatic understanding related to right to health and its legal repercussions, this essay analyzes the fundamental rights theory, explaining the various right to health functions that could be used according to the case. The right to healths positive function is highlighted in this essay, mainly, its importance to the Social State regarding to substantive equality promotion. Afterwards, this essay studies the Brazilian healthcare system (so-called Sistema Único de Saúde, or simply SUS), based on the structure outlined by the Constitution related to development and performance of public health policies. Then, the public participation theme in Public Administration is analyzed as a Democratic State conductor, going through its assumptions, instruments, and also its way of expression in the Brazilian healthcare system (SUS). Finally, the study explores the Brazilian consensual administrative model, especially in relation to conflict resolution activity in the administrative process, with the view to identify if, and in which cases, this action consist on a genuine conventional mechanism. In the conclusion, the analyze focuses on institutional mechanisms in favor of conflicts resolution by consensus regarding to heath in the administrative process, pointing out possible ways which conduces to right of heath effectiveness and achievements related to the objectives stated in the Federal Constitution.

Submitted by Cássia Santos (cassia.bcufg@gmail.com) on 2017-03-31T12:14:03Z No. of bitstreams: 2 Dissertação - Paula dos Santos Pereira - 2017.pdf: 2415595 bytes, checksum: 3dbef76a620567a93d77595cb20c3121 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-03T12:07:03Z (GMT) No. of bitstreams: 2 Dissertação - Paula dos Santos Pereira - 2017.pdf: 2415595 bytes, checksum: 3dbef76a620567a93d77595cb20c3121 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-04-03T12:07:03Z (GMT). No. of bitstreams: 2 Dissertação - Paula dos Santos Pereira - 2017.pdf: 2415595 bytes, checksum: 3dbef76a620567a93d77595cb20c3121 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-13 / Violence in women’s lives can start in their childhood and perpetuate in adulthood. This indicates that such experiences tend to be transmitted intergenerationally, compromising family structure. This research aimed to understand intergenerational violent behavior in the lives of female victims of violence and to identify their perceptions about the performance of healthcare professionals in the context of their care. A qualitative strategic social research was carried out in the Psychology Service of the Program for Prevention of Violence and Health Promotion, of the Epidemiological Surveillance Control of the Municipal Health Department of Aparecida de Goiânia, GO. Data were collected using a recorded semi-structured interview with ten adult women who are or were in situation of violence and analyzed after transcription using content analysis based on themes. As a result of this process, four categories emerged: “family context of childhood”, “intergenerational violent behavior”, “future expectations”, and “the context of the net of attention to violence against women”. The results showed that violence has been present in these women’s lives since their childhood, that they identify the influence of this phenomenon on their affective relationships and on their children’s lives, which compromises their future lives, and that healthcare services were not perceived as places to support victims, showing the need for changes in the conduction of these cases. It was possible to conclude that violence against women has short-, medium-, and long-term consequences and that this behavior may be transmitted to future generations through a learning process. The performance of healthcare professionals was perceived as deficient, and therefore it is not a reference of support for the victims. Based on the results of this study, we suggest interventions in the victims’ families, broader diffusion of information and qualification on the theme to healthcare professionals and inclusion of the theme violence in college syllabi. / A violência na vida da mulher pode se iniciar desde a sua infância, perpetuando-se em sua vida adulta. Isso denota que tais experiências tendem a ser transmitidas intergeracionalmente, comprometendo todo o cenário familiar. Esta pesquisa teve como objetivos compreender a intergeracionalidade do comportamento violento na vida de mulheres vítimas de violência e identificar suas percepções sobre a atuação do profissional de saúde no contexto de seu atendimento. Foi realizada uma pesquisa social estratégica de abordagem qualitativa, tendo como campo de estudo o Serviço de Psicologia do Programa de Prevenção às Violências e Promoção da Saúde, da Vigilância Epidemiológica da Secretaria Municipal de Saúde de Aparecida de Goiânia, GO. Participaram da pesquisa dez mulheres adultas que estiveram ou estão em situação de violência. Os dados foram coletados por meio de entrevista semiestruturada gravada e, após a transcrição, analisados por meio de análise de conteúdo modalidade temática. A partir disso, emergiram quatro categorias: “o contexto familiar da infância”, “a intergeracionalidade do comportamento violento”, “as expectativas futuras” e “o contexto da rede de atenção à violência contra a mulher”. Os resultados mostraram que a violência está presente na vida dessas mulheres desde a sua infância, que elas identificam a influência deste fenômeno em suas relações afetivas e na vida de seus filhos, comprometendo também suas vidas futuras, e que os serviços de saúde não foram percebidos como locais de apoio às vítimas, mostrando a necessidade de mudanças nas condutas diante destes casos. Conclui-se que a violência contra a mulher gera consequências a curto, médio e longo prazos e que se trata de comportamento que pode ser transmitido para as demais gerações por meio do processo de aprendizagem. Já a atuação dos profissionais da saúde foi percebida como deficitária, não sendo uma referência de apoio às vítimas. Com base nos resultados desta pesquisa, sugerem-se intervenções nas famílias das vítimas, maior divulgação de informações e capacitações sobre o tema para os profissionais da rede e inserção da temática violência em grades curriculares.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction. Clinical Pharmacy Services (CPS) have been growing worldwide and have positively impacted health outcomes. However, studies that go deep into the steps of CPS implementation in the healthcare networks of the Brazilian healthcare system (SUS) are incipient. Objective. To analyze the implementation and propose strategies for integrating CPS into healthcare networks. Methods. A study was carried out in the Recife city, in three steps, from July 2015 to October 2017. The first step corresponded to a quasi-experimental study (before and after), carried out through the problematization with the Maguerez Arc in order to implement CPS. The second step gathered two qualitative studies, conducted through focus groups and semi-structured interviews, in order to identify barriers, facilitators and strategies that influenced the implementation. The third step included a methodological development study, conducted through semi-structured interviews and a nominal group, to propose and prioritize CPS integration strategies for SUS. Participants in the study were pharmacists, health managers and decision-makers involved in implementation, patients and panel experts. This study was approved by the Research Ethics Committee. Results. We carried out in the first step: i) initial evaluations (before): identified incipient CPS, deficiencies in the structure and work process of pharmacists; ii) planning: 16 brainstorming meetings and a strategic plan; iii) intervention: 22 political-administrative meetings were held with managers and health staff, 768 hours of theoretical-practical training with Mentoring for pharmacists; iv) preliminary evaluation (after): structure indicators presented a statistically significant difference, differently from the work process, and 1,465 pharmaceutical appointments were performed with 842 patients. It was possible to identify changes in the clinical status of the most prevalent diseases among the patients attended by three pharmaceutical appointments. In the second step, two focus groups were held with pharmacists and five interviews with health managers, which identified 43 barriers and 39 facilitators related to the healthcare networks, pharmacists, health team, implementation process and/or patients. In addition, 21 strategies related to pharmacists were identified as necessary for the implementation of CPS. In the third step, interviews were conducted with five managers and seven decision-makers who identified 21 barriers and 20 facilitators. From these results, specialists who composed the nominal group proposed 41 CPS integration strategies and prioritized the following: formalizing CPS; agreeing on care flows and referral protocols; evaluating and publicizing CPS results/benefits; planning and defining CPS; sensitizing the health managers. Conclusion. The analysis of the process identified factors that may have influenced the implementation of CPS, planning of the interventions and their application to reality, as well as in the prioritization of the strategies of integration of these services to SUS. Thus, the results obtained in this thesis can serve as a guide to help pharmacists, managers and decision-makers to plan, implement and integrate CPS in SUS. / Introdução. Serviços Clínicos Farmacêuticos (SCF) tem se expandido mundialmente e tem impactado positivamente nos resultados em saúde. Entretanto, estudos que se aprofundem nas etapas de implementação de SCF nas redes de atenção à saúde do sistema de saúde brasileiro (SUS) são incipientes. Objetivo. Analisar a implementação e propor estratégias para integração de SCF às redes de atenção à saúde. Métodos. Foi realizado estudo na cidade do Recife-PE, em três etapas, de julho/2015 a outubro/2017. A primeira etapa correspondeu a um estudo quasi-experimental (antes e depois), realizado por meio da metodologia da problematização com Arco de Maguerez, a fim de implementar SCF. A segunda etapa compreendeu dois estudos qualitativos, realizados por meio de grupos focais e entrevistas semiestruturadas, com a finalidade de identificar barreiras, facilitadores e estratégias que influenciaram na implementação dos SCF. A terceira etapa compreendeu estudo de desenvolvimento metodológico, realizado por meio de entrevistas semiestruturadas e grupo nominal, para propor e priorizar estratégias de integração de SCF ao SUS. Os participantes do estudo foram farmacêuticos, gestores e decision-makers envolvidos na implementação dos SCF, pacientes e painel de especialistas. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados. Na primeira etapa foram realizados: i) diagnóstico situacional (antes): identificou SCF incipientes, carências na estrutura e no processo de trabalho dos farmacêuticos; ii) planejamento: foram realizadas 16 reuniões de brainstorming com diferentes atores e um cronograma de atividades; iii) intervenção: foram realizadas 22 reuniões político-administrativas com gestores e equipe de saúde, 768 horas de treinamento teórico-prático com Mentoring para os farmacêuticos; iv) avaliação preliminar (depois): indicadores de estrutura apresentaram diferença estatística significativa, diferentemente dos indicadores de processo, e foram realizadas 1.465 consultas farmacêuticas com 842 pacientes, impactando em mudanças na situação clínica das doenças mais prevalentes entre pacientes atendidos por três consultas. Na segunda etapa foram realizados dois grupos focais com farmacêuticos e cinco entrevistas com gestores, o que identificou 43 barreiras e 39 facilitadores relacionados à rede de saúde, farmacêuticos, equipe de saúde, processo de implementação e/ou pacientes. Ademais, 21 estratégias relacionadas aos farmacêuticos foram identificadas como necessárias à implementação de SCF. Na terceira etapa foram realizadas entrevistas com cinco gestores e sete decision-makers que identificaram 21 barreiras e 20 facilitadores. A partir destes resultados, especialistas que compuseram o grupo nominal propuseram 41 estratégias para integração de SCF e priorizaram as seguintes: institucionalizar os SCF; pactuar fluxos assistenciais e protocolos de encaminhamentos; avaliar e divulgar os resultados/benefícios dos SCF; planejar e definir SCF; sensibilizar a gestão. Conclusão. A análise do processo identificou fatores que podem ter influenciado na implementação de SCF, planejamento das intervenções e sua aplicação à realidade, bem como na priorização das estratégias de integração desses serviços ao SUS. Assim, os resultados obtidos nesta tese poderão servir como eixos norteadores para que farmacêuticos, gestores e decision-makers planejem, implementem e integrem SCF no SUS. / Aracaju

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