O trabalho buscou avaliar as dificuldades e limites da gestão municipal na incorporação de serviços de mamografia em sete municípios selecionados na região do Médio Paraíba. Utilizando abordagem metodológica qualiquantitativa, se desenvolveu a partir do levantamento de dados secundários sobre o parque tecnológico de serviços e a produção de mamografias nos municípios selecionados e da realização de entrevistas semi-estruturadas aplicadas junto aos gestores municipais e aos responsáveis pelos setores de Controle, Avaliação e Auditoria das localidades. A análise das entrevistas identificou sete categorias temáticas principais: (1) o conhecimento do nível local sobre o problema de saúde em tela, onde se pode constatar dificuldades para uma análise mais precisa da situação de saúde relacionada ao câncer de mama nas localidades; (2) o conhecimento dos processos de tomada de decisão, onde se pode perceber que a gestão municipal esbarra em uma série de dificuldades que impossibilitam, em muitos casos, a incorporação de tecnologias nos serviços próprios, trazendo como única alternativa a compra dos serviços mamográficos; (3) a oferta e acesso aos exames mamográficos, evidenciando precariedade, pois é facilitada somente a porta de entrada nos serviços de Atenção Básica; (4) a produção dos procedimentos, revelando que, de uma forma geral, os gestores têm se esforçado por cumprir com as metas pactuadas, ainda que o exame das informações disponíveis mostrem que seu alcance encontra-se, via de regra, distante do pretendido; (5) a regulação e monitoramento dos serviços mamográficos, onde pode se perceber a baixa adesão ao Sistema de Regulação nas gestões locais; (6) a satisfação quanto à prestação dos serviços contratados, usualmente avaliadas de forma subjetiva e ancorada tão somente na falta de reclamações; e, por fim, (7) dificuldades na tomada de decisão relativa à incorporação de um serviço mamográfico próprio, que esbarram em impedimentos políticos, administrativos e financeiros. Pode-se concluir que o estudo permitiu extrair subsídios capazes de contribuir para o conhecimento e reflexão sobre as práticas de incorporação tecnológica e monitoramento dos serviços mamográficos na região. / The study aimed to evaluate the difficulties and limits of the municipal administration in the incorporation of mammography services in seven selected cities in the Middle Paraíba. Using qualitative-quantitative methodological approach, developed from the data collection side of the park service and the production technology of mammography in selected cities and conducting semi-structured interviews with the managers applied and municipal sectors responsible for monitoring, evaluation and Audit of locations. The analysis of interviews identified seven major themes: (1) knowledge of local health problem on the screen, where you can see difficulties in a more precise analysis of the health situation related to breast cancer in the localities, (2 ) knowledge of the processes of decision making, where you can see that the municipal administration was hampered by a number of difficulties that make it impossible in many cases, the incorporation of technologies in their own service, bringing only alternative to the purchase of mammography services, ( 3) the supply and access to mammographic studies, showing insecurity, it is facilitated only port of entry to primary care services, (4) the production procedures, revealing that, in general, managers have been struggling to meet with the agreed targets, in considering the available information shows that their power is as a rule, far from being attained; (5) the regulation and monitoring of mammography services, which can realize low compliance with the Regulatory System the local administrations, (6) satisfaction regarding the provision of contracted services, usually evaluated on a subjective s and anchored solely in the absence of complaints, and, finally, (7) difficulties in making a decision on the incorporation of a service mammography itself, which runs into political impediments, administrative and financial. It can be concluded that the study allowed to extract subsidies can contribute to knowledge and reflection on practices in technological and monitoring of mammography services in the region.

A presente dissertação visa analisar a gestão ambiental municipal de Miguel Pereira, com ênfase no caso da implantação do aterro sanitário municipal. Para tal foram realizadas pesquisas bibliográficas, eletrônicas e documentais, assim como entrevistas com os principais envolvidos no processo da gestão ambiental e dos resíduos sólidos no município de Miguel Pereira. Inicialmente foi realizada uma revisão bibliográfica com os conceitos das principais questões relativas a políticas e gestão públicas e políticas ambientais. São apresentados, além desses conceitos, um histórico da temática ambiental, incluindo a criação do conceito de desenvolvimento sustentável e uma abordagem mais específica do gerenciamento de resíduos sólidos. O estudo de caso realizado no município de Miguel Pereira constou de uma visita de campo e entrevistas realizadas, respectivamente, em maio de 2008 e fevereiro de 2009. Foi também realizada uma análise e uma síntese da tomada de preços realizada para o novo aterro sanitário e do Relatório Ambiental Simplificado apresentado para o processo de licenciamento ambiental desse serviço. Concluiu-se que o município de Miguel Pereira não possui um sistema de gestão ambiental e que a recém-formação da Secretaria Municipal de Meio Ambiente de Miguel Pereira deve ser analisada como uma oportunidade para a criação das diretrizes ambientais municipais. / The following dissertation aims to analyze the environmental municipal management of Miguel Pereira, emphasizing the case of the implementation of the municipal landfill. Bibliographic, electronic and documental researches were performed, so as interviews with the mains characters involved on the process of the environmental management and of the solid waste in the Miguel Pereiras county. Initially it was performed a bibliographic revision with the concepts of the main questions related to policies and public management and environmental policies. Are presented, besides this concepts, an historical of the environmental thematic, including the creation of the concept of sustainable development and an approach more specific of the solid waste management. The case study performed in the county of Miguel Pereira consisted in a field visit and interviews performed, respectively, in May 2008 and February 2009. It was also performed an analysis and a synthesis of the bidding performed for the new landfill and of the Environmental Report presented to the environmental licensing process of the activities. It was concluded that the Miguel Pereiras county doesnt have an environmental management system and that the new formation of the Miguel Pereira Environmental Municipal Secretariat should be analyzed as an opportunity for the creation of environmental municipal guidelines.

O trabalho buscou avaliar as dificuldades e limites da gestão municipal na incorporação de serviços de mamografia em sete municípios selecionados na região do Médio Paraíba. Utilizando abordagem metodológica qualiquantitativa, se desenvolveu a partir do levantamento de dados secundários sobre o parque tecnológico de serviços e a produção de mamografias nos municípios selecionados e da realização de entrevistas semi-estruturadas aplicadas junto aos gestores municipais e aos responsáveis pelos setores de Controle, Avaliação e Auditoria das localidades. A análise das entrevistas identificou sete categorias temáticas principais: (1) o conhecimento do nível local sobre o problema de saúde em tela, onde se pode constatar dificuldades para uma análise mais precisa da situação de saúde relacionada ao câncer de mama nas localidades; (2) o conhecimento dos processos de tomada de decisão, onde se pode perceber que a gestão municipal esbarra em uma série de dificuldades que impossibilitam, em muitos casos, a incorporação de tecnologias nos serviços próprios, trazendo como única alternativa a compra dos serviços mamográficos; (3) a oferta e acesso aos exames mamográficos, evidenciando precariedade, pois é facilitada somente a porta de entrada nos serviços de Atenção Básica; (4) a produção dos procedimentos, revelando que, de uma forma geral, os gestores têm se esforçado por cumprir com as metas pactuadas, ainda que o exame das informações disponíveis mostrem que seu alcance encontra-se, via de regra, distante do pretendido; (5) a regulação e monitoramento dos serviços mamográficos, onde pode se perceber a baixa adesão ao Sistema de Regulação nas gestões locais; (6) a satisfação quanto à prestação dos serviços contratados, usualmente avaliadas de forma subjetiva e ancorada tão somente na falta de reclamações; e, por fim, (7) dificuldades na tomada de decisão relativa à incorporação de um serviço mamográfico próprio, que esbarram em impedimentos políticos, administrativos e financeiros. Pode-se concluir que o estudo permitiu extrair subsídios capazes de contribuir para o conhecimento e reflexão sobre as práticas de incorporação tecnológica e monitoramento dos serviços mamográficos na região. / The study aimed to evaluate the difficulties and limits of the municipal administration in the incorporation of mammography services in seven selected cities in the Middle Paraíba. Using qualitative-quantitative methodological approach, developed from the data collection side of the park service and the production technology of mammography in selected cities and conducting semi-structured interviews with the managers applied and municipal sectors responsible for monitoring, evaluation and Audit of locations. The analysis of interviews identified seven major themes: (1) knowledge of local health problem on the screen, where you can see difficulties in a more precise analysis of the health situation related to breast cancer in the localities, (2 ) knowledge of the processes of decision making, where you can see that the municipal administration was hampered by a number of difficulties that make it impossible in many cases, the incorporation of technologies in their own service, bringing only alternative to the purchase of mammography services, ( 3) the supply and access to mammographic studies, showing insecurity, it is facilitated only port of entry to primary care services, (4) the production procedures, revealing that, in general, managers have been struggling to meet with the agreed targets, in considering the available information shows that their power is as a rule, far from being attained; (5) the regulation and monitoring of mammography services, which can realize low compliance with the Regulatory System the local administrations, (6) satisfaction regarding the provision of contracted services, usually evaluated on a subjective s and anchored solely in the absence of complaints, and, finally, (7) difficulties in making a decision on the incorporation of a service mammography itself, which runs into political impediments, administrative and financial. It can be concluded that the study allowed to extract subsidies can contribute to knowledge and reflection on practices in technological and monitoring of mammography services in the region.

The goal of my dissertation, on the theme financing optimization, is to find out the needs of dwellers in town Žďár nad Sázavou. On the basis of my results I will suggest new financing solutions according to town budget expenditure. Partial target is to analyse income and expenditure budget of Žďár nad Sázavou and its fulfilment. My dissertation is divided into three parts theoretical, analytical and practical. The first part specifies crucial terms and principles related to studied points at issue. In the second part is analysed financial management for the past five years. In the last part are suggested solutions for separated activities in Žďár nad Sázavou according to questionnaire survey. Conclusion consists of synthesis and final summaries of detected information and deficits in financial management in Žďár nad Sázavou.

Masters in Public Administration - MPA / A persistent challenge facing especially post-apartheid South African rural municipalities is service delivery compliance. Under the guise of scarcity, rural municipalities repeatedly do not comply with legislation, policies and guidelines for the provision of drinking water and basic sanitation services for the poor. Yet, such challenges concern equity, justice and fairness to social policy and seriously impact the sustainability of livelihood of millions of rural households. The main objective of this study is to analyse the extent to which Lepelle Nkumpi Local Municipality has complied with or deviated from specific policies and legislation governing the provision of water and sanitation services at the Gedroogte, Ga Molapo and Magatle (in Zebediela) rural communities and the response of communities. The study was also intended to determine the extent to which water challenges affect the livelihood of the people in the communities. It highlights the refugee-like conditions that millions of South African citizens experience despite official statistics that claim that 86% of the country has access to potable water. A mixed methods design was used for this analysis. The qualitative methods that are used in the study include use of in-depth interviews, site visits, personal stories and the Municipal Integrated Development Programme (IDP). Participatory mapping of water sources; story-telling about water issues; timelines and trend lines by focus group members; transect walks and 7 key informant interviews were used to collect data. A total of 657 quantitative interviews were conducted in three communities. Service delivery compliance has been grossly ineffective and inefficient in Lepelle Nkumpi Local Municipality, especially in the Gedroogte, Ga Molapo and Magatle rural communities. The findings were that these rural communities still depend on state-owned boreholes for accessing drinking water, which are regularly broken and/or in disrepair. Sanitation service provision in the rural communities does not comply with the approved policy of providing ventilated improved pit (VIP) toilets. New settlements have increased the demand for clean water. Shortages of staff with relevant skills such as management, technicians, and administrators are one of the main reasons why there is a scarce supply of drinking water and basic sanitation services at the Gedroogte, Ga Molapo and Magatle communities. Inaccessibility to nearby treatment plants for waste disposal services (situation per community) and inaccessible disposal facilities and the use of disposal sites also affect the health conditions of community members within the Lepelle Nkumpi Local Municipality.

Covid-19 pandemin skapade en global hälsokris med svåra konsekvenser för företag och arbetare runt om i världen. I Sverige gav Folkhälsomyndigheten ut allmänna restriktioner som skulle följas i syfte om att begränsa smittspridningen av Covid-19. Konsekvenserna resulterade i att många företag och organisationer blev påtvingade till att arbeta på distans och då blev det inte längre ett alternativ att genomföra arbetet fysiskt på arbetsplatsen längre utan distansarbete blev den enda lösningen. Tidigare forskning presenterar att det har varit en stor och krävande omställning för flera företag runt om i världen att övergå från fysiskt arbete på plats till distansarbete. Vidare framkommer det att olika företag har olika förutsättningar för att kunna bedriva och utföra distansarbete. Studiens syfte var att undersöka vad personalen anser om att bedriva distansarbete inom en kommunledningsförvaltning. Syftet besvarades genom att undersöka vilka för- och nackdelar som personalen upplever att det finns med att utföra distansarbete inom en kommunledningsförvaltning. Semistrukturerade intervjuer har varit studiens tillvägagångssätt för datainsamling. Intervjufrågorna utformades utifrån studiens tidigare forskning och litteraturstudie. Totalt har fyra intervjuer genomförts på kommunledningsförvaltningen på en kommun i södra Sverige. Det empiriska materialet analyserades utifrån Jacobsens analysprocess av kvalitativa data som innefattar fyra olika steg. Därefter jämfördes det empiriska materialet med litteraturstudien för att efterlysa samband mellan studien och tidigare forskning. Efter att analyseringsprocessen av det insamlade resultatet var sammanställt hade fyra fördelar och tre nackdelar identifierats med att genomföra distansarbete på en kommunledningsförvaltning. De fyra fördelar som identifierades var: ökad flexibilitet, ökad produktivitet, effektivare möten och att medarbetarna slipper pendling. De tre nackdelar som identifierades var: ingen anpassad arbetsmiljö, sämre kvalité på möten och svårt att förhålla sig till arbetstider. / The Covid-19 pandemic created a global health crisis with severe consequences for companies and workers around the world. In Sweden, the Swedish Public Health Agency issued general restrictions that were to be followed in order to limit the spread of Covid-19. The consequences resulted in that many companies and organizations has forced to telework and it was no longer an option to carry out the work physically at the workplace anymore and telework became the only solution. Previous research shows that it has been a large and demanding transition for many companies around the world to switch from physical work at the workplace to telework. Furthermore, it appears that different companies have different conditions for being able to conduct and perform telework. The purpose of the study was to investigate what the staff thinks about conducting telework within a municipal management administration. The purpose was answered by examining the advantages and disadvantages that the staff feel there is in carrying out telework within a municipal management administration. Semi-structured interviews have been the study's approach to data collection. The interview questions were designed and based on the study's previous research and literature study. A total of four interviews were conducted at the municipal management administration in a municipality in southern Sweden. The empirical material was analysed and based on Jacobsen's analysis process of qualitative data that includes four different steps. The empirical material was then compared with the literature study to call for a connection between the study and previous research. After the analysis process of the collected result was compiled, four advantages and three disadvantages had been identified with carrying out telework at a municipal management administration. The four advantages that were identified was: increased flexibility, increased productivity, more efficient meetings and that employees avoid commuting. The three disadvantages that were identified was: no adapted work environment, poorer attitude at meetings and difficulty in relating to working hours.

Thesis (MScEng)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: South African municipalities are under pressure to improve the current state of the water andwastewater service delivery industry. Knowing that there exists a need for improvement within the municipal water and wastewater industry, the Department of Water Affairs (DWA) launched a municipal strategic self-assessment (MuSSA) initiative to evaluate the business health of the industry. MuSSA asks high level technical management staff five key questions about sixteen key business attribute areas. This study seeks to determine if theMuSSA data can be used to aid municipal decision making, by way of drawing correlations between key performance indicators contained in the MuSSA questions. The correlations are to bring forth areas thatmust be focussed on to improve selected attribute areas requiring attention within municipalities. Three areas have been chosen from theMuSSA data to be investigated in this research project namely; (i)staff skill levels and capacity, (ii)non-revenue water and (iii)the execution of planned water services activities. In the MuSSA questionnaire there are questions addressing each of (i), (ii) and (iii) to determine the municipality’s performance in each of the three areas. Non-parametric statistics are used to determine with which of the MuSSA questions’ answers the relevant questions’ answers significantly correlate for (i), (ii) and (iii). Engineering judgement and expert opinion are used to determine if the questions correlating with the relevant questions for (i), (ii) and (iii) either affect, are affected by or have no relation with the question. These results are then organized using a flow diagram and are discussed in detail by way of a bivariate histogramof each correlation. The investigation revealed that municipalities not having sufficient technical management capacity are not performing well on at least one of the five questions asked on eleven of the sixteen MuSSA business attributes. The skill level of water and wastewater treatment works staff were found to be strongly affected by technical management capacity and skill, water services planning and financial sustainability of the organization. Municipalities training technical management and operational staff showed a high percentage of skilled operational staff employed at treatment works. Water and wastewater treatment works staff capacity are very dependent of the level of skill and capacity of technical management employed by the municipality. Municipalities having appropriate budgets and funding to appoint and train staff showed a tendency to be better at operational staff capacity building than those lacking funding. The reduction of non-revenue water (NRW) showed strong correlations with technical management and network operational repair staff skills and development. Municipalities employing staff with correct skills and experience combined, with commitment from management to reduce NRW by way of monitoring and practicing of pressuremanagement programs, significantly reduced NRW percentages. Equally crucial to the reduction of NRW, as revealed from the investigation, is the practicing of infrastructure asset management within the municipality. It was concluded that municipalities should strive to reach a NRW percentage of 30% or less to become financially stable, due to correlation between funding of routine operations and building up of cash reserve versus NRW percentages. Municipalities wanting to improve the execution rate of planned water services activities are recommended to address, among other factors, technical management skill levels and capacity. Municipalities lacking technical management skill and capacity reported a low percentages of planned activities being executed. Also of high significance, is the technical operational staff skill levels and capacity, due to their involvement in the execution of planned activates. The involvement of council members in water and wastewater planning and the reporting of data and issues to council greatly enhancesmunicipalities’ abilities to execute planned activities. This can mainly be contributed to increased funding in situations where council members support planned projects. The lack of funding was found to be a major inhibitor of the execution of planned activities. Even though a great deal of municipalities indicated that they are effectively spending allocated budgets, this positive indication is not seen in the percentage municipalities executing planned activities and leads to the conclusion that there is a lack of funding. Municipalities taking actions in other areas of their business such as infrastructure assetmanagement and planning were more effective at executing planned activities. In all, it was concluded that technicalmanagement and operational staff skill levels and capacity need to be present for amunicipality to function properly. Municipalities also are in need of funding to execute planned activities and need to become financially self sustainable. One way of working towards the goal of financial self sustainability is the reduction of NRW percentages. The data from this investigation shows great similarity with the literature consulted on the current state and functioning of South African municipalities. The statistical analysis of the MuSSA data accurately revealed correlations among key performance indicators in municipalities. The conclusion can be drawn that investigation of correlations amongMuSSA questions can be used to help aid municipal decision making. / AFRIKAANSE OPSOMMING: Suid-Afrikaanse munisipaliteite is onder druk om die huidige toestand van die water en afvalwater dienslewering te verbeter. Met die wete dat daar ’n behoefte vir verbetering in die munisipale water en afvalwater bedryf is het dieDepartement vanWaterwese ’n munisipale strategiese self-assessering (MuSSA) projekte geïnisieer omdie welstand van die bedryf te evalueer. MuSSA vra hoë vlak tegniese bestuurs personeel vyf kern vrae oor sestien sleutel besigheids aspekte. Hierdie studie poogomvas te stel of dieMuSSA data gebruik kan word om munisipale besluitneming te help verbeter, deur middel van die evaluering van korrelasies tussen die sleutel prestasie aanwysers soos vervat in MuSSA vrae. Die korrelasies bring na vore gebiede waar op gefokus moet word om geselekteerde kenmerk areas binne munisipaliteite, wat aandag vereis, te verbeter. Drie areas uit die MuSSA-data is ondersoek in hierdie navorsings projek naamlik; (i) personeel vaardigheidsvlakke en kapasiteit, (ii) nie-inkomste water en (iii) die uitvoering van die beplande waterdienste aktiwiteite. In die MuSSA vraelys is daar vrae wat elk van (i), (ii) en (iii) aanspreek om die munisipaliteit se prestasie op die drie gebiede te monitor. Nie-parametriese statistiek word gebruik om die oorblywendeMuSSA vrae wat se antwoorde met die relevante vrae se antwoorde korreleer vir (i), (ii) en (iii) vas te stel. Kundigheid en oordeel van ingenieurs word gebruik om te bepaal of die vrae wat korreleer met die relevante vrae vir (i), (ii) en (iii) die relevante vraag beïnvloed, beïnvloed word deur die relevante vraag of geen verhouding het met die relevante vraag nie. Hierdie resultate word dan georganiseer met behulp van ’n vloeidiagram en word in detail bespreek deur middel van ’n tweeveranderlike histogram van elke korrelasie. Die ondersoek het aan die lig gebring dat munisipaliteite wat nie genoegsame tegniese bestuurs kapasiteit het nie swak presteer op ten minste een van die vyf vrae van elf van die sestienMuSSA besigheid eienskappe. Die personeel vaardigheidsvlakke van water en afvalwater behandelings werke word sterk beïnvloed deur die tegniese bestuurskapasiteit en -vaardigheid, waterdienste beplanning en die finansiële volhoubaarheid van die organisasie. Munisipaliteite wat opleiding van tegniese bestuur en operasionele personeel uitvoer het ’n hoë persentasie van opgeleide operasionele personeel werksaam by suiweringswerke. Water en afvalwater behandelingswerke se personeelkapasiteit is baie afhanklik van die vlak van vaardigheid en kapasiteit van tegniese bestuur in diens van die munisipaliteit. Munisipaliteite met toepaslike begrotings en befondsing om personeel aan te stel en op te lei het ’n neiging om beter te presteer met kapasiteitsbou van operasionele personeel as die wat aan ’n gebrek ly van befondsing. Die vermindering van nie-inkomste water (NRW) het sterk korrelasies met tegniese bestuur en netwerkherstel personeelvaardighede en ontwikkeling. Munisipaliteite wat personeel met die korrekte vaardighede en ervaring in diens het, gekombineer met bestuur wat dit nastreef om NRW te verminder by wyse van monitering en uitvoering van druk beheer in water netwerke het aansienlik kleiner NRWpersentasies. Ewe noodsaaklik vir die vermindering van NRW, soos geopenbaar deur die ondersoek is die beoefening van interne infrastruktuur batebestuur deur diemunisipaliteit. Daar is tot die gevolgtrekking gekom dat munisipaliteite daarna moet streef om ’n NRW persentasie van 30% of minder te bereik om finansieel stabiel te word, as gevolg van die korrelasie tussen befondsing van roetine bedrywighede en die opbou van kontant reserwe teenoor NRWpersentasies. Munisipaliteitewat die uitvoeringskoers van beplande waterdienste aktiwiteitewil verbeter, word aanbeveel om onder andere, tegniese bestuurs vaardigheids vlakke en kapasiteit aan te spreek. Munisipaliteite wat nie tegniese bestuursvaardigheid en -kapasiteit het nie, berig dat ’n lae persentasie van beplande aktiwiteite uitgevoer word. Die tegniese operasionele personeel vaardigheidsvlakke en kapasiteit, as gevolg van hul betrokkenheid in die uitvoering van beplande aktiwiteite is ook van groot belang. Die betrokkenheid van lede van die raad by water en afvalwater beplanning en die rapportering van data en kwessies aan die raad verhoog baiemunisipaliteite se vermoëns om beplande aktiwiteite uit te voer. Dit kan hoofsaaklik toegeskryf word aan verhoogde befondsing in situasies waar raadslede beplande projekte ondersteun. Dit is gevind dat die gebrek aan befondsing ’n groot inhibeerder van die uitvoering van beplande aktiwiteite is. Alhoewel ’n meerderheid van die munisipaliteite aangedui het dat hulle begrotings effektief spandeer, word dit egter nie weerspieël in die persentasie munisipaliteite wat beplande aktiwiteite uivoer nie en lei dit tot die gevolgtrekking dat daar n gebrek aan befondsing is. Munisipaliteite wat klem lê op ander gebiede van hul besigheid soos, infrastruktuur batebestuur en beplanning was meer effektief met die uitvoering van die beplande aktiwiteite. Daar is tot die gevolgtrekking gekom dat tegniese bestuur en operasionele personeel vaardigheidsvlakke en kapasiteit noodsaaklik is vir ’n munisipaliteit om behoorlik te funksioneer. Daar is ook ’n behoefte aan befondsing by munisipaliteite om beplande aktiwiteite uit te voer en munisipaliteite moet finansieel onafhanklik en lewensvatbaar word. Een manier om te werk te gaan om finansiële self volhoubaarheid te bereik, is die vermindering van NRW persentasies. Die data van hierdie ondersoek toon groot ooreenkomste met die literatuur wat geraadpleeg is oor die huidige stand en funksionering van Suid-Afrikaanse munisipaliteite. Die statistiese analise van die MuSSA data het akkurate korrelasies geopenbaar tussen die sleutel prestasie-aanwysers inmunisipaliteite. Die gevolgtrekking kan gemaak word dat die ondersoek in terme van die korrelasie tussen MuSSA vrae gebruik kan word om munisipale besluitneming te help verbeter.

Trata-se da meta-avaliação de um processo avaliativo desenvolvido por secretários e assessores técnicos municipais de uma região de saúde do estado de São Paulo, com foco nos critérios de utilidade e participação. É uma pesquisa qualitativa, cuja base empírica foi 1) o material produzido em sete oficinas realizadas com os representantes municipais, com vistas à avaliação de um aspecto da linha de cuidados em saúde sob a ótica da integralidade; e 2) as entrevistas semiestruturadas realizadas com os mesmos atores após a finalização do processo avaliativo. Para a avaliação do critério de utilidade, utilizou-se principalmente o referencial de KIRKHART (2000), com o objetivo de ampliar a análise para além do uso instrumental dos achados avaliativos e focá-la na identificação de influências múltiplas exercidas por um fenômeno complexo como um processo avaliativo. A análise do critério participação se deu com base no referencial de COUSINS e WHITMORE (1998), buscando a identificação no material empírico de decisões ou aspectos contextuais que fizeram com que a opção participativa fosse aprofundada ou limitada no processo em foco. O trabalho destaca a importância de explicitar pressupostos que baseiam a metodologia da avaliação/ meta-avaliação escolhida, e a necessidade de se buscar referenciais teóricos de análise compatíveis com a opção realizada, frisando a inexistência de posturas neutras ou estudos totalmente objetivos; e a importância de capacitar avaliadores a acompanharem a demanda dos participantes de um processo participativo com a flexibilidade necessária para conferir-lhe o maior aproveitamento possível. Conclui-se pela viabilidade, com vantagens, da realização de processos participativos locais com gestores na Saúde Pública, destacando a possibilidade de ganhos em formação e o enriquecimento dos processos de negociação em nível do território, de forma coerente à política de construção das regiões de saúde no SUS. / This study aims to meta-evaluate an evaluation process developed by policymakers and technical advisors of a Health Region of Sao Paulo, centering on criteria of utility and participation. It analyzes the feasibility and possible benefits of using a participatory methodology in Public Health evaluations, highlighting aspects that facilitate and hinder this undertaking. It is a qualitative research, which empirical basis was 1) the material produced in seven workshops with municipal representatives, aiming the evaluation of an aspect of health care from the perspective of integrity; and 2) semi-structured interviews with the same actors after completion of the evaluation process. KIRKHART´s theoretical framework (2000) was used to evaluate the utility criterion, in order to expand the analysis beyond the instrumental use of the evaluation findings, and focus it in identifying multiple influences exerted by a complex phenomenon as an evaluation process. The evaluation criterion of participation was based on references of COUSINS e WHITMORE (1998), aiming to identify decisions or contextual aspects in the empirical material that made participatory option limited or depth in the focused process. The work highlights the need to seek theoretical frameworks of analysis consistent with the methodological choice carried out in order to enhance the identification of evaluation gains and limitations, and enable evaluators to monitor the demand of participants in the evaluation process with flexibility to reach its best use, even in those cases where there are limitations on the possibilities of participation. The results confirmed the viability, with advantages, of holding local participatory processes with policymakers and managers in Public Health, highlighting the possibility of gains in education and the enrichment of the negotiation process in the territory level, consistent with the policy of building health regions in SUS.

Made available in DSpace on 2016-04-29T14:15:59Z (GMT). No. of bitstreams: 1 Flavia Bortoleto Ortolani.pdf: 902037 bytes, checksum: ebaa4f622fa574b3451bca261599afbc (MD5) Previous issue date: 2011-05-31 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This study discusses the knowledge and understanding of the city managers about the NOB-SUAS/RH, as well about the difficulties and challenges encountered in the execution of the guidelines in the management of social assistence work at the municipal level. From the V National Conference on Social Welfare (2005), when it is approved the resolution on the NOB-RH, a human resources policy is now considered one of the main principles in the SUAS, along with decentralization, financing and social control. The improvement of working conditions enters in the agenda for discussion as a strategic issue for qualifying services socioassistenciais and for effectuation of SUAS. In this sense, the premise that guided this study was that the approval and publication of a document that sets directives for the establishment and management of teams of reference for the deployment of ITS represent a great advance and a first step to promote changes structuring but its realization requires a conjunction of efforts that must be performed and correspond to the current challenge. To understand these dynamics we consider the historical context, political and economic that historically influence and continues directly influencing the institutionalization of social assistance as a public policy of rights. The territorial dimension of this study favored the administrative region of the Regional Office of Social Assistance of Piracicaba, composed of 27 cities of São Paulo. For quantitative research, we applied questionnaires to all the cities that are part of the coverage area. In turn to qualitative research, we used an intentional sample, electing the directors of municipal social assistance policy from four cities of different sizes and levels of management, seeking to include a heterogeneous sample that would allow to verify to what extent they resemble the difficulties and the challenges faced by each of these managers. The obtained results in this investigative trajectory show that the efforts for the effecting of directives contained in the NOB-RH/Suas in the cities researched are still very incipient. The effective of these directives in NOB-RH/Suas is not an exclusive responsibility limited of cities and municipal managers of social assistance policy since its implementation depends on a combination of political efforts, financial and institutional capacities of each level of government, in view of the shared management of social assistance policy / Este estudo busca discutir o conhecimento e a compreensão dos gestores municipais sobre a Norma Operacional Básica de Recursos Humanos (NOB-RH/Suas), bem como sobre as dificuldades e os desafios encontrados na efetivação das diretrizes na gestão do trabalho da assistência social em âmbito municipal. A partir da V Conferência Nacional de Assistência Social (2005), quando é aprovada a deliberação relativa à NOB-RH/Suas, a política de recursos humanos passa a ser considerada um dos eixos estruturantes do Sistema Único da Assistência Social (Suas), ao lado da descentralização, do financiamento, e do controle social. A melhoria das condições de trabalho entra na pauta das discussões como uma estratégia para a qualificação dos serviços socioassistenciais e efetivação do Suas. Nesse sentido, a premissa que norteou este estudo foi a de que a aprovação e publicação de um documento que define diretrizes para a constituição e gestão das equipes de referência para a implantação do Suas representam um grande avanço e o primeiro passo para impulsionar mudanças estruturantes, porém, a sua efetivação exige uma conjunção de esforços que precisam ser realizados e correspondem ao desafio atual. Para compreender essa dinâmica, consideramos os contextos histórico, político e econômico que influenciaram e continuam influenciando diretamente a institucionalização da assistência social como política pública de direitos. A dimensão territorial deste estudo privilegiou a região administrativa da Diretoria Regional de Assistência Social (Drads) de Piracicaba, composta por 27 municípios do Estado de São Paulo. Para a pesquisa quantitativa, foram aplicados questionários para todos os municípios contidos nesta área de abrangência. Por sua vez, para a pesquisa qualitativa, utilizou-se uma amostra intencional, elegendo os gestores municipais da política de assistência social de quatro municípios, de diferentes portes e níveis de gestão, de forma a contemplar uma amostra heterogênea que possibilitasse verificar em que medida se assemelham as dificuldades e os desafios encontrados por esses gestores. Os resultados obtidos no percurso investigativo revelam que os esforços para a efetivação das diretrizes contidas na NOBRH/ Suas nos municípios pesquisados ainda são muito incipientes. A efetivação das diretrizes contidas na NOB-RH/Suas não é responsabilidade exclusiva dos municípios e dos gestores municipais da política de assistência social, pois sua concretização depende da conjunção de esforços políticos, financeiros e institucionais de cada uma das esferas de governo, na perspectiva da gestão compartilhada da política de assistência social

Introdução: O controle exercido pelo Tribunal de Contas dos Municípios do Ceará (TCM) gera freqüentes desaprovações das contas da gestão municipal da saúde, o que justifica esse trabalho. Objetivos e Método: Com o objetivo central de caracterizar as causas dessas desaprovações,foi realizada análise documental em 162 processos de Prestação de Contas e 32 de Tomada de Contas da gestão municipal da saúde, exercícios de 2001 a 2004, julgadas e desaprovadas em decisão definitiva pelo TCM. O conhecimento das bases legais da administração pública ajudou na compreensão dessa realidade. Após a identificação dos municípios e a freqüência das ocorrências em cada ano de exercício, uma amostra dos gestores da saúde e contadores dos municípios implicados foi entrevistada para o levantamento da opinião deles sobre as causas das desaprovações, objetivos específicos do estudo. Resultados: Do total de 184 municípios do estado do Ceará 107(58 por cento) tiveram suas contas desaprovadas em um ou mais anos. As desaprovações são mais freqüentes nos municípios de pequeno porte (70,2 por cento) e a reincidência é maior nos dois primeiros anos do mandato. As irregularidades relacionadas à licitação ocupam o primeiro lugar no ranking das causas apontadas pelo TCM, seguidas por outras relacionadas ao setor de contabilidade. Os dois grupos entrevistados apontam como causas o desconhecimento, excesso de atividades, sobrecarga do gestor da saúde e a falta de integração com os demais setores da administração. Os gestores citam ainda, a falta de autonomia e ingerência alheia no setor. Os contadores acrescentam a falta de planejamento e de controle interno pelo pessoal da saúde e consideram também, que as orientações do Procurador do município podem ser descritas como incabíveis. Conclusões: As desaprovações ocorrem pela falta de integração, cooperação formativa e técnica entre as diversas instâncias administrativas e de controle. Os resultados do estudo somados à experiência profissional da autora geraram relevantes recomendações aos gestores / Introduction: This thesis is justified by the (Tribunal de Contas dos Municípios do Ceará-TCM) control that is responsible for frequent disapprovals of the accounts from municipal management of health. Aims and methods: To point out the reasons of these disapprovals, the documental analysis of 162 process about rendering of accounts and 32 about taking municipal management of health, years 2001 to 2004, judged and disapproved in final decision by TCM, were realized. The knowledge of the legal basis of the public management helped to understand this reality. After the cities and frequency identification of each year, a sample of health supervisors and accountants from the cities involved was interviewed in order to have a survey about their opinion about the reasons for disapprovals. Results: From the total of 184 cities in Ceará state, 107(58 per cent) had the accounts disapproved one or more years. The disapprovals are more frequent in small cities (70,2 per cent) and the more recidivists occur in the first years of mandate. The irregularities related to bidding are in the first place on the rank of reasons pointed by TCM, followed by others related to accounting sector. According two groups interviewed, the reasons are: dissatisfaction, activities excessive, lots of activities to health supervisors and the lack of integration with other sectors of management. The supervisors mention the lack of autonomy and interference in the sector. The accountants mention the lack of planning and internal control by people who work in health sector and they consider that the Procurators orientations could be described as unreasonable. Conclusions: The disapprovals occur by the lack of integration, formative and technique co-operation between the management and control instances. The study results added to the authors experience give relevant recommendations to supervisors