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Para a implanta??o da meritocracia na gest?o de carreira: implica??es dos contextos cultural, gerencial e pol?tico de uma empresa estatal federal brasileira / Toward the introduction of meritocracy in career management: the implications of the cultural, managerial and political contexts in a Brazilian federal state-owned companyPESTANA, Rayner Carvalho 03 July 2015 (has links)
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Previous issue date: 2015-07-03 / The transformation of the Brazilian Public Management, specifically about the adoption of modern tools for human resources, has been happening since the last century and the concern about the introduction of meritocracy in career management is still considered a recurring theme. An evidence of that is the guidance from management and control department of federal state-owned companies to adopt meritocracy in their career management systems. The organization studied here, although already have passed thirteen years of validity of its current jobs and salaries plan, seems not yet to have been able to establish career management policies based on meritocracy. Due to the problem presented, the main objective of this research focused on raising the implications of the organizational context of a Brazilian federal state-owned company, dependent on the Treasury, for the introduction of meritocracy in career management. An applied qualitative research was carried out, configured in the form of a single case study to map the features of the current cultural, managerial and political contexts and to interpret their implications in the adoption of meritocracy as an organizational value. The research subjects were purposefully selected, among managers and career employees, and interviewed based on a script and from a photograph (photo elicitation) to reveal the current context. The field data were subjected to an inductive hermeneutic analysis. Based on these results, it can be inferred that meritocracy in career management, understood as ?a set of criteria, adopted by an organization that has on individual performance, effort and results, the fundamental pillars for granting promotions and progressions to its employees in their own careers?, is not yet explicitly manifested in the studied company. It was perceived that the company is set as a political arena type and that the current alternative process of granting promotions and progressions has been working as a fundamental mechanism for the on going internal power dynamics. On the context found, some manager actions were proposed to contribute to the implementation of meritocracy in career management. It can be considered, as a contribution to the field, the opportunity for reflecting on the negative implications of the penetration of management values in human resources, regarding: uncritical transfer of tools from the private sector to the public one; defense of entrepreneurship discourse that considers the career management as sole responsibility of the professional; only financial and quantitative focus on performance evaluations; and probability of management tools not resulting in professional development but only in the control and exploitation of the individual. For future research it is suggested i.e.: to investigate what commitment means to the organizational members in order to connect it to the company's concepts raised in the study; to analyze meritocracy from the psychological contract breach viewpoint; and to expand this study to other public organizations dependent or not on the Treasury, to ascertain the implications of cultural and managerial traits and the power dynamics for the adoption of meritocracy in career management. / A transforma??o da Administra??o P?blica Brasileira, no que tange ? ado??o de ferramentas modernas de gest?o de pessoas, vem ocorrendo desde o s?culo passado e a preocupa??o com a meritocracia na gest?o de carreira se configura como um assunto ainda recorrente. Como prova disso, destacam-se as orienta??es do ?rg?o de gest?o e controle das empresas estatais federais para que elas adotem a meritocracia nos seus sistemas de gest?o de carreira. A organiza??o aqui estudada, embora passados treze anos de vig?ncia do atual plano de cargos e sal?rios, parece ainda n?o ter conseguido instituir pol?ticas de gest?o de carreira calcadas na meritocracia. Diante do problema apresentado, o objetivo principal desta pesquisa se concentrou em levantar as implica??es dos tra?os provenientes do contexto organizacional de uma estatal federal brasileira, dependente do Tesouro Nacional, para a implanta??o da meritocracia na gest?o de carreira. Realizou-se pesquisa aplicada de natureza qualitativa, configurada em forma de estudo de caso ?nico para mapear os tra?os do contexto cultural, gerencial e pol?tico vigentes e interpretar suas implica??es na ado??o da meritocracia como um valor organizacional. Os sujeitos da pesquisa foram selecionados pelo m?todo proposital, entre gerentes e empregados de carreira, e entrevistados mediante roteiro e a partir de uma fotografia (elicita??o fotogr?fica) que revelasse o contexto vigente na ?tica dos mesmos. Os dados de campo foram qualitativamente analisados de forma hermen?utico-indutiva. Com base nos resultados obtidos, conclui-se que a meritocracia na gest?o de carreira, entendida como ?o conjunto de crit?rios, adotado por uma organiza??o, que possui no desempenho, no esfor?o individual e nos resultados alcan?ados os pilares fundamentais para a concess?o de promo??es e progress?es dos empregados em suas respectivas carreiras?, n?o ?, ainda, praticada explicitamente na empresa estudada. Revelou-se que a empresa se configura como uma organiza??o do tipo arena pol?tica e que o vigente processo alternativo de concess?o de promo??es e progress?es tem funcionado como um mecanismo fundamental na din?mica interna de poder. Diante deste contexto, foram propostas a??es de forma a contribuir com a implanta??o da meritocracia na gest?o de carreira. Considera-se como contribui??o ? ?rea a oportunidade de reflex?o sobre as implica??es da penetra??o de valores do management na gest?o de pessoas, relativas a: transfer?ncia acr?tica de ferramentas do setor privado para o p?blico; defesa do discurso do empreendedorismo, pressupondo a gest?o de carreira como responsabilidade unicamente do profissional; perspectiva apenas financeira e quantitativa das avalia??es de desempenho; e probabilidade das ferramentas de gest?o n?o resultarem no desenvolvimento profissional, mas no controle e explora??o do indiv?duo. Para aprofundamento em futuras pesquisas, sugere-se, dentre outras a??es: investigar o conceito de comprometimento na organiza??o, conectando-o ?s concep??es da Empresa levantadas no estudo; analisar a meritocracia a partir da ?tica da quebra do contrato psicol?gico; e expandir a presente pesquisa a outras organiza??es p?blicas dependentes ou n?o do Tesouro, a fim de evidenciar as implica??es dos tra?os culturais e gerenciais e da din?mica de poder existentes na ado??o da meritocracia na gest?o de carreira.
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Modelo de gest?o da informa??o aplicado ao ambiente empresarial : um estudo do setor sucroalcooleiroGiacomelli, Adilson Lu?s 16 December 2003 (has links)
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Previous issue date: 2003-12-16 / The proposal of an information management model is characterized as a capable way of supporting and directing the enterprise management system. For the study of this subject, it was chosen a sector of the Brazilian economy that was out of the patterns of the new products and businesses enterprises, classified as dot.com and, at the same time globalized, with high fluctuation of prices and demand, requiring integrated information. According to this, it is important to consider that the way of sustaining the basic columns of enterprise management, named statistical, economical and behavioral, needs supporting of the information management. In this way, some information models have been developed, according to the management techniques, to make possible a dynamic process for the maximization of the performance indicators of the organization. Nevertheless, in these models, it is considered that the communication of information is closely related to the individual performance and, therefore, related to the human subjectivity. Thus, the relationship between the information management and the segments of enterprise management systems, aligned with the strategy of the undertaking, incite competitive differential, assuring the increasingly improvement of the organization process. / A proposta de um modelo de gest?o da informa??o caracteriza-se como um meio capaz de sustentar e direcionar o sistema de gest?o empresarial. Para o estudo deste assunto, escolheu-se um setor da economia brasileira que estivesse fora dos padr?es das empresas de novos neg?cios e produtos, categorizados como dot.com, mas que, ao mesmo tempo, estivesse globalizado, com alta volatilidade de pre?os e demanda, por conseguinte, requerente de informa??es integradas. Diante disso, urge considerar que a forma de sustenta??o dos pilares b?sicos da gest?o empresarial, denominados como estat?sticos, econ?micos e comportamentais, necessita do apoio da gest?o da informa??o. Neste sentido, foram desenvolvidos alguns modelos informacionais que, em conformidade com as t?cnicas de gest?o, venham possibilitar um processo din?mico de maximiza??o dos indicadores de desempenho da organiza??o. Todavia, nestes modelos, considera-se que a comunica??o da informa??o est? condicionada ? atua??o de cada indiv?duo, portanto, associada ? subjetividade humana. Desta forma, a rela??o entre a gest?o da informa??o e os segmentos do sistema de gest?o empresarial, alinhados com a estrat?gia do empreendimento estimulam diferenciais competitivos, assegurando, assim, a melhoria cont?nua dos processos da organiza??o.
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Capacita??o gerencial para a UFRRJ: uma proposta baseada na aprendizagem dos gestores no escopo de uma gest?o de pessoas por compet?ncias / Managerial development for UFRRJ: Building a Proposal based on managers learning to support a Professional Competencies Management SystemSALLES, Michelle de Andrade Souza Diniz 01 July 2013 (has links)
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Previous issue date: 2013-07-01 / This is an exploratory qualitative research accomplished at a Higher Education Federal Institution (HEFI), situated in Rio de Janeiro State. It aimed at developing a proposal for public managers? capacity building departing from their managerial learning capacity in order to develop their managerial competency to support a Professional Competencies Management System. Therefore, this research answered: How to develop managerial capacity dedicated to the HEFI real context considering managers emergent learning process at work? Five intermediate goals were also attained: (a) Characterizing the management learning activity in public service; (b) Elucidating the managers? perception about the required competencies for practicing their managerial role; (c) Identifying managerial competencies developed by managers in the exercise of managerial activity; (d) Identifying individual and collective learning processes embedded in managers work, (e) Setting up the managerial development activities. Empirical data collected among 19 managers of the HEFI, through semi-structured individual interviews, were qualitatively analyzed by means of hermeneutic interpretive inductive approach. Empirical results indicates that the managers learning process and managerial competency development occurred through: (a) Self-learning, (b) vicarious learning, c) self-experience, and by solving problems in a trial and error mode (d) Social and collective interactions (e) Formal education (f) Working practice deconstruction; g) Managers? life activities off work. To trigger the development of managerial competencies including the emerging managers learning processes at this HEFI, an institutionalized managerial development project is needed grounded in andragogy pedagogy, this is, specific for adult learning process based on public managers awareness enhancement about the importance of the various ways of learning in the working practice. For instance, encouraging vicarious learning through the presentation of other institutions cases and the collective identification of the required managerial competencies. The managerial development project structure should take into account the need to meet individual managers? development requirement as well as the constraints imposed by the collective election process for being a public manager at this HEFI. Developing managerial competencies should have as structure: a) Evaluation b) learning c) Analysis d) Practice e) Application. Managerial competencies development should follow a continuous learning at work approach, taking into account profile differences concerning the academic and technical managerial positions. / Trata-se de uma pesquisa explorat?ria de natureza qualitativa realizada em uma institui??o federal de ensino superior (IFES), situada no Estado do Rio de Janeiro. O objetivo do estudo foi subsidiar uma capacita??o de gestores p?blicos com vistas a desenvolver compet?ncias gerenciais no escopo da Gest?o de Pessoas por Compet?ncias. Para tanto partiu-se da quest?o como capacitar gestores da UFRRJ nas compet?ncias gerenciais tendo como base a aprendizagem dos gestores no escopo de uma Gest?o de Pessoas por Compet?ncias? e cinco objetivos intermedi?rios foram alcan?ados: (a) Caracterizar a aprendizagem gerencial no servi?o p?blico; (b) Levantar as compet?ncias requeridas dos gestores segundo a percep??o dos mesmos para o exerc?cio da fun??o gerencial; (c) Identificar as compet?ncias gerenciais desenvolvidas pelos gestores no exerc?cio da atividade gerencial; (d) Identificar processos de aprendizagem individual e coletiva presentes no trabalho dos gestores; (e) Propor atividades de capacita??o gerencial para desenvolvimento de compet?ncias gerenciais pertinentes aos gestores da IFES examinada. A coleta de dados emp?ricos foi feita junto a 19 gestores, por meio de entrevistas semiestruturadas conduzidas pessoalmente com cada entrevistado. A an?lise qualitativa dos dados se realizou por meio de abordagem indutiva com interpreta??o hermen?utica. Os resultados emp?ricos indicam que o processo de aprendizagem gerencial ocorre por meio de: a) Auto-aprendizagem; b) Aprendizagem vic?ria; c) Experi?ncia pr?pria, resolvendo problemas e por tentativa e erro; d) Intera??es sociais e coletivas; e) Educa??o formal; f) Desconstru??o de pr?ticas de trabalho; g) Atividades na vida dos gestores fora do trabalho. As compet?ncias foram desenvolvidas por meio destes processos de aprendizagem. Para ativar o desenvolvimento de compet?ncias gerenciais por meio de aprendizagem na IFES recomenda-se a institucionaliza??o de um Programa de capacita??o gerencial, com base na andragogia, ou seja especifica para aprendizagem de adultos, pautada em um processo de sensibiliza??o dos quadros gestores, a ser feita propiciando uma aprendizagem vic?ria por meio da apresenta??o de exemplos de outras institui??es e pela identifica??o coletiva das necessidades dos pr?prios gestores da IFES. A estrutura da capacita??o dever? levar em considera??o a necessidade de atender as demandas de desenvolvimento gerencial assim como as restri??es impostas pelo processo de elei??o colegiada de gestores vigente. Recomenda-se uma capacita??o assim estruturada: a) Avalia??o; b) Aprendizagem; c) An?lise; d) Pr?tica; e) Aplica??o. S?o sugeridas capacita??es gerenciais seguindo a abordagem da capacita??o continuada por n?veis, considerando as diferen?as dos respectivos perfis dos cargos t?cnicos e docentes.
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Avalia??o do Programa Mais M?dicos nos Vales do Jequitinhonha e MucuriPereira, Elizeu de Castro 12 September 2017 (has links)
Incluir como ag?ncias financiadoras: Funda??o de Amparo ? Pesquisa do Estado de Minas Gerais (FAPEMIG), Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (FUNDAEPE). / Submitted by Jos? Henrique Henrique (jose.neves@ufvjm.edu.br) on 2018-01-09T21:32:26Z
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Previous issue date: 2017 / Funda??o de Amparo ? Pesquisa do Estado de Minas Gerais (FAPEMIG) / Funda??o Diamantinense de Apoio ao Ensino, Pesquisa e Extens?o (FUNDAEPE) / O Programa Mais M?dicos para o Brasil foi implementado pelo Governo Federal nos Vales do Jequitinhonha e Mucuri de 2013 a 2016. V?rios fatores influenciam na satisfa??o dos profissionais m?dicos na presta??o de servi?o. A avalia??o desses fatores ? importante, pois pode trazer alternativas para a amplia??o da perman?ncia desses profissionais nas Unidades B?sicas de Sa?de, apontar lacunas importantes nas Estrat?gias Sa?de da Fam?lia e no Programa Mais M?dicos e, assim, subsidiar a??es efetivas no ?mbito da Aten??o Prim?ria em Sa?de, direcionadas ?s equipes de sa?de da fam?lia e equacionar as dificuldades apresentadas nas Unidades B?sicas de Sa?de do munic?pio de Diamantina, bem como dos demais munic?pios dos Vales do Jequitinhonha e Mucuri. O objetivo do presente projeto foi avaliar a satisfa??o dos m?dicos do Programa Mais M?dicos para o Brasil nos Vales do Jequitinhonha e Mucuri. Tratou-se de um estudo descritivo, o qual foi realizado por meio de uma estrat?gia de combina??o de abordagens quantitativas, denominada triangula??o de m?todos. A popula??o de estudo foi constitu?da por 90 m?dicos, distribu?dos nos 82 munic?pios dos Vales em quest?o. Dos 82 munic?pios investigados foi constatado que apenas 23, at? o momento, n?o fizeram ades?o ao Programa Mais M?dicos para o Brasil. Em rela??o ? satisfa??o dos profissionais m?dicos foi verificado, atrav?s da escala de Likert, que 63% (n=90) dos que responderam as perguntas relacionadas ? satisfa??o se encontram totalmente satisfeitos. Esses dados foram corroborados com outras an?lises estat?sticas como o dendograma e an?lise multicrit?rios. Foi observada a correla??o entre a satisfa??o dos m?dicos e o maior grau de escolaridade. Os resultados alcan?ados nessa pesquisa permitem visualizar quest?es importantes do Programa Mais M?dicos para o Brasil e, desta forma, subsidiar a??es efetivas no ?mbito da Aten??o Prim?ria ? Sa?de. / Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Sa?de, Sociedade e Ambiente, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017. / More Doctors Program for Brazil was implemented by the Federal Government in the Jequitinhonha and Mucuri Valleys from 2013 to 2016. Several factors influence the satisfaction of medical professionals in the provision of services. The evaluation of these factors is important, since it can provide alternatives for the expansion of the permanence of these professionals in the Basic Health Units. It is believed that the results achieved so far may point to important shortcomings in the Family Health Strategies and the Medical Program and thus, subsidize effective actions in the scope of Primary Health Care directed to the family health teams and equate the difficulties presented in the Basic Health Units of the municipality of Diamantina and also of other municipalities of the Jequitinhonha and Mucuri Valleys. The objective of the present project was to evaluate More Doctors Program for the Brazilians in the Jequitinhonha and Mucuri Valleys. This was a descriptive study, which was carried out through a combination strategy of quantitative approaches, called method triangulation. The study population consisted of 90 physicians, divided among the 82 municipalities of the concerned Valleys. Of the 82 municipalities investigated, it was verified that only 23, untill now, they did not join More Doctor Program for Brazilians. Related to the satisfaction of medical professionals, 63% (n = 90) of those who answered the questions related to satisfaction they were found fully satisfied with the Likert scale. These data were corroborated with other statistical analyzes such as dendrogram and multicriteria analysis. Correlation between physician satisfaction and educational level was observed. The results obtained in this research allow to visualize important issues of More Doctor Program for Brazilians and thus subsidize effective actions in the ambit of the Primary Healthy Care. / El Programa M?s M?dicos para Brasil (PMMB) fue implementado por el Gobierno Federal en los Valles del Jequitinhonha y Mucuri de 2013 a 2016. Varios factores influencian en la satisfacci?n de los profesionales m?dicos en la prestaci?n de servicio. La evaluaci?n de estos factores es importante, pues puede traer alternativas para la ampliaci?n de la permanencia de esos profesionales en las Unidades B?sicas de Salud, se?alar lagunas importantes en las Estrategias Salud de la Familia y en el Programa M?s M?dicos y, as?, subsidiar acciones efectivas en el ?mbito de la Atenci?n Primaria en De la Salud, dirigidas a los equipos de salud de la familia y abordar las dificultades presentadas en las Unidades B?sicas de Salud del municipio de Diamantina, as? como de los dem?s municipios de los Valles del Jequitinhonha y Mucuri. El objetivo del presente proyecto fue evaluar la satisfacci?n de los m?dicos del Programa M?s M?dicos para Brasil en los Valles del Jequitinhonha y Mucuri. Se trat? de un estudio descriptivo, el cual fue realizado por medio de una estrategia de combinaci?n de abordajes cuantitativos, denominada triangulaci?n de m?todos. La poblaci?n de estudio fue constituida por 90 m?dicos, distribuidos en los 82 municipios de los Valles en cuesti?n. De los 82 municipios investigados se constat? que s?lo 23, hasta el momento, no hicieron adhesi?n al PMMB. En cuanto a la satisfacci?n de los profesionales m?dicos se verific?, a trav?s de la escala de Likert, que el 63% (n = 90) de los que respondieron las preguntas relacionadas a la satisfacci?n se encuentran totalmente satisfechos. Estos datos fueron corroborados con otros an?lisis estad?sticos como el dendograma y an?lisis multicriterios. Se observ? la correlaci?n entre la satisfacci?n de los m?dicos y el mayor grado de escolaridad. Los resultados alcanzados en esta investigaci?n permiten visualizar cuestiones importantes del PMMB y, de esta forma, subsidiar acciones efectivas en el ?mbito de la APS.
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Qualidade do servi?o em organiza??o do terceiro setor: um estudo na casa de apoio ? crian?a com c?ncerCampos, Rilson Flaubert de Paiva 27 February 2009 (has links)
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Previous issue date: 2009-02-27 / The research aimed identify how the quality of services provided by Casa de
Apoio ? Crian?a com C?ncer Durval Paiva is perceived by its users, giving an
opportunity of improve their performance in social services provision pointing
out the failures experienced, the institution will have the user as a important
partner in fails identification, serving as a subsidy to the actions of correction
and improvement to such situations demands. With this work implementation
will be observed contributions that will permeate to the fields of theory and
practice, enabling progress and enrichment on the subject. The theoretical
contribution is observed as this work execution will provide greater advance
about the models developed for the third sector. The proposed work will raise
awareness issues about the full potential of the social economy, with regard to
the quality of services provided by organizations, allowing a better definition of
priorities on their development. The study addressed three issues: identifying
the people that receive support of the Casa Durval Paiva, identifying what is the
level of satisfaction of families served and evaluate the services provided by
Casa Durval Paiva that demand improvements in the perception of families
assisted. Found a demand for services has been found that the institution has a
multidisciplinary team with a high level of professionalism, and supervised with
students of various educational institutions and many volunteers to complement
the actions of individual professionals. Was measured a high satisfaction of
users of the services provided by Casa Durval Paiva / prestados, pela Casa de Apoio ? Crian?a com C?ncer Durval Paiva, ?
percebida por seus usu?rios, fornecendo-lhe oportunidade de avalia??o do
desempenho desta na presta??o de servi?os sociais, uma vez que, ao apontar
as falhas vivenciadas, a institui??o ter? o usu?rio como forte aliado na
identifica??o dos erros cometidos, servindo de subs?dios ?s a??es de corre??o
e melhoria que tais situa??es demandar?o. Com a execu??o do trabalho
proposto, ser?o observadas contribui??es que permear?o os campos da teoria
e da pr?tica, possibilitando avan?os e enriquecimento acerca do tema. A
contribui??o te?rica se observar? ? medida que a execu??o do trabalho
propiciar? um maior aprofundamento a respeito dos modelos desenvolvidos
para o terceiro setor. O trabalho proposto possibilitar? a consci?ncia de
aspectos limitantes ao aproveitamento pleno dos potenciais da economia
social, com rela??o ? qualidade dos servi?os prestados por organiza??es do
terceiro setor, permitindo uma melhor defini??o de prioridades sobre o seu
desenvolvimento. O trabalho abordou tr?s temas: identificar o p?blico alvo
atendido pela Casa Durval Paiva; identificar qual ? o n?vel de satisfa??o das
fam?lias atendidas com rela??o aos servi?os prestados pela Casa Durval Paiva
e avaliar quais os servi?os prestados pela Casa Durval Paiva que demandam
melhorias, na percep??o das fam?lias assistidas. Verificada a demanda dos
servi?os oferecidos, foi constatado que a institui??o tem uma equipe
multidisciplinar com um elevado n?vel de profissionalismo, al?m de est?gios
supervisionados com alunos das diversas institui??es de ensinos e um corpo
de volunt?rios que complementam as a??es de cada um dos profissionais.
Aferido uma alta satisfa??o dos usu?rios pelos servi?os prestados pela Casa
Durval Paiva
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Health for community dwelling older people : trends, inequalities, needs and care in rural VietnamVan Hoi, Le January 2011 (has links)
Background InVietnam, the proportion of people aged 60 and above has increased rapidly in recent decades. The majority live in rural areas where socioeconomic status is more disadvantaged than in urban areas.Vietnam’s economic status is improving but disparities in income and living conditions are widening between groups and regions. A consistent and emerging danger of communicable diseases and an increase of non-communicable diseases exist concurrently. The emigration of young people and the impact of other socioeconomic changes leave more elderly on their own and with less family support. Introduction of user fees and development of a private sector improve the coverage and quality of health care but increase household health expenditures and inequalities in health care. Life expectancy at birth has increased, but not much is known about changes during old age. There is a lack of evidence, particularly in rural settings, about health-related quality of life (HRQoL) among older people within the context of socioeconomic changes and health-sector reform. Knowledge of long-term elderly care needs in the community and the relevant models are still limited. To provide evidence for developing new policies and models of care, this thesis aimed to assess general health status, health care needs, and perspectives on future health care options for community-dwelling older people. Methods An abridged life table was used to estimate cohort life expectancies at old age from longitudinal data collected by FilaBavi DSS during 1999-2006. This covered 7,668 people aged 60 and above with 43,272 person-years. A 2007 cross-sectional survey was conducted among people aged 60 and over living in 2,240 households that were randomly selected from the FilaBavi DSS. Interviews used a structured questionnaire to assess HRQoL, daily care needs, and willingness to use and to pay for models of care. Participant and household socioeconomic characteristics were extracted from the 2007 DSS re-census. Differences in life expectancy are examined by socioeconomic factors. The EQ-5D index is calculated based on the time trade-off tariff. Distributions of study subjects by study variables are described with 95% confidence intervals. Multivariate analyses are performed to identify socioeconomic determinants of HRQoL, need of support, ADL index, and willingness to use and pay for models of care. In addition, four focus group discussions with the elderly, their household members, and community association representatives were conducted to explore perspectives on the use of services by applying content analysis. Results Life expectancy at age 60 increased by approximately one year from 1999-2002 to 2003-2006, but tended to decrease in the most vulnerable groups. There is a wide gap in life expectancy by poverty status and living arrangement. The sex gap in life expectancy is consistent across all socioeconomic groups and is wider among the more disadvantaged populations. The EQ-5D index at old age is 0.876. Younger age groups, position as household head, working, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on HRQoL that is mainly due to reduction in physical (rather than mental) functions. Being a household head and working at old age are advantageous for attaining better HRQoL in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical functions. Long-term living conditions are more likely to affect HRQoL than short-term economic conditions. Dependence in instrumental or intellectual activities of daily living (ADLs) is more common than in basic ADLs. People who need complete help are fewer than those who need some help in almost all ADLs. Over two-fifths of people who needed help received enough support in all ADL dimensions. Children and grand-children are confirmed to be the main caregivers. Presence of chronic illness, age groups, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, and poverty status are determinants of the need for care. Use of mobile teams is the most requested service; the fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than did the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require free services is 2 to 3 times higher than those willing to pay full cost. Households are willing to pay more for day care and nursing centres than are the elderly. The elderly are more willing to pay for mobile teams than are their households. ADL index, age group, sex, literacy, marital status, living arrangement, head of household status, living area, working status, poverty and household wealth are factors related to willingness to use services. Conclusions There is a trend of increasing life expectancy at older ages in ruralVietnam. Inequalities in life expectancy exist between socioeconomic groups. HRQoL at old age is at a high level, but varies substantially according to socioeconomic factors. An unmet need of daily care for older people remains. Family is the main source of support for care. Need for care is in more demand among disadvantaged groups. Development of a social network for community-based long-term elderly care is needed. The network should focus on instrumental and intellectual ADLs rather than basic ADLs. Home-based care is more essential than institutionalized care. Community-based elderly care will be used and partly paid for if it is provided by the government or associations. The determinants of elderly health and care needs should be addressed by appropriate social and health policies with greater targeting of the poorest and most disadvantaged groups. Building capacity for health professionals and informal caregivers, as well as support for the most vulnerable elderly groups, is essential for providing and assessing the services. / Aging and Living Conditions Program / Vietnam-Sweden Collaborative Program in Health, SIDA/Sarec
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