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Previous issue date: 2013-03-27 / Funda??o de Amparo ? Pesquisa do Estado da Bahia - FAPEB / Research on the practices of SUS management in Primary Care in the city of Alagoinhas-BA, whose aims were understand the sense and/or the meaning on the care management in Primary Heath Care, considering the participation of managers, health workers and users in Primary Care in the city of Alagoinhas ?BA; analyze the practice of the SUS management in Primary Care and discuss the competence and attribution of the municipal government (managers, health workers and householders), policies and 'new' models of health in Primary Care. Qualitative research, with family health units as investigation field. The participant subjects in the study were divided into four groups: Group I, managers; Group II, health workers; Group III, users; Group IV, key informants, in total 26 participants. We used systematic observation, semi-structured interviews and document analysis as data collection techniques. The method of data analysis was an approximation with Hermeneutics-dialectical, from which were drawn three categories of analysis: categorical-Practice of management in Primary Health Care: sense and meaning; category 2-A orchestra-'ideal' of rationality, hegemonic order and productive and category 3-social Control: in search of democracy. According to the survey results, the SUS management practices in Primary Care of Alagoinhas-BA municipality occur disjointed among user subjects, health workers and managers, characterized by the centralization of decision-making power of managers to the detriment of the interests of users and workers, reflecting the fragility of the citizenship exercise. Thus, social control, permanent education and health planning as a tool for sharing of power among subjects has only been theorized, reproducing one centralized management, since the senses and meanings for the management sometimes approach, sometimes depart from the practices of the involved participants. In the subject understanding, the management practices should be established in the user-centered model of health to provide the best service to users. However, these manager practices are still rooted in the hegemonic model, focused in normative planning. Regarding to the workers, there is a double understanding: the planning owns features of normative focus and a small part in the situational-local strategic focus. However, the workers practices have been developed in care model of Programmatic Actions, welcome and user participation in the work process. The social participation occurs in the county through the Municipal Health Council and community neighborhood Association. Faced with such reality, the practices of health management in the county of Alagoinhas are stuck to the model of a Taylorist management, although of starting hearing the echo of co-management in family health Units. / Estudo sobre as pr?ticas de gest?o do SUS na Aten??o B?sica no munic?pio de Alagoinhas-BA, cujos os objetivos foram Compreender o(s) sentido(s) e/ou significado(s) sobre a gest?o do cuidado na Aten??o B?sica de Sa?de, considerando-se a participa??o dos gestores, trabalhadores de sa?de e usu?rios da Aten??o B?sica no munic?pio de Alagoinhas-BA; analisar a pr?tica de gest?o do SUS na Aten??o B?sica e discutir a(s) compet?ncia(s) e a(s) atribui??o(?es) do governo municipal (gestores, trabalhadores de sa?de e mun?cipes) as pol?ticas e ?novos? modelos de sa?de na Aten??o B?sica. Pesquisa qualitativa, tendo como campo de investiga??o as unidades sa?de da fam?lia. Os sujeitos participantes do estudo foram divididos em quatro grupos: Grupo I, gestores; Grupo II, trabalhadores de sa?de; Grupo III, usu?rios; Grupo IV, informantes-chave, no total 26 participantes. Como t?cnicas de coleta dos dados utilizamos observa??o sistem?tica, entrevista semi-estruturada e an?lise de documentos. O m?todo de an?lise de dados foi uma aproxima??o com a Hermen?utica-dial?tica, a partir do qual foram elaboradas tr?s categorias de an?lise: categoria1-Pr?tica da Gest?o na Aten??o B?sica de Sa?de: sentidos e significados; categoria 2-A orquestra ?ideal? da racionalidade, ordem hegem?nica e produtiva e categoria 3-Controle social: em busca da democracia. De acordo com os resultados da pesquisa, as pr?ticas de gest?o do SUS na Aten??o B?sica do munic?pio de Alagoinhas-BA ocorrem desarticuladas entre os sujeitos usu?rios, trabalhadores de sa?de e gestores, caracterizada pela centraliza??o do poder de decis?o dos gestores em detrimento dos interesses dos usu?rios e trabalhadores, traduzindo a fragilidade do exerc?cio da cidadania. Desse modo, o controle social, a educa??o permanente e o planejamento em sa?de como instrumentos de partilhamento do poder entre sujeitos tem sido apenas teorizado, reproduzindo uma gest?o centralizada, j? que os sentidos e significados para gest?o ora aproximam, ora se afastam das pr?ticas dos sujeitos envolvidos. Na compreens?o dos sujeitos, as pr?ticas de gest?o devem ser baseadas no modelo de sa?de usu?rio-centrado para proporcionar o melhor atendimento aos usu?rios. No entanto, as pr?ticas dos gestores ainda continuam arraigadas no modelo hegem?nico, focado no planejamento normativo. Quanto aos trabalhadores h? um entendimento duplo: o planejamento possui caracter?sticas do enfoque normativo e uma pequena parte no enfoque estrat?gico situacional local. Contudo, as pr?ticas dos trabalhadores tem sido desenvolvidas no modelo de aten??o das A??es Program?ticas, acolhimento e participa??o dos usu?rios no processo de trabalho. A participa??o social ocorre no munic?pio atrav?s do Conselho Municipal de Sa?de e Associa??o comunit?ria de bairro. Diante de tal realidade, as pr?ticas de gest?o em sa?de no munic?pio de Alagoinhas encontram-se presas ao modelo de uma gest?o Taylorista, apesar de come?ar a ouvir o eco da co-gest?o nas Unidades de sa?de da fam?lia.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.uefs.br:8080:tede/405 |
| Date | 27 March 2013 |
| Creators | Gon?alves, Carolina de Camargo Teixeira |
| Contributors | Nascimento, Maria Angela Alves do |
| Publisher | Universidade Estadual de Feira de Santana, Mestrado Acad?mico em Sa?de Coletiva, UEFS, Brasil, DEPARTAMENTO DE SA?DE |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | Portuguese |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da UEFS, instname:Universidade Estadual de Feira de Santana, instacron:UEFS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | -2122225376607208326, 600, 600, 600, 600, 1006395569471477890, -6173167103754495199, -8233071094704392586 |
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