Navegando por Palavras-chave "unified health system"

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    Colonialismo ou solidariedade nas relações entre trabalhadores de saúde e usuários? Implicações para a continuidade do cuidado
    (Universidade Federal de São Paulo (UNIFESP), 2013-02-27) Schimith, Maria Denise [UNIFESP]; Bretas, Ana Cristina Passarella Bretas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    This research is inserted in the theme of comprehensive care of the Unified Health System, contemplating the issue continuity of care in the Health Care Networks and having as object the relations that are established in a Family Health Unit of the city of Santa Maria, Rio Grande do Sul. The objectives were: to analyze the process of implementation and monitoring of the Family Health Strategy in Santa Maria; to understand the relation between workers and users during the care practices realized in a Family Health Unit of the city of Santa Maria, relating them to the effective continuity of care in the Health Care Network of the Unified Health System (UHS). It is a social research, with qualitative methodological approach. The objectives of this thesis were developed in two stages. For the first objective, the data collection was conducted through document analysis and semi-structured interviews with managers. We analyze the resolutions, minutes and documents of the Municipal Health Council. The interviews were realized with 16 managers, indicated intentionally, starting with the Municipal Health Secretary which implemented the Family Health Strategy. The presentation of results was organized in themes: The Primary Care in Santa Maria before the implementation of Family Health Strategy, "was how the strategy began in Santa Maria: the presence of UHS in people's lives"; The transition in exchange of management; New management: is it new choices? and Challenge to explain the ups and downs of the Family Health Strategy in Santa Maria. The second objective had the case study as methodological reference. The analysis unit was a Family Health Unit of the city of Santa Maria. The data collection happened for participant observation, direct and unstructured, semi-structured interviews, analysis of documents and records. The research subjects were health workers and users. The analysis was guided for the data collection, mediated by theoretical orientation and premises established. The following themes presented the results: The different ways that the user is subject in Health Care Network; The user participation in the decision of referral: is it possible negotiation?; Use refereed to the Health Care Network: factors that affect this to walk; the manage mode influencing in the autonomy and responsibility of workers; User generalized, disrespected. We learn that the choices of management or the proposed of government are need for improvement or degradation of the Unified Health System. The course of the Family Health Strategy is reflected in daily of the teams, with intends that must be coped to become ineffective and inefficient the restructuration of care model. We advocate the transparency, publicity and the collective construction of criteria, technical and unique, to be used for teams in order to develop new ways to seek the comprehensive care and regulate the Health Care Network. It is need to reverse the pattern of relationship between users and workers, going from colonialism to the solidarity and of cultural invasion to the health promotion.
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    Saúde e cogestão popular: os limites e desafios da implantação e efetivação dos conselhos locais de saúde em um território da cidade de Santos/SP
    (Universidade Federal de São Paulo (UNIFESP), 2014-08-26) Benedito, Ivone Leal [UNIFESP]; Acosta, Ana Rojas [UNIFESP]; http://lattes.cnpq.br/4761034356311819; http://lattes.cnpq.br/2679034722235011; Universidade Federal de São Paulo (UNIFESP)
    The present study aimed to investigate the development, operation and impact of Conselhos Locais de Saúde (CLS) in the co-management of primary care of the Sistema Único de Saúde (SUS) of Santos / SP from a specific territory, which was the region of Morros. The methodological path followed was the qualitative approach, carrying out field research to collect primary source. During the exploratory phase visits in locus were conducted in seven of eight primary care units belonging to the territory searched.These visits were analyzed all the minutes of the Board since their election. It was also made visits to the Conselho Municipal de Saúde de Santos (CMS) in order to understand and know about the process of implementation and monitoring of these CLS. To support this research semi-structured interviews were conducted with the directors (manager / user / professional area), as well as professionals and users who are not as representatives of the Local Council of the same units. Found on analysis that arise from the Local Councils intention of encouraging closer relations between primary care units with the local community. The CLS was created by resolution of CMS in 2006, but only in 2008 the municipal administration chose to start the implementation process into three units healths with one primary care unit located on the territory searched. After two years of experience, CMS opened the electoral process in other primary care units in the city. In the region of hills, elections were held between October 2010 to September 2011, lasting almost a year. In this period, since the elections, we observe that these CLS suffered decline in the frequency of meetings and solidification of CLS. However, we identify as potential local comanagement enriching experiences to think about participation, social control and local health policy. But although they have lived these experiences, the CLS still cannot play a role of co-management in health policy and those involved are very fragile in the public participation process. Much disinformation and poor coordination between the actors and agencies involved in the process of social control has been found. The CLS are privileged to units and territories spaces but require reflection and encouragement in political education by all stakeholders: local and municipal government; directors of CLS; CMS; health professionals and the SUS.
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    Trabalho do enfermeiro na atenção primária à saúde no Brasil: recortes históricos e desafios profissionais
    (Universidade Federal de São Paulo (UNIFESP), 2013-12-20) Ximenes Neto, Francisco Rosemiro Guimaraes [UNIFESP]; Cunha, Isabel Cristina Kowal Olm Cunha [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Nursing, since 1920, has been developing important role in the Brazilian Public Health, especially in Primary Health Care (PHC). As the Unified Health System (SUS) started in the 1980s, the country was undergoing an intense process of decentralization of policies, programs, projects, services and health actions, PHC was one of the priority attention. Thus, the Ministry of Health has institutionalized policies such as Community Agent Health Strategy in 1991, and the Family Health Strategy (FHS), created in 1994 with the designation of the Family Health Program (FHP), in which the nurse receives a new strategic role. The study aimed to analyze the process of nursing work in the PHC in light of the Brazilian Health Policies from SUS, based on a documented research, analytical and critical, with historical and interpretation recovery of information based on logic dialectic, developed during the period of April to November 2013, using five institutional documents of the Ministry of Health, in the light of the analysis of referential context of Souza (2001), which examines the events, scenarios, actors, force and structures relationships after being referred to the content analysis of Minayo (2008), which derived the following category of results: Conjunctures of the Nursing work in the FHS. Events and structures that showed potent symbolism for the work of nurses in PHC were: the creation of the PSF in 1994 as decentralization strategy of the Brazilian PHC; the strengthening of health decentralization, with the institutionalization of the Basic Health Tread funding via FHP, by Basic Operational Norm-SUS 01/1996, augmented with Operational Norm for Health Care-SUS 01/2001, which led to the consolidation and expansion of PHC and internalization of the labor market in Health and Nursing; improving indicators and the rapid growth in the number of PSF teams throughout the country, as institutionalization reason of it as policy, the FHS in 1997; the revitalization and strengthening of FHS with National Primary Care Policy. Scenarios where the health production development of nurses in the PHC occurring are: in the territory, in the community, at home and at Basic Health Unit, having focus on care of the family and individuals. Actors that influence the nursing work environment at PHC depend on the organization of the work process, whether individual (physicians, nursing assistants and CHA) or collective (multidisciplinary team, with minimal staff, Oral Health of CHA among others. The main actors/elements that mediate the forces in the field of practice with FHS nurses are community, the established local culture, local political power, the Municipal health Management, the pyramidal system model of health organization, health workers team, which exercises also strong social and technical work, among other. The working process of nurses in PHC is socially determined, influenced by instituted and instituting health policies and the territorialized political scene.