Dificuldades e estratégias de enfrentamento para a operacionalização das Redes de Atenção à Saúde

Abstract

The operationalization of the Health Care Networks allows users actions and offer services that need with effectiveness, efficiency and guided by the comprehensive care. This study aims: Know the difficulties faced in the operationalization of the Health Care Networks; Summarize the coping strategies for operationalization of the Health Care Networks, suggested by workers and users of municipal Unified Health System. It is a study of descriptive and exploratory with a qualitative approach, developed with the participation of managers, workers and Unified Health System service users within the municipality of Santo Antônio de Jesus, resulting in a total of 59 subjects. Data collection was used through semistructured interviews, guided by previously developed scripts according to the three categories of participants. Data were analyzed employing the Content Analysis. The study was approved by the Research Ethics Committee of the Federal University of Bahia Recôncavo and respected the principles of bioethics and the ethical aspects of research involving human subjects present in Resolution number 466/2012 of National Health Council. Data analysis resulted in two analytical categories: Difficulties in the operationalization of Unified Health System; Coping strategies for operationalization of Unified Health System. They were identified in the first category: flaws in the joint, particularly the practice of counter- no, lack of human, material and financial resources of the health system bureaucracy, lack of collaborative culture among network professionals, lack of knowledge of the services that make up the network, as well as functions of each of these, and the imbalance between supply versus demand. It has been suggested as a coping strategy: bring together professionals from different services of the Unified Health System at the municipal level for these to dialogue, to train professionals network, systematization of information on health, adequate supply of human resources to the growing demand for health services , reduce the delay in assistance flows, the determination of service fees for each Health Unit Family based on ascribed population group, reorienting health practices focusing on the realization of preventive actions because of curatives, adoption of improvements with regard to the marking of exams and consultation, empowerment of the population about their rights as users of Unified Health System, and the counter- compliance. Diverting this last strategy it was suggested by one of the respondents not using the system of reference and counter. This study led to the conclusion that the Health Care Network in the city studied is fragile, mainly due to the difficulties raised here, and that generally propose coping strategies conducive to overcoming these challenges. There is a need to empower managers, workers and users of the Health Care Network with regard to their role as agents of change in reality and to perform further studies enabling the introduction of new perspectives on the topic.