A gestão em saúde no contexto da regionalização: facilidades e dificuldades na perspectiva de gestores municipais da saúde

Abstract

The process of building the Single Health System (SUS) implies the change of structure and process of management in each sphere of government. For the operationalisation him, principles gained prominence, among them - the regionalisation, which press the transfer of decision-making power requiring analysis of aspects of each region and by structuring and organization of the network of care and health care. From the interest in exploring the management of municipal SUS, this exploratory study, of qualitative nature has as its general objective analyze the Management process of the SUS Municipal de Santo Antonio Jesus Bahia (SAJ-BA) in the context of regionalization. As regards the specific objectives: Describe the process of management of municipal SUS; Identify difficulties and facilities for the management of municipal SUS of Santo Antonio de Jesus-Bahia in the context of regionalization. To develop the study counted with the participation of nine occupants of formal positions of the management of the Municipal Health Department of SAJ-BA and with the representative state Scholastics of Management Data Analysis (Esda)management of 2008-2012. The technique used was the semi-structured interview. The analysis of data was performed using the method of Content Analysis of Bardin. Thus it was possible to define two categories of analysis and their respective subcategories, namely: 1.Processo of Municipal Management of SUS: format, capacity manager, instruments: 1.1Formato and management Capacity; 1.2 Strategies for health management: methodologies, instruments of management and information systems; and, 2.Dificuldades, Facilities and Challenge of Municipal Governance in the context of Regionalization; 2.1 Difficulties and facilities of municipal governance in the context of regionalization; 2.2 The consolidation of networks of health as a challenge to the constitution of SUS in the perspective of regionalisation. In this study, all the ethical criteria have been met in accordance with the Resolution no. 196/96 and no. 466/2012, being approved by the Research Ethics Committee. This study showed that the process of managing the health of the municipality studied if processes in the context of devolution incomplete and with the "departamentalizacao" and fragmentation of industries and services. The strategies for health management (methodologies, instruments of management and information systems) were also reason to highlight in this study, since these tools enable a quality management and assume its space increasingly permanent on legal bulwark of SUS being fundamental in streamlining the organization, monitoring and evaluation of the SUS. The structure of the networks of attention to health (RAS), it was noticed that the levels of attention to health should be better articulated and that the demand for services does not occur in a satisfactory manner to meet the real needs of the municipalities. The underfunding of services, it was also pointed out as a difficulty for the deployment of new services and the improvement of existing ones. The development of this study was of the utmost importance, there are views that allowed us deepen the analysis of the process of health management in the context of regionalization.