A política nacional e a rede de cuidados à pessoa com deficiência no SUS: contextos de influência e de produção de textos
Data
2024-06-21
Autores
Kielmann, Samara 
Orientadores
Reis, Ademar Arthur Chioro
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Analisar os contextos de influência e de produção de texto da Política Nacional e da Rede de Cuidados às Pessoas com Deficiência no SUS. Método: A pesquisa tem caráter qualitativo. Foi desenvolvida por meio de revisão de literatura, análise de documentos e entrevistas com atores-chave que participaram da formulação da Política Nacional e da Rede de Cuidados à Pessoa com Deficiência (PCD). A análise teve como principal referência a Abordagem do Ciclo de Políticas desenvolvida por Ball e Bowe, uma abordagem crítica ao modelo estruturalista, flexível e não linear. Resultados e discussão: Os principais resultados apontam para uma Política Nacional de Saúde da Pessoa com Deficiência (PNSPCD) prescritiva e com pouca participação do movimento social em sua produção. Tem como influência o modelo biomédico da deficiência, a reabilitação como única forma de cuidado e evidencia as instituições filantrópicas enquanto principais responsáveis pela agenda e assistência às Pessoas com Deficiência. Já a Rede de Cuidados à Pessoa com Deficiência (RCPCD) apresenta maior influência do modelo social da deficiência e forte influência da Convenção Internacional dos Direitos da PCD, especialmente em relação ao conceito definidor de PCD. A rede de cuidados induz uma discussão mais ampla sobre cuidado e destaca a reabilitação enquanto parte de um processo maior e mais complexo que privilegia a participação do usuário no seu cuidado. Estabelece os Centros Especializados em Reabilitação (CER) como principal local de cuidado deste público, mas o coloca como matriciador da rede de atenção à saúde. Considerações finais: A abordagem do ciclo de políticas de Ball e Bowe contribui para a análise de políticas públicas de saúde na medida em que é um método de campo aberto e que provoca a reflexão sobre desconstrução de conceitos e certezas e induz engajamento crítico. A PNSPCD foi importante porque deu visibilidade ao tema à época de sua formulação. No entanto, possui muitas questões a serem superadas. A RCPCD se apresenta com a intencionalidade de ampliar acesso e fortalecer a integralidade do cuidado.
Objective: analyze the contexts of influence and production of texts of the National Policy and the Care Network for People with Disabilities in the SUS. Methods: The research has a qualitative character, it was developed through a literature review, document analysis and interviews with key actors and actresses who participated in the formulation of the National Policy and the Care Network for People with Disabilities PWD. The main reference for the analysis was the Policy Cycle Approach developed by Ball and Bowe, as this is a critical approach to the structuralist model, as it is flexible and nonlinear. Results and discussion: The main results point to a National Health Policy for People with Disabilities (PNSPCD) that is prescriptive and with little participation from the social movement in its production. It is influenced by the biomedical model of disability, rehabilitation as the only form of care and highlights philanthropic institutions as the main responsible for the agenda (and assistance) of People with Disabilities. The Care Network for People with Disabilities (RCPCD), has greater influence from the social model of disability. Strong influence of the International Convention on the Rights of PWD, especially in relation to the defining concept of PWD. The care network encourages a broader discussion about care and highlights rehabilitation as part of a larger and more complex process that privileges user participation in their care. It establishes the Specialized Rehabilitation Centers (CER) as the main place of care for this public, but places it as a matrix for the health care network – RAS. Final Considerations: Ball and Bowe's policy cycle approach contributes to the analysis of public health policies as it is an openfield method that provokes reflection on the deconstruction of concepts and certainties and induces critical engagement. The PNSPCD was important because it gave visibility to the topic at the time of its formulation, however, it has many issues to be overcome. The RCPCD presents itself with the intention of expanding access and strengthening comprehensive care.
Objective: analyze the contexts of influence and production of texts of the National Policy and the Care Network for People with Disabilities in the SUS. Methods: The research has a qualitative character, it was developed through a literature review, document analysis and interviews with key actors and actresses who participated in the formulation of the National Policy and the Care Network for People with Disabilities PWD. The main reference for the analysis was the Policy Cycle Approach developed by Ball and Bowe, as this is a critical approach to the structuralist model, as it is flexible and nonlinear. Results and discussion: The main results point to a National Health Policy for People with Disabilities (PNSPCD) that is prescriptive and with little participation from the social movement in its production. It is influenced by the biomedical model of disability, rehabilitation as the only form of care and highlights philanthropic institutions as the main responsible for the agenda (and assistance) of People with Disabilities. The Care Network for People with Disabilities (RCPCD), has greater influence from the social model of disability. Strong influence of the International Convention on the Rights of PWD, especially in relation to the defining concept of PWD. The care network encourages a broader discussion about care and highlights rehabilitation as part of a larger and more complex process that privileges user participation in their care. It establishes the Specialized Rehabilitation Centers (CER) as the main place of care for this public, but places it as a matrix for the health care network – RAS. Final Considerations: Ball and Bowe's policy cycle approach contributes to the analysis of public health policies as it is an openfield method that provokes reflection on the deconstruction of concepts and certainties and induces critical engagement. The PNSPCD was important because it gave visibility to the topic at the time of its formulation, however, it has many issues to be overcome. The RCPCD presents itself with the intention of expanding access and strengthening comprehensive care.
Descrição
Citação
KIELMANN, Samara. A política nacional e a rede de cuidados à pessoa com deficiência no SUS: contextos de influência e de produção de textos. 2024. 150 f. Dissertação (Mestrado em Ciências da Saúde Coletiva) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2024.