O Gerente de Atenção Básica: formação e características de gestão na Atenção Primária em Saúde no Município de Praia Grande - SP
Data
2023-09-27
Autores
Pacheco, Jocemar Dias 
Orientadores
Nicolau, Stella Maris
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Unidades Básicas de Saúde estão presentes em todos os municípios do Brasil e contam com gerentes, profissionais preferencialmente com nível universitário, responsáveis pela coordenação dos processos de trabalho e do planejamento em saúde de acordo com as necessidades do território e da comunidade. Este estudo visa analisar os percursos formativos e as características da atuação de Gerentes de Unidades Saúde da Família (Usafas) do município de Praia Grande, litoral do Estado de São Paulo. A pesquisa foi realizada através de entrevistas semiestruturadas, realizadas presencialmente, nas dependências dos serviços em salas reservadas, gravadas e transcritas e submetidas à análise temática do discurso. Foram coletados dados demográficos como gênero, idade, tempo de atuação no município e no cargo, formação e dados da unidade. Para a manutenção do sigilo, foram utilizados codinomes e as unidades foram identificadas com nomes fictícios. De um total de 30 gerentes de todas as Usafas, foram realizadas 15 entrevistas (06 homens e 09 mulheres) em uma amostra de conveniência, buscando diversificar gênero dos entrevistados, regiões geográficas da cidade e contemplar gerentes mais novatos e mais experientes. Os resultados apontam que todos os entrevistados possuem nível superior mesmo que sejam concursados na prefeitura em cargos técnicos da saúde ou cargos administrativos, e nos discursos não foi percebida uma diferença significativa nos processos de trabalho do gerente com formação de origem técnica daquele com formação administrativa. Ficou evidente que as maiores dificuldades dos gerentes estão na gestão das pessoas, todavia, isso não se configura como um obstáculo na relação interpessoal entre eles e os demais membros da equipe. Também foi possível verificar que, pela percepção destes, o gerente possui um papel fundamental na garantia dos princípios do SUS e na manutenção dos protocolos na gestão das agendas e da regulação, pois precisam diariamente lidar com interferências externas, como a pressão de lideranças políticas formais e informais demandando algum tipo de prioridade a usuários de sua indicação em âmbito local. Para a maior parte dos gerentes, o contato com a comunidade atendida pela Usafa é considerado um ponto positivo de lidar em meio a suas rotinas. A falta de atividades de educação permanente em saúde (EPS) específicas para gerentes e a falta de reuniões para troca de experiências entre gerentes das Usafas foram referidas como um dificultador de seu processo de trabalho. Também foi identificado como um fator dificultador de seu processo de trabalho o fato de ocuparem cargos de confiança, sendo, portanto, indicados pelo gestor municipal, o que gera incertezas quanto ao tempo de permanência no cargo, e acaba por prejudicar o planejamento de ações e projetos a longo prazo.
Basic Health Units are present in all municipalities in Brazil and have managers, preferably professionals with university degrees, responsible for coordinating work processes and health planning according to the needs of the territory and the community. This study aims to analyze the training paths and the characteristics of the performance of Family Health Unit Managers (Usafas) in the municipality of Praia Grande, on the coast of the State of São Paulo. The research was carried out through semi-structured interviews, carried out in person, on the premises of the services in reserved rooms, recorded and transcribed and submitted to thematic discourse analysis. Demographic data such as gender, age, length of experience in the municipality and position, education, and unit data were collected. To maintain secrecy, code names were used and the units were identified with fictitious names. From a total of 30 managers from all Usafas, 15 interviews were conducted (06 men and 09 women) in a convenience sample, seeking to diversify the gender of the interviewees, geographic regions of the city and include more novice and more experienced managers. The results indicate that all the interviewees have higher education, even if they are hired in the city hall in technical health or administrative positions, and in the discourses there was no significant difference in the work processes of the manager with technical training and those with administrative training. It was evident that the biggest difficulties of managers are in the management of people, however, this is not an obstacle in the interpersonal relationship between them and the other members of the team. It was also possible to verify that, according to their perception, the manager has a fundamental role in guaranteeing the principles of the SUS and in maintaining the protocols in the management of agendas and regulation, as they have to deal with external interference on a daily basis, such as pressure from formal and informal political leaders demanding some kind of priority to users of their indication at the local level. For most managers, contact with the community served by USAFA is considered a positive point to deal with in the midst of their routines. The lack of specific continuing health education (PHE) activities for managers and the lack of meetings to exchange experiences among USAFAS managers were reported as a hindrance to their work process. It was also identified as a complicating factor of their work process the fact that they occupy positions of trust, and are therefore appointed by the municipal manager, which generates uncertainties regarding the length of permanence in the position, and ends up hindering the planning of actions and projects in the long term.
Basic Health Units are present in all municipalities in Brazil and have managers, preferably professionals with university degrees, responsible for coordinating work processes and health planning according to the needs of the territory and the community. This study aims to analyze the training paths and the characteristics of the performance of Family Health Unit Managers (Usafas) in the municipality of Praia Grande, on the coast of the State of São Paulo. The research was carried out through semi-structured interviews, carried out in person, on the premises of the services in reserved rooms, recorded and transcribed and submitted to thematic discourse analysis. Demographic data such as gender, age, length of experience in the municipality and position, education, and unit data were collected. To maintain secrecy, code names were used and the units were identified with fictitious names. From a total of 30 managers from all Usafas, 15 interviews were conducted (06 men and 09 women) in a convenience sample, seeking to diversify the gender of the interviewees, geographic regions of the city and include more novice and more experienced managers. The results indicate that all the interviewees have higher education, even if they are hired in the city hall in technical health or administrative positions, and in the discourses there was no significant difference in the work processes of the manager with technical training and those with administrative training. It was evident that the biggest difficulties of managers are in the management of people, however, this is not an obstacle in the interpersonal relationship between them and the other members of the team. It was also possible to verify that, according to their perception, the manager has a fundamental role in guaranteeing the principles of the SUS and in maintaining the protocols in the management of agendas and regulation, as they have to deal with external interference on a daily basis, such as pressure from formal and informal political leaders demanding some kind of priority to users of their indication at the local level. For most managers, contact with the community served by USAFA is considered a positive point to deal with in the midst of their routines. The lack of specific continuing health education (PHE) activities for managers and the lack of meetings to exchange experiences among USAFAS managers were reported as a hindrance to their work process. It was also identified as a complicating factor of their work process the fact that they occupy positions of trust, and are therefore appointed by the municipal manager, which generates uncertainties regarding the length of permanence in the position, and ends up hindering the planning of actions and projects in the long term.