Capacidade de gestão no sistema estadual de vigilância sanitária da Bahia: enfoque do planejamento estratégico e instrumentos de gestão.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

This study about the the Administrative Capacity of the Bahia State Health Surveillance System: Focus on Strategic Planning and Management Instruments has the following objectives: a) to assess the planning capacity of municipal authorities to reach the set goals in the area of Health Surveillance b) analyze the Health Plans (2002-2005) and Health Surveillance Plans (2006) of municipalities in administration and/or following TAM as an instrument of municipal administration c) evaluate the contribution of planning Health Surveillance to widen the administrative capacity d) assess the capacity of the municipalities to reach the goals agreed in the Integrated Pact Program (PPI) and in the Term of Adjustment and Goals (TAM) in 2006. The study used the theoretical framework for planning proposed by Carlos Matus, Situational Strategic Planning (PES) which is a method designed for the public sector in which the actors are political parties, governors, leaders of public organizations, business people and unio ns. It is a descriptive qualitative study using municipalities which had adopted either Full Management of the Municipal System or TAM by December 2006. The municipal health secretaries and the municipal coordinators of VISA were the focus of the study. As regards the data collection, the primary sources were semistructured interviews with questionnaires and secondary data came from document analysis of management reports of DIVISA, Municipal Health Plans and Municipal Plans for Health Surveillance. The data was analyzed for content using structural analysis. From the data collected 5 categories of analysis were identified: the reality; the image-object; them objective situation; strategy of action and the management of implementation. The study showed a dichotomy between the proposed planning Marxist discourse of the federal and state coordinators of the VISA system and the organizational model which follows lines of the bureaucratic model proposed by Weber. As far as the work process is concerned, the model tends to follow that of Taylor. The results show that most of the individuals had neither knowledge of the planning process in health, nor notions of the importance of planning for the administration of health services so as to attain the organizational objectives and the agreed goals. The main results were: most municipalities in this study had limited administrative capacity; they demonstrated incipient planning capacity; they presented insignificant participation of health surveillance in the drawing up of Municipal Health Plans; VISA Plans do not deal with the Medium Complexity actions agreed through TAM; the management and planning tools are not used in the drawing up of Municipal Health Plans and the VISA Plans; the discourse is bottom- up, though in practice planning is top down. In order to change this, the present study proposes the strengthening of the municipal system VISA through support and advice for municipal managers so that they may assume the competences and responsibilities of the agreed pacts; inclusion of the low and medium VISA actions into the Municipal Health Plan and the VISA plan; training of municipal managers and VISA professionals in the area of public health policy, management and planning.

ASSUNTO(S)

vigilância sanitária health surveillance administracao capacidade de gestão capacity building in management strategic planning planejamento estratégico

ACESSO AO ARTIGO

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