O envolvimento de gestores e equipes de saúde com o controle da tuberculose em municípios prioritários do Estado de São Paulo (2005) / The Involvement of Health Secretaries and Health Teams with Tuberculosis Control in Priority Cities in the State of São Paulo (2005)

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The aim of this study was to explore the involvement of municipal health managers (Health Secretaries) and basic health attention teams with actions for tuberculosis (TB) control in nine priority cities in São Paulo, from the viewpoint of the TB Control Program coordinators. Theoretical references were based on the model proposed by the World Health Organization (2003), which consists of the integration of health system structural elements (Macro, Meso, and Micro) for the organization of services targeting chronic conditions, among which is TB. This study involves the use of a qualitative approach and data were collected through semi-structured interviews and analyzed by means of theme unit content analysis techniques. Two major theme units stood out after testimonials were encoded: "Tuberculosis control in the municipal health agenda: Is it a priority?" and "The incorporation of TB control actions into basic Health services". The first theme unit identified the following, as elements that hinder the inclusion of TB in the health agenda and allocation of essential financial resources for its control: 1) a lack of interest in strategies and policies for TB control; 2) disagreement on Supervised Treatment practice; 3) other existing health priorities, and 4) the Health Secretarys focus on implementing and expanding the Family Health Program actions and teams. The second theme unit showed that the lack of human resources, inadequate professional capacity building, and a centralized and fragmented understanding about organizing the disease control actions within the health system represent barriers that need to be overcome in order to include TB into the Basic Health Services. The conclusion is that setting up a more responsible municipal health system and making basic health attention providers more participatory in an effective control of TB requires a kind of management that is concerned with the disease and the strategies proposed for its control, such as DOTS. Furthermore, it is mandatory to organize an integrated, problem-solving, and human service network as well as design and implement a human resources policy that will ensure continuing education and capacity building targeting health teams.

ASSUNTO(S)

tuberculosis enfermagem em saúde pública public health nursing recursos humanos em saúde tuberculose terapia diretamente observada directly observed therapy atenção primária à saúde health manpower health systems primary health care sistemas de saúde

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