Banca de DEFESA: SISSE FIGUEIREDO DE SANTANA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : SISSE FIGUEIREDO DE SANTANA
DATA : 26/06/2019
HORA: 09:00
LOCAL: Sala 01 do Instituto de Saúde Coletiva
TÍTULO:

State Management of Oral Health Care in Brazil: modeling and evaluation of implantation.

PALAVRAS-CHAVES:

Health policy, Oral health; Organization and administration; evaluation of health programs and projects; Health manager.

PÁGINAS: 154
GRANDE ÁREA: Ciências da Saúde
ÁREA: Saúde Coletiva
RESUMO:

Problems: extensive academic production related to the National Oral Health Policy (PNSB) in Brazil has been published since 2000, with prioritization of analyzes in the municipal and federal spheres, secondary to the performance of the state level. However, the state authorities have been understood as fundamental in the configuration of the Brazilian federative arrangement for conducting public policies. Objective: This thesis analyzed the implementation of state management of public oral health care in a state of the Brazilian Northeast, and sought to understand elements of the social trajectory of the agents involved and their points of view about the state sphere and the historical conditions of possibility of implementation of the oral health policy at the state level. Methodology: this is a research of an evaluative, exploratory and qualitative nature. In the first moment, a logical model was elaborated to subsidize the evaluation of the state management. International guidelines on health management, state health management reports, state and national health plans, as well as national and international studies were reviewed, with the consequent development of a matrix of criteria and standards, validated by a committee of eleven area experts through the Delphi consensus method. Fifteen leaders, coordinators and technicians related to the oral health area of the state were interviewed. The assignment of points in the matrix was performed by two evaluators separately, based on the triangulation of evidence from key informants, on-site observation and documentary analysis. Finally, it characterized the social trajectories and dispositions of agents involved in the state bureaucratic field of oral health, from the categories agent, dispositions and field, developed by the French sociologist Pierre Bourdieu. Results and discussion: This study revealed that the degree of implementation of oral health management in the state investigated was incipient, reaching 32.8% of the total score, with difficulties related mainly to the lack of communication between the areas within the institution, infrastructure problems and lack of regional public health care projects. Nevertheless, the "tools for implementing the policy" and "accountability" were considered intermediate, reaching 37.2% and 37% respectively of the total points in these dimensions. As for the analysis of the trajectories, the majority graduated in public institutions, with balance in the studied group in relation to the social origin. The insertion in the state bureaucratic field was influenced by the disposition directed to the bureaucratic field, restlessness with the public service, reduction of the private market and the expansion of collective health. The agents' trajectory evidenced a low intersection of the bureaucratic field of oral health with the political and scientific fields, besides the low political disposition of the agents of the state bureaucracy. There is a group composed predominantly of women, with a sanitary disposition, driven by universal interest, expressing their "love for the clinic and public health". In this sense, the ambivalence of dentist / sanitary identity due to the influence exerted by the dental field of origin may make it difficult for dentists to fight within the state bureaucratic field. Final considerations: The present study pointed out that it is probable that the agents' disposition, in view of their adjustment to the bureaucratic field, can facilitate or obscure the conformation of the agenda, the accountability and the management by operations.

MEMBROS DA BANCA:
Externo à Instituição - ANA ÁUREA ALÉCIO DE OLIVEIRA RODRIGUES
Externo à Instituição - CLAUDIA FLEMMING COLUSSI
Interno - 110.227.285-04 - LIGIA MARIA VIEIRA DA SILVA - UFBA
Interno - 3498044 - MONIQUE AZEVEDO ESPERIDIAO
Interno - 1114664 - SONIA CRISTINA LIMA CHAVES