Banca de DEFESA: DEISE SANTANA DE JESUS BARBOSA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
DISCENTE : DEISE SANTANA DE JESUS BARBOSA
DATA : 28/06/2019
HORA: 14:00
LOCAL: ADM
TÍTULO:

The Assistance Regulation and the integration of the Health Care Network in SUS: between opportunities and constraints

PALAVRAS-CHAVES:

Assistance regulation, health care network, integration, structuring theory

PÁGINAS: 184
GRANDE ÁREA: Ciências Sociais Aplicadas
ÁREA: Administração
RESUMO:

This thesis aims to study the Assistance Regulation for access to health services, in the implementation of the SUS Health Care Network. It is understood that the normative mechanisms that have been adopted by the regulatory action within SUS are not adherent to a conception of regulation as a social practice, which presupposes a continuous implementation of Health Care Network. The conception of health care network, ordered by primary care through a systemic integration between the points of attention of different care complexities, is configured in practice as a process that involves conflicts and tensions, and are not subject to only normative control. This contradiction has made that the Health Care Regulation of the SUS is considered as a barrier to access to health services. The general objective of this study is to analyze the patterns of structuring that guide the network integration, through the regulatory action of access to prenatal and childbirth services, within the scope of SUS, in Salvador - Ba. It also seeks to analyze the configuration of the communication network produced from the perspective of managers and professionals and users in the search for access to services, involving primary care units and other points of attention, as well as identify the possibilities and constraints produced by the social structure under the regulatory action for the integration of the Health Care Network in the SUS. This analysis is based on the theory of structuring, which argues that action shapes structure and structure molds action symbiotically into the reality of social systems, establishing the reproduction or transformation of social practices over time, in a given context . These elements can be observed in the social practices produced in the interaction between the actors involved in the regulatory action for access to health services in SUS. This research is characterized as qualitative, of the explanatory type. It is a case study, whose locus of empirical research was the city of Salvador-Bahia, the prenatal and childbirth care network analyzed is composed by the Regulatory Complex and health care units, including points of attention in the categories of basic care, outpatient services, emergency services and maternity units, distributed in the territory in 12 Health Districts. Documentary research, an exploratory analysis of secondary data and semi-structured interviews were used as instruments and techniques for collecting the empirical data. The results demonstrate that there is a multiplicity of social actors involved in regulatory action whose performance developed in constant interaction with other actors is not completely controllable. In the description of the structure, normative rules and semantic rules were identified, as well as practices for mobilizing the resources offered in the care network. It was observed that the social practices produced in the regulatory action are asymmetric, presenting contradictions can produce, on the one hand a favorable condition to the particularist possibilities of integration between points of the network, and on the other hand generate constraints to the systemic performance of the attention as access.

MEMBROS DA BANCA:
Externo à Instituição - GISELIA SANTANA SOUZA - UFBA
Interno - 287196 - MARIA DO CARMO LESSA GUIMARAES
Externo à Instituição - MARILIA CRISTINA PRADO LOUVISON - USP
Externo à Instituição - MARLUCE MARIA ARAÚJO ASSIS - UEFS
Externo à Instituição - WASHINGTON LUIZ ABREU DE JESUS - UFSCAR