Banca de DEFESA: Celmário Castro Brandão

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Celmário Castro Brandão
DATE: 17/02/2023
TIME: 09:00
LOCAL: Plataforma Teams
TITLE:

FEDERAL GOVERNANCE IN THE MANAGEMENT OF PRIMARY HEALTH CARE TO COMBAT THE COVID-19 IN BRAZIL

KEY WORDS:

Unified health system; Health policy; Health governance; Primary health care; Covid -19

PAGES: 100
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

The objective of the present study is to understand the governance of the Ministry of Health (MH) in the management of primary health care (PHC) to face the covid-19 pandemic and its systemic implications in the health care of the brazilian population in the period. This is a study with a qualitative and quantitative approach, subdivided into three stages. In the first one, through exploratory documentary research, a contextualization was carried out about the work of the MH, in its relationship with the Presidency of the Republic (PR), in facing the pandemic in Brazil. In the second stage, the process of agreeing on the policy to deal with the pandemic within the scope of the PHC, by the MH, was approached, also through documentary research. In the third stage, documentary research and the study of data about the production of actions by the teams working in the PHC were carried out, to analyze the response of the services to the propositions made by the MH, taking into account the governance model in the ministry for the formulation and implementation process of such policies. Measures strongly orchestrated by the PR that negatively influenced its performance in coping with the pandemic were evidenced in the MH: turnover of ministers, weakening of the PHC, ineffectiveness in the collapse of the care network, rupture of the federative pact, slowness in the acquisition of vaccines, disregard for science, weakening of the testing strategy, militarization of health, opacity of health information, corruption, lack of coordination of politics, among others. The debate on combat the pandemic in PHC was identified in 23 official meetings, mostly within the scope of management, with scientific spaces and popular participation being reduced. With regard to the content of the 34 ministerial publications, only 15 had been previously discussed with other institutional representations. Finally, the teams'production data allowed an analysis of the PHC's response to the MH's propositions, legitimizing or not it as coordinator of the Unified Health System (UHS) governance network. It was noted that, in most situations, the ordinances published by the MH did not produce any increase in the teams'production in the listed variables. Also, taking into account that more than R$1.7 billion were contributed by the ordinances, a substantial increase in production was expected. However, it is believed that the stance of the MH and the PR led to a deterioration in governance to the point where the legitimacy of the MH in conducting the policy to combat the pandemic in PHC was eroded. It is concluded that the evident central lack of coordination, rupture of the federative pact and hierarchization of the historical model of governance in networks in the UHS, induced in the MH by the authoritarian and denialist agenda of the PR, culminated in harmful consequences for the performance of the country as a whole in facing the pandemic. The main outcome of this action can be summarized in the sad statistics of cases and deaths from covid-19 unevenly distributed in the country, reinforcing the idea that there is an ongoing necropolitics in Brazil.

BANKING MEMBERS:
Externo à Instituição - ADEMAR ARTHUR CHIORO DOS REIS - UNIFESP
Presidente - 1701960 - ANA VALERIA MACHADO MENDONCA
Externo à Instituição - Andre Luis Bonifacio de Carvalho - FIOCRUZ
Interno - 1063328 - EVERTON LUIS PEREIRA
Externa à Instituição - ISABELA CARDOSO DE MATOS PINTO - UFBA