Banca de DEFESA: Ana Cláudia Cardozo Chaves

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : Ana Cláudia Cardozo Chaves
DATE: 31/07/2023
TIME: 14:30
LOCAL: plataforma teams - link disponível na página do programa
TITLE:

"Mechanisms that influence Primary Health Care effectiveness"

KEY WORDS:

Primary Health Care; effectiveness; response capacity

PAGES: 1000
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

At Primary Health Care (PHC), a proposal to reorient services making them more effective, achieving effectiveness is a challenge. In many realities, there are gaps between what individuals and communities need, and services quality, leaving many users without access or excluded from standardized actions for specific conditions, with low effectiveness leading even to the chronification of acute events. The present work aims to understand the mechanisms that influence PHC effectiveness, from conceptions, critical elements and agents with potential influence for its development. This is a single integrated case study, with exploratory and analytical character, qualitative approach, whose unit of analysis is PHC effectiveness in Brazil’s Federal District (FD), based on the evaluative activities of the Qualification Program of Primary Health Care (QualisAPS). A triangulation of documentary research and focus groups techniques were used for data collection, in which participants were managers or supervisors of PHC, and health professionals of the higher and middle levels from FD Family Health Strategy, totaling 245 participants. The results came from 10 documents and 22 focus groups conducted in 2020 and 2022. The software ATLAS.ti version 9.0 was used for systematization and data analysis according to effectiveness, PHC and multilevel governance theoretical frameworks, and Ergology theoretical-methodological framework. It is possible to conceive effectiveness in PHC from several approaches, more or less comprehensive, incurring risks of relativism and reductionism. There is confusion between the concepts of effectiveness and quality in health, as well as effectiveness and response capacity. Several attributes, capacities and expected results were considered critical elements, as well as the complex nature of health problems and structuring conditions for PHC proper functioning, aspects already recognized in the literature. None of these critical elements are exclusive to effectiveness and its use as an analytical or evaluative category of PHC is questionable. In addition, effectiveness in PHC falls massively as a charge on health professionals and frontline managers, agents of the micro level, when it should be understood as a shared responsibility by a multilevel governance network, involving several agents from brazilian Unified Health System, directly or indirectly. The more macro is the level of the agent in this network, lower isthe clarity about their responsibilities for an effective PHC, but their influence is present anyway, either in omissions or worsening flows, impairing resolvability. By not recognizing this network, we distance ourselves from implementing an effective PHC in solving health problems. In the FD, predominates the perception of PHC low effectiveness. To mitigate the conceptual limitationsidentified and better instrumentalize the search for results, it isrecommended to review the use of the word resolvability in technical documents, which can be used as jargon, but should be replaced to guide clearer and more strategic guidelines by the concepts of effectiveness and response capacity

COMMITTEE MEMBERS:
Externa à Instituição - LIGIA GIOVANELLA - FIOCRUZ
Externa à Instituição - PATRÍCIA SAMPAIO CHUEIRI - EINSTEIN
Externa à Instituição - LEILA BERNARDA DONATO GOTTEMS - ESCS
Presidente - ***.220.779-** - MAGDA DUARTE DOS ANJOS SCHERER - UnB
Interna - 1996218 - NOEMIA URRUTH LEAO TAVARES