OBJECTIVE:To analyze the importance of inclusion, from women's perspective, in the evaluation of the Program for the Humanization of Antenatal Care and Childbirth, carried out by the Brazilian Ministry of Health. METHODOLOGICAL PROCEDURES:This qualitative study was based on primary data collected in 2003 in an evaluation of the Program conducted in seven towns spread out among Brazil's fi ve geographic regions. These sites were selected from a Federal Government data base utilized for quantitative analysis. Women attended by the Program were considered key informants when primary data was collected. Sixteen focal groups were performed in the primary care units. The Collective Subject Speech (CSS) method was used for qualitative analysis. The theoretical concepts of accessibility and Paideia Health within the framework of public health were used to interpret the fi ndings. ANALYSIS OF RESULTS:The Program standardizes procedures to be taken in antenatal care and childbirth for all health services in the country, including the fl ow among these services. However, analysis of women's discourse in the focal groups elucidated the existence of dissonances between their needs and desires and many of the program's recommendations. Pregnant women thus choose among available services and professionals and try to set up their own schedules which, in turn, do not correspond to those set up by the program. This discrepancy damages the bond women establish with the health services and creates obstacles for the control of the activities actually provided by the health services to the women. CONCLUSIONS:Analysis of the Program based on women's perspective identifi ed aspects that might result in more humanized and effective antenatal care, if they are taken into account in the redefi nition or correction of the Program schedule Miolo abstract Miolo abstract Miolo abstract.
This article presents the main results of the survey on the regional management building process in the State of São Paulo, during the discussion of the COAP / Care Networks, in order to provide a basis for understanding this process of regional health pact, focusing on the metropolitan areas of Bauru, Santos, Grande ABC and the Ribeira Valley. In addition to the results presented on the health regions studied, the methodology used in the development of the construction of profiles of the regions is itself a proposal for a methodology of analyzing regional health profiles. The first section presents the general methodology for analyzing health regions. The second part covers the results and discussion of the research, organized into two items. The first refers to the analysis of the profiles of the five São Paulo health regions surveyed. The second item analyzes the main aspects of the process of regional health pact in São Paulo, highlighting strengths and limitations, based on interviews with municipal managers and supporters of the Council of Municipal Health Secretaries of São Paulo in these regions.
OBJECTIVE To analyze scopes and limits of the use of participatory methodology of evaluation with municipal health managers and administrators.METHODS Qualitative research with health policymakers and managers of the Comissão Intergestores Regional (CIR – Regional Interagency Commission) of a health region of the state of Sao Paulo in Brazil. Representatives from seven member cities participated in seven workshops facilitated by the researchers, with the aim of assessing a specific problem of the care line, which would be used as a tracer of the system integrality. The analysis of the collected empirical material was based on the hermeneutic-dialectic methodology and aimed at the evaluation of the applied participatory methodology, according to its capacity of promoting a process of assessment capable to be used as a support for municipal management.RESULTS With the participatory approach of evaluation, we were able to promote in-depth discussions with the group, especially related to the construction of integral care and to the inclusion of the user’s perspective in decision-making, linked to the search for solution to concrete problems of managers. By joint exploration, the possibility of using data from electronic information systems was opened, as well as information coming directly from the users of the services, to enhance discussions and negotiations between partners. The participants were disbelievers of the replication potential of this type of evaluation without the direct monitoring of the academy, given the difficulty of organizing the process in everyday life, already taken by emergency and political issues.CONCLUSIONS Evaluations of programs and services carried out within the Regional Interagency Commission, starting from the local interest and facilitating the involvement of its members by the use of participatory methodologies, can contribute to the construction of integral care. To the extent that the act of evaluating stay invested with greater significance to the local actors, its involvement with the evaluations at the federal level can also be stimulated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.