Cooperação entre academia e governo para avaliar a Atenção Primária à Saúde no Sistema Único de Saúde

Abstract

Este artigo analisa o papel da academia na cooperação institucional com o Ministério da Saúde para implementação do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica. Trata-se de uma pesquisa qualitativa, baseada em um estudo de caso, que combinou análise documental e entrevistas com atores-chave do governo e da academia. A cooperação visou efetivar a avaliação externa do programa e o censo das unidades de saúde do Brasil. Dezenas de instituições acadêmicas mobilizaram seu aparato institucional para realizar atividades de formulação e operacionalização da avaliação, de apoio à gestão e acadêmicas, e conferiram qualificação e legitimação política e técnica ao projeto. Esse processo se desenvolveu sob influência do contexto político-institucional do país e das intervenções balizadas pelas instituições.

Primary Healthcare meta-evaluation in Brazil: Lessons learned from the external assessment of the program to improve primary healthcare access and quality.

“…This implied in articulation strategies and agreements between interested parties, and con gured a robust preparation that preceded performing the AE/PMAQ-AB in the three developed cycles, contributing to avoid or minimize distortions in the information collection. In this sense, they are in line with the studies by Uchoa et al [31], and by Cavalcanti, Fernandez and Gurgel Júnior [49], which highlight the institutional role played by the IEPs in the various activities that involved the eldwork of the research, resulting in a national standardization of procedures, and particularly the information technology resource which is useful in training researchers and interviewers, homogeneously collecting and validating data throughout the country.…”

“…The criticisms regarding the possible "makeup" developed in some places served as a warning signal for researchers and for national management. However, analyzes such as those by Cavalcanti, Fernandez and Gurgel Júnior [49] address that this occurrence of "false scenarios" to obtain good performances did not prevent the nding that the PMAQ-AB induced changes in the way of working in PHC.…”

“…In this context of Brazilian PHC, from the DAB/MS, proponent and driver of the PMAQ-AB (primary stakeholder) [44], the necessary con dence was evidenced regarding the adequate conditions gathered by the IEPs to obtain results with a high degree of credibility. In an integrative review of evaluative studies and their possible uses, Medeiros,Nickel and Calvo [48] indicate the importance of this credibility; as pointed out in the research by the objectivity component given by university researchers as a decisive guarantee in the local assessment process, rea rming the political-institutional importance of the IEPs in the AE/PMAQ-AB process, printing a true "quality seal" by legitimizing and attesting this assessment with scienti c rigor [49].…”

“…Tomasi et al [19] detail how the assessment procedures were included in the AE/PMAQ-AB and how the collection instruments were structured and standardized to meet the objectives, with guidance from the technical areas of the MS and available for consultation on the institutional website. Cavalcanti, Fernandez and Gurgel Júnior [49] highlight the use of the electronic module (online) lled in by managers and teams in order to complement information. The obtained data security indicates rigor in the collection and validation process with the use of tablets, speeding up feeding of the centralized database in the MS. Data control was highlighted by Facchini et al [19] as a result of the computerized management system developed by the information technology team at the Federal University of Rio Grande do Norte, allowing "real-time checking" of the consistency of responses and controlling the interview time.…”

Cooperação governo-academia no Sistema Único de Saúde: uma análise do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica

“…Em 2011, o Ministério da Saúde (MS) criou o Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), com o objetivo de ampliar a capacidade de resposta desse nível de atenção do Sistema Único de Saúde (SUS) aos problemas sanitários do país (Cavalcanti, Fernandez, & Gurgel, 2021;Pinto, A. N. Sousa, & Ferla, 2014;A. N. Sousa, 2018).…”