Management in the Family Health Strategy: workloads and structured institutional violence

Abstract

Objectives: to understand the relationship between workloads and institutional violence in Family Health Strategy managers’ practice. Methods: qualitative research using theoretical triangulation and data from semi-structured interviews. Participants were 35 managers of Basic Health Units in the five Regions of Brazil, who worked in the Family Health Strategy. We used thematic analysis and ATLAS.ti for data analysis. Results: workloads were analyzed, showing relationships with institutional violence. Thematic categories emerged: “related to the management work itself”; “related to other instances of health system management”; “related to users and community”. There was an interrelationship between increased managers’ workloads and institutional violence. Final Considerations: the Family Health Strategy is relevant for universal access to health and requires favorable institutional conditions for its effectiveness. Adverse scenarios lead to increased workloads, approaching institutional violence.