Meta-evaluation of a participatory process in the strengthening of municipal management

Abstract

OBJECTIVE To evaluate, with a focus on participation, an evaluation process developed by municipal managers and administrators of a health region in the state of São Paulo, considering the need for theoretical reflection on participatory health practices in the Brazilian context.METHODS Qualitative research that used the framework developed by Daigneault and Jacob (2009) to analyze the empirical material, encompassing three dimensions of participation: control of the evaluation process, diversity of participants, and extent of their involvement. We highlighted decisions or contextual aspects that deepened or limited the participatory option in the process under study.RESULTS We identified the presence and important performance of stakeholders who are “not specialists in evaluation”, through participation both in the direction of the evaluation process and in its distinct stages. The formed group started from their own annoyances added to the need for information and reflection to define the subject and scope of the evaluation; the use of the process planned by them guided the definition of the data to be collected and the format of result dissemination; the empirical material analysis was undertaken jointly by the participants. Regarding the third dimension, a limitation was identified regarding the diversity of actors involved due to the prioritization of the possibility of in-depth work with a fixed group of managers.CONCLUSIONS It is stated that there is no “ideal participation model” for evaluations. In certain contexts and structures, real opportunities for participation – even if they seem fragile at first sight – should be leveraged, and that requires flexibility and critical reflection on the part of those responsible for the evaluation processes to undertake the necessary adjustments.

Percepção dos usuários sobre a Atenção Primária à Saúde: estudo transversal em um município de grande porte

“…Ferramenta para apurar a satisfação dos usuários, o Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB), busca aferir a posição dos usuários sobre a rede de saúde, outros dispositivos, entes envolvidos ou mesmo modo de funcionamento local 10 , o que permite diagnóstico aproximado da situação a qual o usuário vive, potencialmente refletindo os problemas e os pontos fortes do serviço demandado pelo usuário 11 . Dessa forma, o objetivo do presente estudo foi compreender a percepção dos usuários sobre a APS de um município de grande porte 12 .…”