Planning pathways in the transfer of Directly Observed Treatment of Tuberculosis

Abstract

Objective:to investigate the planning pathways in the transfer of Directly Observed Treatment of tuberculosis. Method:a qualitative study conducted using interviews and a semi-structured guide, administered to five subjects who were among the coordinators and managers of the tuberculosis control programs, and the secretary of health of a municipality in the south of Brazil. Situational Strategic Planning and Discourse Analysis of the French matrix were the theoretical and analytical references used, respectively. Results:three reflexive axes were identified: weaknesses in the process of planning the Directly Observed Treatment transfer, antagonism between planning and daily requirements and formulation of planning and execution. Lack of systematization regarding the planning and execution for transfer the Directly Observed Treatment policy, demonstrates the fragility and incipience of this activity, and the possibility of its non-existence. Conclusion:the urgent need for managers and coordinators to better appropriate the theoretical framework for changing public policies, and the related planning mechanisms, includes a proposal for reorganization and qualification of the diffusion process, both practical-operative and political-organization.

Spatial patterns of multidrug-resistant tuberculosis: correlation with sociodemographic variables and type of notification

“…Through the descriptive analysis of the study, it was possible to verify the proportion of cases of MDR-TB and socioeconomic factors. The profile of the cases studied shows a predominance of males, possibly due to the tendency to spread the disease twice as much in men as in women, as well as the lack of self-care being greater among men, in addition to their greater exposure to risk factors (14)(15)(16)(17) .…”

“…According to the study's findings, there was a greater involvement of economically active adults, which may be related to the lifestyle of this population, which does not have a regular meal schedule, who drinks alcohol and, thus, does not continue the Directly Observed treatment (DOT). uch a situation can have a negative impact on the evolution of treatment and on the family economy, due to the consequent unemployment, reduction of hours worked and difficulty to perform paid activities, resulting in income impairment, essentially when it comes to cases of MDR-TB in which treatment is different from standard, with higher cost and time to take anti-TB drugs (14)(15)(18)(19) .…”

Planejamento das ações desenvolvidas pelas equipes de estratégia de saúde da famí­lia: revisão integrativa

“…Os estudos relacionam fragilidades no trabalho interno das equipes (4,13) , como ênfase em ações programáticas e atendimento à demanda espontânea (4)(5)(6)(8)(9)(10)(11)(15)(16)(17)(18)(19)(20)(21)(22)(23) , além de pouco diálogo na rede de serviços e escassez de ações intersetoriais (4)(5)(6)(17)(18)(19)21,23) . Os gestores, em geral, priorizam ações padronizadas do Ministério da Saúde que não consideram especificidades e perfil epidemiológico local, com foco no financiamento (5,7,16,20,23,27,32) .…”

Patients’ perceptions regarding multidrug-resistant tuberculosis and barriers to seeking care in a priority city in Brazil during COVID-19 pandemic: A qualitative study

“…Thus, DA would be the intermediary, since it is formed in the place where language has to be referred to its exteriority. With these considerations, it is worth reflecting that DA seeks a specificity that it dismembers in ideology and discourse [ 23 ].…”

“…Ideology is defined as a concept of the world of the person enrolled in a given social group in a historical circumstance [ 26 ]. Therefore, ideology is a fundamental concept for DA, since it combines the linguistic with the socio-historical [ 23 ].…”