Estratégias planejadas e implementadas pelos municípios da região de saúde 20: uma análise do planejamento de saúde para a população do campo

Abstract

In Brazil, Primary Health Care has advanced concerning population coverage and has presented itself as a proposal against the hegemonic private medical care model. However, the Family Health Strategy, as a gateway for people into the Unified Health System (SUS), still has presented several issues related to its implementation, such as: worse performance in rural areas. In this regard, Primary Care must be based on humanized and collaborative practices which promote better quality in the Unified Health System, emphasis on universality, equity and comprehensiveness, with health planning as a guide for taking actions. The research aims at analyzing the strategies planned and implemented by the municipalities of Health Region 20 – Rota da Produção, with the purpose of qualifying the Integrality attribute, focusing on the rural population. This is a cross-sectional mixed method study. The study participants are health professionals who work in the primary care network in the municipalities of Health Region 20 - Rota da Produção, which composes the 15th Regional Health Coordination. The first moment of generating quantitative data was the assessment instrument applied for primary care proposed by Starfield, the second stage consisted in documentary research, having the analysis of current Municipal Health Plans (2022-2025), in order to contextualize how municipalities plan and structure actions related to the health of the Rural Population. The qualitative phase began with the analysis of data from the first stage, when the Focus Group technique was used with the managers from the Region. Quantitative data were subjected to statistical analysis. To interpret the qualitative data, the content analysis proposed by Bardin was used. The results obtained showed that, concerning the view of health professionals who work in Primary Health Care in the municipalities of Region 20, the attribute comprehensiveness – available services obtained a high score. The sensitivity analysis of Municipal Health Plans demonstrated that, although inserted in a scenario marked by the presence of rural areas, there is no planning of strategies aimed at ensuring comprehensive health services for the population living in the countryside. The focus group analysis disclosed the causes: the lack of awarness of the differences between rural and urban, caused by the regional constitution of small municipalities; lack of team and user engagement in the planning process. In this study, the fragility of policy and resource management was found, attesting the fragility of municipalities in conducting autonomy the management process based on SUS guidelines and principles, in relation to the context and the rural population.