Planificação da atenção primária à saúde: contribuições para a 4ª Coordenadoria Regional de Saúde do Rio Grande do Sul

Abstract

The discussions that permeate health in Brazil focus on its organization in terms of care, the development of health promotion and disease prevention actions. Although different strategies have been developed to consolidate it, Health Care Planning stands out with the purpose of planning health care and the collective construction of knowledge from the first level, Primary Care. The objective was to analyze the Primary Health Care Planning Process in the 4th Regional Health Coordination of the State of Rio Grande do Sul and as specific objectives to know the implementation of the Primary Health Care Planning Process in the 4th Regional Health Coordination of the State of Rio Grande do Sul and to identify the strengths and weaknesses of the Primary Health Care Planning Process in the 4th Regional Health Coordination of the State of Rio Grande do Sul. The state of the art was developed in “Primary Health Care: (re ) knowing historical trajectory and concepts ”; "Planning of Primary Health Care: from the strategic possibility to ensuring the reorientation of health care" and "Planning of health care as a tool for the work process in Primary Care". A qualitative study was conducted, in the context of the 4th Regional Health Coordination of the State of Rio Grande do Sul; seven managers participated, with higher education and a statutory professional bond who led the process of implementing the Planification, including the sampling of nine balls. Data collection was developed between the months of May to October 2019, through documentary search and semi-structured interview. The ethical recommendations of resolutions nº 466/2012 and nº 580/2018 were followed and approved under opinion nº 3,073,876/2018. The data were analyzed using Minayo's operative proposal. The results were grouped into two cores of meaning: 1) “Planning of Primary Health Care: from Claims to Implementation” highlighting why it was first developed in 4ªCRS / RS, the operationalization in two stages and what it meant for the Conductor Group professionals; 2) "Strengths and weaknesses of Primary Health Care Planning" presented Planning as a powerful tool for organizing the work process, a meeting between the different actors who work in Primary Care and deepened relations with Higher Education Institutions, Municipal Secretariats and However, it was weakened by the lack of understanding of the entire Proposal and because it was a “Pilot project”, the non-positioning of Municipal Management in assuming Primary Care as the organizer of the Care Network and the lack of evaluation and monitoring of this process. Therefore, the Primary Health Care Planning mobilized managers, health professionals and users from seventeen municipalities that are part of the 4th Regional Health Coordination of the State of Rio Grande do Sul, providing opportunities for discussion, reflection and qualification of the actions and services developed in primary care services. Although this Proposal was not identified as an innovative process, it had the merit of systematizing the knowledge produced, becoming a support device for the management of State and Municipal Health Departments. It should be noted that the Planning implemented in the first stage in 4th Regional Health Coordination of the State of Rio Grande do Sul did not reach its initial assumptions of redefining flows and agreeing on Health Care Networks due to a set of weaknesses. Thus, there is a need for continuity of studies that can assess its effectiveness and consolidate it as a management device for Health Care Networks.