Suchergebnisse

Objetivo: investigar o processo de planejamento da transferência da política do Tratamento Diretamente Observado da tuberculose. Método: estudo qualitativo, realizado por meio de entrevistas e roteiro semiestruturado aplicado a cinco sujeitos, dentre coordenadores e gestores dos programas de controle da tuberculose e o secretário de saúde de um município do Sul do Brasil. O Planejamento Estratégico Situacional e a Análise de Discurso de matriz francesa foram os referenciais teórico e analítico utilizados, respectivamente. Resultados: três eixos reflexivos sobressaíram: as fragilidades no processo de planejamento da transferência do Tratamento Diretamente Observado; o antagonismo entre o planejamento e as exigências cotidianas; e a formulação do planejamento e sua execução. A assistematização do planejamento para a execução da transferência do Tratamento Diretamente Observado indica não apenas a fragilidade e incipiência dessa atividade, mas também a possibilidade de sua inexistência. Conclusão: é notória a premente necessidade de os gestores e coordenadores se apropriarem melhor tanto do referencial teórico da transferência de políticas públicas quanto dos próprios mecanismos de planejamento em si, incluindo, nesse sentido, uma proposta de reorganização e qualificação do processo difusor, prático-operativo e político-organizativo. ; 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. ; Objetivo: investigar el proceso de planificación de la transferencia de la política del Tratamiento Directamente Observado de la tuberculosis. Método: estudio cualitativo realizado por medio de entrevistas y con guión semiestructurado, aplicado en cinco sujetos: coordinadores y gestores de los programas de control de la tuberculosis y el secretario de salud de un municipio del sur de Brasil. La Planificación Estratégica Situacional y el Análisis de Discurso de matriz francesa fueron los referenciales teóricos y analíticos utilizados, respectivamente. Resultados: tres ejes reflexivos se destacaron: las fragilidades en el proceso de planificación de la transferencia del Tratamiento Directamente Observado; el antagonismo entre la planificación y las exigencias cotidianas y la formulación de la planificación; y su ejecución. La falta de sistematización, de la planificación para la ejecución de la transferencia del Tratamiento Directamente Observado, nos indica no apenas la fragilidad e insipiencia de esta actividad, pero además la posibilidad de que este no exista. Conclusión: es notaria la urgente necesidad de los gestores y coordinadores de conocer mejor tanto el referencial teórico de la transferencia de políticas públicas como los propios mecanismos de planificación, incluyendo con ese propósito una propuesta de reorganización y calificación del proceso difusor, práctico operativo y político organizativo.

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.

ABSTRACT Objective: to investigate the possibilities of positive and negative association of improvisation and the understanding of what will be the planning by managers and coordinators of tuberculosis control programs, in a context of transference of the Directly Observed Treatment policy. Method: this is a qualitative study, developed through semi-structured interviews analyzed in the light of French Discourse Analysis. Results: there was a weakening of the constructive and operational planning process, which is at the mercy of political will and the need of putting out fires. This, in turn, along with achômetro (Brazilian popular expression used on unsubstantiated point of view or opinion that is based solely and exclusively on the intuition of the person who says it), composed the metaphor of improvisation in its negative perspective, understood by automatism and unsystematization process. Improvisation, however, emerged as a representation of innovation, creativity, and contextual change. Final considerations: both the planning and the transfer of public policies constitute processes that need to be strengthened and qualified in the field of public health.

ABSTRACT Objective: To analyze the discourses of health professionals about the obstacles in the process of detection and reporting of tuberculosis cases in Mozambique. Method: Qualitative exploratory study with a theoretical-methodological approach of Discourse Analysis of French matrix. The study was conducted in Mozambique in 2014 at three levels: central, provincial and district. The study included 15 health professionals, 4 physicians, 6 technicians and 5 nursing professionals, who worked in the National Tuberculosis Control Program, with more than 1 year of experience. Result: The following discursive blocks emerged: Detection of tuberculosis cases in laboratories; Underreporting of tuberculosis cases; Obstacles to detect cases of tuberculosis: long distances and lack of transport; and Reporting of cases for decision making. Final considerations: The discourses analyzed point to the ideological affiliation that includes the lack of investment policies in the health sector and the political commitment as basic obstacles in the detection and reporting of tuberculosis cases.

ABSTRACT Objective: To analyze whether user-centered nursing practices in TB DOT are being carried out and are contributing to democracy. Method: A cross-sectional, exploratory, descriptive study with 123 nurses in three capital cities with high incidence of TB (Manaus-AM, João Pessoa-PB, Porto Alegre-RS) in Brazil. Data were collected from January to June 2014. Descriptive and multiple correspondence analyzes were used. Results: It was identified that the most user-centered care actions had scores below 50%, considered unfavorable to the exercise of democracy. In the analysis of the general user-centered practice score per municipality, Manaus and João Pessoa presented unfavorable results, and the municipality of Porto Alegre was partially favorable. Conclusion: The three municipalities need to advance in the implementation of user-centered practices in DOT, because their health system still has difficulties and challenges to overcome.