Social control in the Unique Health System: analysis of the social participation and empowerment of the population that uses the sanitary system / Controle social no Sistema Único de Saúde: Análise da participação social e empoderamento da população usuária do sistema sanitário

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

The health councils had become a strategical mechanism for the guarantee of the democratization of the decisory power in the Unique Health System - UHS. These spaces have great importance for the effective participation of the civil society when it has to take decisions about health, and a deep reflection of the shades of this utopia becomes essential to evaluate the challenges and the possibilities presented for an effective social participation in the country; standing out the possibility of the active presence of the citizens in the construction of the democratic process in the UHS; opening a discussion about the necessity of the empowerment/release of the population that uses the system. In this conjuncture, the Family Health Program - FHP can be seen as an odd strategy to stimulate the empowerment/release of the users, in order to get their active participation in the decisions. With these estimated theories, this present study propose to analyze the experience of the social control through the City Health Council CHC and understand the social representation of the FHP users, about reality of the UHS, in the city of Teixeiras - MG. This present study is placed in the social research field and used primordially, the methodological instrumental theoretical referential of the qualitative research, where 32 council members (84.2% of the total council members) and 136 users of the Health Family Units (HFU) were interviewed (11% of the registered in the HIPERDIA cadastre that had a accompaniment in the 4 HFU), these last ones had been randomly selected during the attendance and activities realized in the HFUs. The analyses of the experience of the health social control, through CHC, show that the possibility of a UHS participative management did not consolidate as an effective practical of public administration. Actually, a great unfamiliarity of the legal and ideological bases of the social participation in the health was observed, generating a strong influence of the local managers in the dynamic and functioning of the CHC, mainly in determination of its members, hindering, in such a way, that this space becomes a concrete space so that the users can appropriate of the politic and institutional form of the council, mainly of the possibility to intervene, argue and deliberate about the questions of the city health. In the analyses of the social representations of the UHS users, a vision defined by the assistance focus is observed, pointing to the concentration of public resources in poor segments of the society, and also a vision centered in the biomedical model of attention. Its important to stand out that the FHP did not reach its objectives of providing changes in the praxis in health, aiming to stimulate the collective empowerment/release of the population. The data that were presented in both evaluations, point to a great unfamiliarity of the studied population about the sanitary system and about its social rights conquered by the Constitution of 1988, as well. Ahead of the reality, there is a necessity of bigger empowerment/release of the population, aiming to construct effective possibilities so that the population can have an active participation in the process of construction of a common assistance project, based on the UHS democratic ideals, being the FHP strategically important to the transformation of this reality. One of the possibilities for the change of this reality would be the accomplishment of educative actions, transforming these social actors into protagonist of the construction of their own history.

ASSUNTO(S)

family health program programa saúde da família participação social unique health system social participation nutricao public health policies sistema Único de saúde política de saúde saúde pública

ACESSO AO ARTIGO

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