Estratégias de mobilização para a participação comunitária de conselheiros municipais de saúde
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Data
2019-06-07
Autores
Fernandes, Violeta Campolina [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução. A participação da comunidade é uma das diretrizes do Sistema Único de Saúde (SUS), sendo entendida como instrumento fortalecer a democracia e ampliar a cidadania. O presente estudo insere-se no contexto da participação comunitária de conselheiros de saúde e no fortalecimento de suas práticas. O objetivo geral foi qualificar conselheiros/as municipais de saúde por meio de oficinas educativas e do método da pesquisa-ação, com vistas a melhorar a participação da comunidade enquanto diretriz do SUS. Os objetivos específicos foram: identificar as temáticas discutidas nas reuniões dos conselhos municipais de saúde; levantar as fragilidades e potencialidades da participação comunitária nos conselhos municipais de saúde por meio de revisão integrativa da literatura; analisar mapas conceituais desenvolvidos em oficinas educativas no âmbito da capacitação profissional de conselheiros/as municipais de saúde; compreender a percepção dos conselheiros em relação a sua função participativa nos conselhos de saúde. Método. O projeto foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos da Faculdade de Medicina de Botucatu – UNESP sob número 1.578.025/2016. Trata-se de pesquisa-ação, de abordagem qualitativa e multi métodos: oficinas educativas, observação participante e grupos focais. A construção de informações foi realizada em três municípios da região de saúde do Pólo Cuesta no interior do Estado de São Paulo nos anos de 2016 e 2017. Foram realizadas análises documentais, oficinas educativas e grupos focais. Ao final de cada oficina, utilizou-se mapa conceitual como estratégia de acompanhamento e avaliação da aprendizagem dos conselheiros. Os dados dos grupos focais foram analisados por meio da análise de discurso na vertente representacional temática e os dados dos mapas conceituais através da análise temática dialógica e análise semiótica da imagem parada. A discussão foi alicerçada pelos referenciais teóricos da Política Nacional de Educação Permanente para o Controle Social no Sistema Único de Saúde, a Teoria da Aprendizagem Significativa do construtivista David Ausubel e a Teoria da Democracia e Participação a partir dos pressupostos de Robert Dahl. Resultados. As oficinas melhoraram a participação comunitária nos fóruns de saúde e a intervenção contribuiu para a formação de conselheiros críticos e reflexivos. Nos grupos focais, foi observada uma participação ativa dos conselheiros, com troca de saberes, interação entre o grupo, expressão de vivências e desmitificação de conceitos acerca dos temas debatidos. Além disso, o mapa conceitual proporcionou a aprendizagem dos participantes, por evidenciar o conhecimento adquirido ao longo das oficinas educativas realizadas. Conclusão. As oficinas educativas e mapas conceituais são estratégias educacionais extremamente relevantes em vários contextos, inclusive no fortalecimento das práticas de conselheiros de saúde, por estarem centrados na aprendizagem e na transformação. Faz-se necessário a construção de trabalhos educativos com uso de métodos participativos como esse com conselheiros de saúde para que novos olhares surjam a partir do fortalecimento de todos os membros, apoiados por uma nova visão de mundo na perspectiva de melhorias da diretriz da participação da comunidade.
Introduction. Community participation is one of the guidelines of the Unified Health System (SUS), and is understood as an instrument to foster social capital, strengthen democracy and broaden citizenship. This study is part of the community participation of health advisors and the strengthening of their practices. The general objective was to qualify municipal health councilors throuch educational workshops and the action-research method, with a view to improving community participation as a SUS guideline. The specific objectives were: to identify the topics discussed in the meetings of the municipal health councils; to raise the weaknesses and potencial of community participation in municipal health councils through an integrative literature review; analyze conceptual maps developed in educational workshops in the scope of professional trainning of municipal councilors of health; understand the perception of counselors regarding their participative role in health councils. Method. The project was approved by the Committee of Ethics in Research with Human Beings of Botucatu Medical School - UNESP under number 1,578,025 / 2016. These are action research, qualitative and multi-method approaches: qualification workshops, participant observation and focus groups. Data collection was carried out in three municipalities in the health area of the Cuesta Pole in the interior of the State of São Paulo in the years 2016 and 2017. Documental analyzes, qualification workshops and focus groups were carried out. At the end of each workshop, a conceptual map was used as a follow-up strategy and evaluation of the directors' learning. The data of the focus groups were analyzed through the discourse analysis in the thematic representational section and the data of the conceptual maps through the dialogical thematic analysis and the semiotic analysis of the still image. The discussion was based on the theoretical references of the National Policy of Permanent Education for Social Control in the Unified Health System, the Constructivist Theory of Meaningful Learning by David Ausubel and the Theory of Democracy and Participation based on the assumptions of Robert Dahl. Results. The workshops improved community participation in health forums and the intervention contributed to the formation of critical and reflective counselors. In the focus groups an active participation of the councilors was observed, with exchange of knowledge, interaction between the group, expression of experiences and demythologization of concepts about the subjects discussed. In addition, the conceptual map provided the participants' learning, by highlighting the knowledge acquired during the qualification workshops held. Conclusion. Educational workshops and concept maps are extremely relevant educational strategies in a variety of contexts, including strengthening health practitioner practices by focusing on learning and transformation. It is necessary to construct educational work with the use of participatory methods such as this one with health advisors so that new looks can arise from the strengthening of all members, supported by a new world view in the perspective of improvements of the guideline of participation of the community.
Introduction. Community participation is one of the guidelines of the Unified Health System (SUS), and is understood as an instrument to foster social capital, strengthen democracy and broaden citizenship. This study is part of the community participation of health advisors and the strengthening of their practices. The general objective was to qualify municipal health councilors throuch educational workshops and the action-research method, with a view to improving community participation as a SUS guideline. The specific objectives were: to identify the topics discussed in the meetings of the municipal health councils; to raise the weaknesses and potencial of community participation in municipal health councils through an integrative literature review; analyze conceptual maps developed in educational workshops in the scope of professional trainning of municipal councilors of health; understand the perception of counselors regarding their participative role in health councils. Method. The project was approved by the Committee of Ethics in Research with Human Beings of Botucatu Medical School - UNESP under number 1,578,025 / 2016. These are action research, qualitative and multi-method approaches: qualification workshops, participant observation and focus groups. Data collection was carried out in three municipalities in the health area of the Cuesta Pole in the interior of the State of São Paulo in the years 2016 and 2017. Documental analyzes, qualification workshops and focus groups were carried out. At the end of each workshop, a conceptual map was used as a follow-up strategy and evaluation of the directors' learning. The data of the focus groups were analyzed through the discourse analysis in the thematic representational section and the data of the conceptual maps through the dialogical thematic analysis and the semiotic analysis of the still image. The discussion was based on the theoretical references of the National Policy of Permanent Education for Social Control in the Unified Health System, the Constructivist Theory of Meaningful Learning by David Ausubel and the Theory of Democracy and Participation based on the assumptions of Robert Dahl. Results. The workshops improved community participation in health forums and the intervention contributed to the formation of critical and reflective counselors. In the focus groups an active participation of the councilors was observed, with exchange of knowledge, interaction between the group, expression of experiences and demythologization of concepts about the subjects discussed. In addition, the conceptual map provided the participants' learning, by highlighting the knowledge acquired during the qualification workshops held. Conclusion. Educational workshops and concept maps are extremely relevant educational strategies in a variety of contexts, including strengthening health practitioner practices by focusing on learning and transformation. It is necessary to construct educational work with the use of participatory methods such as this one with health advisors so that new looks can arise from the strengthening of all members, supported by a new world view in the perspective of improvements of the guideline of participation of the community.
Descrição
Palavras-chave
Conselhos de Saúde, Participação Comunitária, Participação Social, Saúde Pública, Sistema Único de Saúde, Health Councils, Community Participation, Social Participation, Public Health, Unified Health System