Análise da organização das ações municipais de saúde bucal na atenção básica
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Data
2016-02-25
Autores
Melo, Lúcia Maria Lima Lemos de [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O diagnóstico é uma etapa fundamental do planejamento pois possibilita o conhecimento da realidade e a definição de estratégias intervencionais com eficácia e resolutividade. O objetivo nesse estudo foi realizar o diagnóstico situacional sob a ótica dos coordenadores de saúde bucal dos 40 municípios do Departamento Regional de Saúde (DRSII) Araçatuba-SP e por meio da pesquisa–ação no município de Pereira Barreto-SP, analisar o funcionamento da agenda de saúde bucal. Foram entrevistados os 40 coordenadores municipais de saúde bucal do DRS II e no município de Pereira Barreto além do gestor, dezoito profissionais da Equipe da Saúde da Família. Foi utilizado um questionário semiestruturado e autoadministrado, com perguntas abertas e fechadas. O método da análise de conteúdo foi empregado para as questões abertas, com base na identificação da ideia central expressa nas respostas dos atores envolvidos. Em Pereira Barreto, foram realizadas também análises documentais do plano municipal de saúde, da agenda de saúde bucal e observações in loco da estrutura odontológica. As seguintes dimensões foram definidas no diagnóstico situacional realizado nos municípios: caracterização da infraestrutura odontológica, acesso e regulação, organização do processo de trabalho, estratégias de avaliação e na análise da agenda de saúde bucal: construção, atividades e avaliação da agenda em uma Unidade Básica de Saúde - UBS. No diagnóstico situacional dos 40 municípios constatou-se que apesar da unidade básica de saúde ser a principal porta de entrada para o sistema, para 23% o atendimento odontológico ainda era realizado em escolas; a principal forma de acesso da população aos serviços foi a demanda espontânea e havia inconsistências nos dados de produção nos sistemas de informações. Na agenda de saúde bucal analisada verificou-se que houve aumento na cobertura em 63% de pacientes atendidos em primeira consulta, redução de 30% dos casos de urgência, aumento de 11% na cobertura de tratamentos completados e ampliação dos atendimentos a grupos prioritários. Os resultados foram contextualizados em oficinas com os atores envolvidos, fundamentados na literatura e nas diretrizes institucionalizadas da Secretaria Estadual de Saúde - São Paulo e do Ministério da Saúde. Conclui-se que a área de saúde bucal dos municípios pesquisados apresentou diferentes momentos na estruturação do processo de trabalho. Há evidente progresso com o modelo assistencial adotado centrado na saúde da família, que a agenda foi facilitadora para a ampliação da assistência. Novos estudos devem ser realizados e experiências exitosas compartilhadas para subsidiarem os coordenadores de saúde bucal na reorganização das ações do processo de trabalho das equipes.
The diagnosis is a fundamental step in planning because it enables the knowledge of reality and the definition of interventional strategies effectively and resoluteness. The aim of this study was the situational diagnostic from the perspective of oral health coordinators of the 40 municipalities of the Regional Health Department (DRSII) Araçatuba-SP and through action research in the city of Pereira Barreto, SP, analyze the functioning of oral health agenda. Were interviewed the 40 municipal coordinators of oral health DRS II and Pereira Barreto municipality beyond the manager, eighteen professionals of the Family Health Team. A semi-structured and self-administered questionnaire with open and closed questions was used. The method of content analysis was used for the open questions, based on the identification of the central idea expressed in the responses of the actors involved. Pereira Barreto, were also carried out documentary analysis of the municipal health plan, oral health agenda and in situ observations of the dental structure. The following dimensions were defined in the situational diagnosis made in the cities: characterization of dental infrastructure, access and regulation, organization of the work process, evaluation of strategies and analysis of oral health agenda: construction, activities and evaluation of the agenda in a Basic Unit Health. In the situational diagnosis of the 40 municipalities it was found that although the basic health unit is the main gateway to the system, 23% dental care was also conducted in schools; the main form of access of the population to services was the spontaneous demand and there were inconsistencies in production data in information systems. In oral health agenda we examined it was found that there was an increase in coverage in 63% of patients at first consultation, 30% of emergency cases, 11% increase in coverage completed treatments and expansion of care to priority groups. The results were contextualized in workshops with the actors involved, based on the literature and institutionalized guidelines of the State Department of Health. - São Paulo and the Ministry of Health. Concluded that the oral health of the municipalities surveyed had different times in structuring the work process. There is clear progress with the care model adopted focused on family health, that the agenda was facilitator for the expansion of the form of assistance. Further studies should be conducted and successful experiences shared to subsidize oral health coordinators in the reorganization of the shares of the work process of the teams.
The diagnosis is a fundamental step in planning because it enables the knowledge of reality and the definition of interventional strategies effectively and resoluteness. The aim of this study was the situational diagnostic from the perspective of oral health coordinators of the 40 municipalities of the Regional Health Department (DRSII) Araçatuba-SP and through action research in the city of Pereira Barreto, SP, analyze the functioning of oral health agenda. Were interviewed the 40 municipal coordinators of oral health DRS II and Pereira Barreto municipality beyond the manager, eighteen professionals of the Family Health Team. A semi-structured and self-administered questionnaire with open and closed questions was used. The method of content analysis was used for the open questions, based on the identification of the central idea expressed in the responses of the actors involved. Pereira Barreto, were also carried out documentary analysis of the municipal health plan, oral health agenda and in situ observations of the dental structure. The following dimensions were defined in the situational diagnosis made in the cities: characterization of dental infrastructure, access and regulation, organization of the work process, evaluation of strategies and analysis of oral health agenda: construction, activities and evaluation of the agenda in a Basic Unit Health. In the situational diagnosis of the 40 municipalities it was found that although the basic health unit is the main gateway to the system, 23% dental care was also conducted in schools; the main form of access of the population to services was the spontaneous demand and there were inconsistencies in production data in information systems. In oral health agenda we examined it was found that there was an increase in coverage in 63% of patients at first consultation, 30% of emergency cases, 11% increase in coverage completed treatments and expansion of care to priority groups. The results were contextualized in workshops with the actors involved, based on the literature and institutionalized guidelines of the State Department of Health. - São Paulo and the Ministry of Health. Concluded that the oral health of the municipalities surveyed had different times in structuring the work process. There is clear progress with the care model adopted focused on family health, that the agenda was facilitator for the expansion of the form of assistance. Further studies should be conducted and successful experiences shared to subsidize oral health coordinators in the reorganization of the shares of the work process of the teams.
Descrição
Palavras-chave
Atenção primária à saúde, Avaliação, Saúde bucal, Assistência odontológica, Primary health care, Evaluation, Oral health, Dental care