BUILDING
THE POSSIBILITY OF USER PARTICIPATION IN MUNICIPAL HEALTH CONFERENCES: AN
EXPERIENCE REPORT
CONSTRUINDO
A POSSIBILIDADE DE PARTICIPAÇÃO DOS USUÁRIOS NAS
CONFERÊNCIAS DE SAÚDE MUNICIPAIS: UM RELATO DE EXPERIÊNC=
IA
Karen
Silva de Castro[1]
* Lauany Silva de Mede=
iros[2]
* Nayara Fernanda Alves Morei=
ra[3]
* Michele Pinheiro Ferreira[4]
* Amanda
Ouriques de Gouveia[5]
* Aline Ouriques de Gouveia[6]
* Laís Araújo Tavares Silva[7]
* Carina Lopes de Sousa Antonio[8]
* Valeria Regina Cavalcante dos Santo=
s[9]
Abstract
Objective: To analyze=
the decision-making process during the 12th Municipal Health Conference of=
the Municipal Health Council, held in the municipality of Tucuruí-P=
A. Methodology: It is a qualitative study of the descriptive-exploratory ty=
pe, which is based on the problematization method with the application of A=
rco de Maguerez for the theoretical and practical foundation of the study, =
based on five steps, being the observation of reality , key points, theoriz=
ation, solution hypotheses and application in reality. Results: The municip=
al management and the Municipal Health Council promoted the 12th Municipal =
Health Conference, on April 13, 2019, with the presence of 80 people, being=
citizens, mayor, secretaries, professionals and academics, among the age g=
roup of 18 to 60 years old. However, previously, 04 council meetings were h=
eld, 02 pre-conference, one in the Basic Health Unit of Santa Monica and th=
e other in the Teapykawa Assurini Indigenous Village, through seminars, rou=
nd tables, as well as open debates. Conclusion: It was possible during the =
municipal health conference to address how themes related to the principle =
of community participation in the construction of the draft health laws are=
essential for maintaining the universality, equity and integrality of the =
Unified Health System.Keywords: Health System; Health Conference; Democracy; Communit= y Participation.
Resumo
Objetivo: An
Palavras-Chave: Sis=
tema
Único de Saúde; Conferência de Saúde; Democracia;
Participação Comunitária.
INTRODUCTION
=
The
Federal Constitution of 1988 promoted the decentralization of public policy
management, making the participation of civil society effective in the
decision-making process on matters related to health as a general right. Th=
us,
norms and deliberations were created with the aim of providing greater auto=
nomy
and effective participation of the community regarding the structuring proc=
ess
of health care, thus, the influence of the various social elements in public
institutions were surely expanded and essential for the development of serv=
ices
provided (1).
=
Furthermore,
the formulation of constitutional regulations established by the Unified He=
alth
System (SUS), supported the implementation of institutional innovations suc=
h as
the formation of municipal, state and national conferences and public policy
management councils, which became essential for the strengthening of the de=
mocratic
regime in society, enabling the expansion of their civil rights and
contributing to closer relations with the legislative sectors (2).
=
Furthermore,
as proposed by Law No. 8142/1990, the Health Council must establish strateg=
ies
capable of promoting the maintenance and control of health policies, as wel=
l as
structuring the economic and financial sectors, so that the services provid=
ed
are qualified and trained each increasingly, verifying needs and needs and
formulating ways to remedy them. In addition, this law regulates the role of
Health Conferences, elucidating their circumstances and purposes, evidencing
that this event must take place every four years, in order to analyze and
discuss public policies in each sphere of government and to introduce guide=
lines
on the issue at national, state and municipal level, contributing to the
verification of other social policies, which correspond to the policy of wo=
men,
children and adolescentes (3).
=
In
this perspective, the Councils and Conferences are essential for the
maintenance of a comprehensive public health policy, essential for the
strengthening and qualification of the services offered, in addition to
complementing the effective participation of the community in the formulati=
on
of deliberations, in a way that emphasizes the the value of democracy again=
st
the structuring of social health measures, demonstrating that the discussio=
ns
held in this environment provide the assessment of social interests and
conflicts, permeating ideas for harmonizing the proposed subjects and the b=
asis
for remedying the main problems imposed (4).
In the meant=
ime,
the study aimed to analyze the decision-making process during the XII Munic=
ipal
Health Conference of the Municipal Health Council, held in the municipality=
of
Tucuruí-PA, in 2019, using the influence of policies as a reference
base. public at municipal conferences and how popular representation can ac=
t in
the formulation of deliberations for the qualification and qualification of=
the
health services provided. In addition, the presentation and importance of t=
his
institutional element for the improvement of the democratic premise and the
legislative sectors was verified.
METHODOLOGY
This is a
qualitative descriptive-exploratory study, which is based on the
problematization method with the application of the Arch of Maguerez for the
theoretical and practical foundation of the study. This method is based on =
five
steps, which are: The observation of reality, key points, theorization,
solution hypotheses and application in reality, being characterized as
potential stimuli to an educational and adaptive process (5).
From this
perspective, the first phase, called observation of reality, was promoted
through debates held at meetings of the Municipal Health Council, where
community issues, claims and needs of each neighborhood and also of indigen=
ous
communities were put on the agenda, through of 3 meetings in planned sector=
s.
Then, the second stage was started, which consisted of defining the guiding
questions, namely: What are the main needs related to health institutions? =
How
to alleviate community problems? What are the most emergency issues? How to
list and cover all audiences?
From this,
followed to the formulation of the third stage, which consists of theorizat=
ion,
promoted by the bibliographic analysis of data searched on websites and dig=
ital
platforms such as Scielo, LILACS and other literature that served as the ba=
sis
for the study, which included content on Health Conferences, their importan=
ce
and citizens' rights. Thus, the bibliographies were selected and organized =
in
an organizational chart following the inclusion criteria, such as a five-ye=
ar
time frame and full article, in order to then analyze popular participation
during a conference and the impact of this process on social reality.
In this sens=
e,
the fourth stage took place to define the hypotheses for a solution, in ord=
er
to organize the plans that were intended to integrate the demands of the
communities and solve the existing problems. Finally, there was the fifth s=
tage
for the application in reality, which was developed through two meetings ai=
med
at the population of the city of Tucuruí-PA, where information,
questions and positions were raised about the Health Council and its role in
ensuring rights of the community and health professionals.
RESULTS
Health
Conferences (HC) are an institutional advance based on the principle of
deliberate democracy in Brazil. From this, they are characterized by popular
support in the development of public policies aimed at guiding the health
services certified by the Unified Health System (SUS) since 1986. Therefore,
this care model occurs through a pathway double, the first is the adherence,
mobilization and social representation of different communities, in order to
guarantee the right to equity, especially among marginalized groups and,
second, a political representative committed to dialogue with those involve=
d in
CS, seeking to create a consensus among the interests of all (6)=
.
In this sense, community engagement bec=
omes a
pillar to the “social control” of public service, which represe=
nts
a national achievement to decentralize and municipalize care networks.
Consequently, there was a transition in which the user (patient) took
responsibility for evaluating the effectiveness of resolving measures in
health, thus, Law No. 8142/90 was recognized, which provides for the
organization of federal, state and municipal health councils, which would
affirm the bases of the SUS, such as universalization, integrality, hierarc=
hy
and cooperation of Society (7).
Thus, the municipal administration of
Tucuruí-Pa and the Municipal Health Council promoted the XII Municip=
al
Health Conference, on April 13, 2019, to expand forums for political traini=
ng
and deliberation of action plans for the promotion, protection and recovery=
the
quality of life of individuals, as well as defining the allocation of social
security resources to these decisions, with this, had the presence of 80
From this perspective, the conference
presented the generating theme “Democracy and Health” which was
divided into 04 axes of discussion, such as I) Health as a right – it
addressed the creation of the National Health Council, in addition to the
current parity configuration; II) Consolidation of the SUS – dealt wi=
th
Organic Law n° 8.080/90 in the formation of the SUS; III) SUS Financing=
-
worked on the SUS underfunding associated with the invention of the Electro=
nic
Citizen's Record (PEC) and IV) Democracy and Popular Participation -
conceptualized democracy, through a playful dynamic, in which they created =
04
groups, with the objective to prepare municipal and state proposals for each
axis, with this, 39 representatives attended the plenary, among these 05 we=
re
on the motion and 12 delegates were chosen, among the segments of
"Management",
=
Regarding
the limitations found in the event, it is reported the attendance of few
residents of the city of Tucuruí, located
in the southeast region of the state of Par&aac=
ute;,
associated with inefficient dissemination, given that the municipality has a
vast geospatial extension and the need for a majority to be present at this
event, as it is, in this way, that the leaders will be buried in the
real conditions of health services, the efficiency of the care provided, the
programs that are active and the pending issues of the unit in each
neighborhood.
Therefore, a=
s a
solution measure, it is proposed to articulate marketing strategies through
which contact networks will be formed with communities, such as social page=
s of
the health council, in which relevant decisions would be disclosed to the
conference, as well as posts about social commitment in acting on these
occasions, in addition to using public tools to make the invitations, infor=
ming
the local date and time, in general, the car-sound would be used and, at a
local level, the UBS for the distribution of leaflets.
DISCUSSION
Perspective of meetings in the health council:
Health councils represent an organ of social control, as the collecti=
ve
and governmental sector needs, in an integrated way, to articulate and
implement health services, programs, protocols, based on surveillance and
integral commitment, hence the composition of members it must be between us=
ers
and government representatives. In the municipality of Tucuruí-PA, t=
he
coordination of the Health Council is formed by a president, first secretar=
y,
executive secretary, health secretary and democratically elected counselor,
according to the ethical-political-ideological principles (8).
In view of t=
his,
the municipal level has the commitment to
mobilize social groups to add the social cause of holding conferences, both
local and district, in order to transform them into the true protagonists of
“doing health”, through the recognition of rights and duties as=
SUS
users (9). Therefore, the Tucuruí council meetings took p=
lace
between March and April 2019, with a total of 04 meetings, from 5:00 pm to =
6:30
pm, of counselors, professors and nursing students from the teaching
institutions Universidade Estadual do Pará (UEPA ) and Faculty Gamal=
iel.
From then on, the conversations were saved, by a recording device, to
file the raised agendas, as well as the decisions reached at the end of the
meeting. With that, the main points discussed were the pre-conference dates,
being signed that the UBS Santa Mônica was on April 3, 2019, starting=
at
6:00 pm (afternoon period), and that of the Teapykawa Assurini village on A=
pril
21 of 2019, at 9:00 am (morning period), the date and location of the munic=
ipal
conference, which consisted of April 12 and 13, 2019, at the establishment
Sabor dos Sonhos Eventos, respectively.
Soon, there was a proposal to divide the academics into organizational
committees, with the intention of optimizing the tasks of the conference, w=
ith
this, 3 teams were formed for "Report", which would write the min=
utes
with the proposals chosen in the plenary and the description of the activit=
ies
carried out on each of the two days; “Organization” that were i=
n charge
of organizing the place, such as delegation of spaces for the round table,
accreditation, time limit for the plenary sessions and the speakers of each
axis; “Accreditation” responsible for collecting the signature =
of
all participants, aiming at the delivery of the event certificate with a
workload of 40 hours.
FINAL CONSIDERATIONS
Therefore, it was possible during the municipal health conference to
address how issues relating to the principle of community participation in =
the
construction of health bills are essential for maintaining the universality,
equity and integrality of the Unified Health System. social control emerges=
as
an effect of this participation, which has as its object not strictly the
health sector, but the understanding of this field in its reciprocal
implications with social and economic policies.
REFERENCES
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rini
DM. The propositions of Heal=
th
Conferences and Municipal Health Plans: a study in municipalities of Santa =
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cited
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Brazil.
Submission: 2021-02-18
=
Approval:
2021-06-22
[1]=
Orcid: https://orcid.org/0000-0001-8463-0322=
[2]=
Orcid: https://orcid.org/0000-0002-5683-6347=
[3]=
Orcid: https://orcid.org/0000-0003-1094-7399=
[4]=
Orcid: https://orcid.org/0000-0001-5316-9908=
[5]=
Orcid: https://orcid.org/0000-0002-6874-8352=
[6]=
Orcid: https://orcid.org/0000-0001-8743-1433=
[7]=
Orcid: https://orcid.org/0000-0002-6517-3338=
[8]=
Orcid: https://orcid.org/0000-0002-8980-4368=
[9]=
Orcid: https://orcid.org/0000-0002-1264-8125=