Gestão do SUS: a dimensão participativa da representatividade tripartite no interior do Conselho Municipal de Saúde na Cidade de Manaus, no período de 2011 a 2014

Abstract

The Health Policy in the Brazilian reality encompasses a significant complexity, as thinking about it necessarily implies reflecting issues such as health paradigms, building citizenship, social protection modalities, legal and normative instruments. In this sense, the present study analyzed the way in which the shared, shared and solidary management of Health Policy in the City of Manaus is consolidated from the perspective of tripartite representativeness within the CMS / MAO in the period from 2011 to 2014. In addition , the study in question: Characterized the effectiveness of the mechanisms of social representativeness in the Municipal Health Council; It verified the power relations within the scope of tripartite representation in the Municipal Health Council and; He learned about the operationality of the actions deliberated in the Municipal Health Council from the perspective of the users' representatives. Therefore, the construction of the present study was based on a qualitative approach, developed through a theoretical survey and discussion, documentary study and field research, which took place through the conduct of open interviews with the tripartite representation, which at the end consolidated a total of 9 interviewed subjects, subdivided as follows: 1 - Government Representative; 2 - Workers' Representatives and; 6- Representatives of SUS Users. In addition, it is emphasized that the technique used for the treatment of the subjects' speeches was content analysis. As for the main results of the research, it was found that, although the municipality of Manaus implemented the regulation in 2008, little progress was made in the field of shared, shared and solidary management SUS, given the difficulty of the feasibility of the plans and schedules, because there is a gap between programmed and achieved goals, especially with regard to Permanent Education, SUS Strengthening Strategies and Civil Society Empowerment. In this way, it is added that social control in reality in Manaus, despite providing a space for public dialogue, still suffers hard blows due to the confrontations of personalities, the supremacy of individual projects to the detriment of collective projects, of “mandos and desmandos” ”, Among others that in the practical order, impoverish the discussion, the negotiation, the interlocution, as well as the consensus inside the Municipal Health Council. However, the scenario in question is not only of discouragement, because even if in a minimum participation in the exercise of social control has been making qualitative leaps, while more users have been engaged in the daily struggle for the affirmation of the right to health, based on the occupation of local councils, whether in the health units, in the clubs of mothers and others. This means that the subjects of rights, regardless of whether they are advisers or do not gradually conceive the political scenario as an action mechanism that allows to reinforce the social bond beyond that, making it possible to reconstruct the State intellectually and morally with regard to public and social policies, such as health, so that the promotion, protection and recovery of the health of the Brazilian population is experienced, as well as manauara.