PREVIEW NOTES

Permanent education in the decentralization of health surveillance: a descriptive study

¹Irene França Guimarães, ,²Marcos Paulo Fonseca Corvino

^1,2 Fluminense Federal University

ABSTRACT
This is a research project that focuses on the expansion of a service as a consequence of decentralization of the action of Health Surveillance (HS) to municipal level, using the strategy of Permanent Education in Health (PEH).
Aims: To perform a situational survey of the education of health professionals that work in HS; to identify the processes of PEH used in HS; to map the necessities of PEH for HS professionals and to create an educational proposal to optimize the actions of HS.
Method: This is a descriptive study, with a qualitative approach. The collection of information will occur during the second semester of 2013, through documental research, semi-structured interviews and a focal group with the members of the HS Central team of a city located in the Brazilian state of Rio de Janeiro. The technique of content analysis will be used to treat the data. This study expects to contribute to the improvement of the actions of Health Surveillance at the municipal level.
Descriptors: Decentralization; Health Surveillance; Education, Continuing

PROBLEM SITUATION AND ITS SIGNIFICANCE

With the implementation of the Brazilian Unified Health System in 1990, the Brazilian Ministry of Health took the first measures to decentralize the actions of Health Surveillance (HS), which led to a challenge for the managers of the three levels of the Union. The complexity of the actions of surveillance has generated, in the structure and the organization of the agencies responsible to perform them, the confrontation of difficult problems to be solved. These aspects interfere in the process of decentralization of HS, because they demand higher mobilization of technical and political resources to be effective⁽¹⁾. In the Brazilian state of Rio de Janeiro, the challenge to implement the process of decentralization affects the ordering of municipal HS, with the formation of a minimum multiprofessional team and its education⁽²⁾. The municipal HS to be studied will be submitted to the process of decentralization of actions. This process is demanding strategies of greater coverage in a short term, as the municipal employees are working directly in the activities related to HS. This implies encouraging professionals to work on organizing and performing the activities to eliminate the problems faced in a daily basis in the process of the municipalization of HS. In the process of the work performed, some fragilities are seen when dealing with more complex demands of service. The expansion of HS services in the municipality demonstrates significant changes in the composition and structure of the work force. This can be observed by the importance of the education of the worker at the workplace to understand the actions to be developed in the restructuring of the services, the stimulation of the professionals to be reflexive about their reality and their capability to interfere in their process of work. From the main author, as part of a HS team, emerges the perception about the education, the work of health professionals and the challenge to perform the actions given to the municipalities, as well as the identification of the necessity to develop strategies of the education of the worker at his workplace. The way to make workers responsible for their own education is called Permanent Education in Health and it aims to achieve individual and collective competence, besides strengthening professional categories and, as a consequence, the health team⁽³⁾. Then, this research will have, as the object of analysis, the permanent education of the HS team, aiming towards the decentralization of their actions.

GUIDING QUESTIONS

How do the public employees understand the educational processes performed in the HS work process? Which educational initiatives are performed in work processes to be used in HS actions? What are the difficulties found in the use of permanent education in HS?

AIMS

To perform a situational survey of the education of health professionals working at the HS of a municipality located in the Brazilian state of Rio de Janeiro; to identify the processes of PEH used in HS; to map the necessities of PEH for professionals that work in HS in a municipality located in the Brazilian state of Rio de Janeiro; to elaborate an educational proposal to optimize the actions of HS in order to subsidize local or regional processes of PEH.

METODOLOGY

This is a descriptive study, with a qualitative approach. The data collection will be performed during the second semester of 2013, through documental research in management reports, minutes of meetings, request letters with educational purposes of the HS team, and regular newspapers circulating in the municipality, followed by the literal transcription of parts that involve the topic here proposed, and after that, the categorization and the crossing of identified key terms. After this step, there will be created a group of professionals that work in HS in a municipality away from the capital, more specifically located in the mountainside of the state of Rio de Janeiro. The participants will be professionals that work in HS; a total of seven subjects. The criteria of exclusion will be the employees that do not have any availability of time to participate in all occasions of data collection. The treatment of the data will follow content analysis technique according to the method proposed by In regards to the ethical aspects, this project will follow the directives of Resolution 466/12, of the Brazilian National Health Council, and it will be submitted to the Ethics in Research Committee, of Fluminense Federal University.

REFERENCES

1. Cohen MM. Dilemas do processo de gestão descentralizada da vigilância sanitária no Estado do Rio de Janeiro. Physis (Rio J) [ Internet ]. 2009 [ cited 2013 June 15 ] 19(3): 867-901. Available from: http://www.scielo.br/pdf/physis/v19n3/a18v19n3.pdf.

2. Governo do Estado do Rio de Janeiro. Resolução SESDEC nº 1411, de 15 de outubro de 2010. Delega competências de ações de Vigilância Sanitária para as Secretarias Municipais de Saúde no âmbito do Estado do Rio de Janeiro e dá outras providências. Diário Oficial do Estado do Rio de Janeiro 22 Out 2013.

3. Ferreira GSM, Ponte KMA, Aragão AEA, Arruda LP, Ferreira IS. Continuous education of professionals in the hospital environment: an exploratory study. Online braz j nurs [ Internet ]. 2012 Oct [ cited 2013 July 18 ] 11 Suppl 1:488-91. Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3874

PROJECT DATA
Dissertation Project of the Professional Master in Education in Health – UFF
Irene França Guimarães – Master student of the Professional Master in Education in Health, Aurora de Afonso Costa Nursing School - UFF
Marcos Paulo Fonseca Corvino – Tutor – Professor at the Professional Master in Education in Health, Aurora de Afonso Costa Nursing School - UFF

Received: 30/08/2013
Revised:   05/09/2013
Approved: 07/09/2013