Care networks coordinating teaching and service in health: a descriptive study


Ana Lúcia Abrahão1, Ândrea Cardoso Souza2, Sérgio Ricardo Aboud Dutra3, Marcos Antônio Albuquerque Senna4, Ranieri Carvalho Camuzi5, Francisco Leonel de Figueiredo Fernandes6

1, 2, 3, 4, 5, 6 Fluminense Federal University


Aim: To identify in the Health Care networks, the guidance and organization modes of healthcare and the vocational training that articulates teaching and service in a Brazilian municipality.
Method: This is a descriptive study, in which a qualitative approach was used. The research subjects will be professionals and managers of care networks that have operated in the network for at least one year. These individuals should be involved in the organization and planning activities of the network in the case of the manager and their assistants, and in the case of health professionals. Students, teachers and professionals not affiliated to the Municipal Secretariat will be excluded. Data collection will consist of semi-structured interviews and observation through daily field records, from September 2013 to April 2014. The Networks involved will be: Non-communicable Chronic Diseases; Stork and; Alcohol, Crack and Other Drugs. The identified material will be analyzed in terms of the content of the material collected in the field.
Descriptors: Teaching; Human Resources Formation; Patient-Centered Care; Health Policy



The network of health services in Niterói, committed to the Pact for Health, recognizes, through a partnership with the Fluminense Federal University, the potential for developing impact strategies in diverse territories and scenarios. It must be said that such a partnership was stimulated primarily by the National Reorientation of Vocational Training in Health (Pro-Health), the Education Program for Labor (Pet-Health)(1) and for the Permanent Education in Health Politics.

One of the strategies that emerged from this partnership was the transformation in the way in which care is performed on a daily basis in such a way as to respect social needs, thus becoming a training design and practice supported in its entirety, transversality and interdisciplinarity.

From this perspective, the participation of Health Care networks as an advisor to the healthcare organization and vocational training becomes the subject of this project. This is a broadened conception that includes the subjective and social dimensions of people, and the autonomy of the patient and the family, as well as teamwork, reflecting the social commitment of managers and trainers in terms of situations that are relevant to the improvement of the Unified Health System (UHS).

The incorporation of health actions implies the mobilization of social actors and the articulation of macro and micro politics within the health services. This is an exercise that is tense, uncertain and which contains many detours, which constitutes one of the main challenges faced by health services, health teams and educational institutions, in the construction of means that are capable of supporting the health needs of the population in accordance with the principles of the UHS(2).



Does the construction of care networks allow users to access healthcare services?
Can networks be identified as health devices, ensuring the integrity of actions among the different hierarchical levels?



To identify in the Health Care networks in a Brazilian municipality, the orientation and organization modes of healthcare that articulate teaching and service.



This is a descriptive study in which a qualitative approach was used. This will be developed in the context of the health networks of the city of Niterói, RJ, namely: attention to Non-communicable Chronic Diseases; Stork and; Combat and Control of Alcohol, Crack and Other Drugs.

The research subjects will be managers and health professionals who will be included by means of the following criteria: acting in the network for at least one year; developing the organizational and planning activities of the network, in the case of a manager, and of assistance in the case of health professionals. Those who do not have a formal employment relationship with the Department of Health of Niterói, students and teachers, will be excluded.

Data collection will take place through semi-structured interviews with professionals and network managers, and through non-participant observation. This data will be recorded in a field diary. Interviews will take as their main focus the planning of actions on the construction of care networks; proposals that are being built, and the articulation between the different services. The period of fieldwork will be September 2013 to April 2014. The interviews will be transcribed and, along with the field diary, will be treated by the means of content analysis.

The research will enable the exploration of already known phenomena, but which still display unexplored interfaces of the care world and in the creation of networks(3).



1. Araújo AMPB, Abrahão AL. Analysis of training in the health area: a map of curricular changes in education. Online braz j nurs [ Internet ]. 2012 October [ Cited 2013 Sep 7 ] 11 (2): 483-7. Available from: doi:

2. Abrahão AL, Cordeiro BC, Marques D, Daher DV, Teixeira GHMC, Monteiro KA, et al. A pesquisa como dispositivo para o exercício no PET-Saúde UFF/FMS Niterói. Rio de Janeiro, Brazil. Rev. bras. educ. med. 2011 set. [ Cited 2013 Aug 31 ] 35(3). Available from: doi:

3. Merhy EE, Pesquisa Saúde Mental – Acesso e barreira em uma complexa rede de cuidado: o caso de Campinas, Processo575121/2008 4. Relatório Final. CNPq. 2011.



The authors take part in the research as a researcher in the field, in the collection, organization and data analysis.

Project linked to the Center for Studies and Research in Management and Health Work / CNPq; Approved in the CEP HUAP / FFU: 209 321. Scholarship funding for students with resources of the Management Secretariat of Labor and Health Education (SGETS/MS. Announcement No. 24/2012 - SGTES).



Recived: 31/08/2013
Revised: 30/09/2013
Approved: 30/09/2013