Author: Roberto Santos Oliveira, RN, Nursing Teacher. Nursing
Administration Department,
Advisor: Marilda Andrade, RN. PhD. Teacher at
Professional and Academic Master Degree in
Bibliografic reference: Oliveira RS. Describe the network health care in the
Nova Iguaçu county: Situational analysis. [Dissertation]. Niteroi (RJ),
Problem: The
lack of strategic planning for the deployment of health services, the lack of
knowing of own network installed to use the system health in reference strategy
and cross-reference between the levels of complexity of health care.
Objective: Describe the own care network's
Health System in Nova Iguacu county, by geographic location of health units and
their area of healthcare coverage using the tool of geo-processing.
Method: Descriptive
study of qualitative approach, using the Collective Subject Discourse as a way
of interpreting reality found in study scenario. Descriptive analytical
approach, explores the event, correlating the variables without manipulating
them. The scenario used was a geographic region known as Nova Iguaçu, and as
social actors the health units found. This study is approved
by the Ética Comitê Research as legal guarantee of Resolution 196 of
1996 which deals with research on human beings, having been approved under
Protocol No. 014/2008. Registry Nº 0012.0.316.258-08.
To collect data we used participant observation supported by a roadmap,
identifing the elements of study and the collected information. Using the
locator "Google map", available on the web, to the geo-referencing of
health units identified in the research. To analyze the information the
Collective Subject Discourse, allowed the triangulation of data and
construction of indicators to quantify objective dimensions, interpreting
subjective facets of the social process studied. Besides expressing
characteristics of the social scene, enabling approach to accessibility
planning the location and extent of health services.
Results: Nova Iguaçu county operates
coverage actions of health facilities through the basic atention, with
administrative, managerial, economic and political influence; develops health
practices with care actions toward care promotion and health prevention. The interventions on the problems is also about the living
conditions of populations. The organization of health services follows
regionals and hierarchical principles, defining territorial base for a range of
services and actions. We found 72 health units: one General Hospital, 03 Units
Mixed, 02 polyclinics, 03 Psychosocial Care Center, 2001 Center Reference
Maternal Child; 01 Health Center, 01 Health Post, 24 Basic Health Units, 33
Strategy Family Health Units and 03 Family Units. For contextualized
evaluation, we must consider the Human Development Index: comparative measure
comprising three dimensions: wealth, education and life expectancy. The use of
the Human Development Index has advantages by his potential for comparison
between countries, regions, states and municipalities and is important to
measure the progress of human development with emphasis on social dimensions
such as health and education. Nova Iguaçu county have: Life expectancy at
birth: 67.99 years old, giving an index of longevity (IDHM-L): 0.717;
readability index at 92.81% school attendance rate: 79.67%, giving a education
index (IDHM-E): 0.884; and per capita income (in Real) at R$ 237,50 giving an
index of income (IDHM-R): 0.686; which together determine an average for the
index Human Development Index (HDI-M) of: 0.762; which puts Nova Iguaçu in the
17th position on the ranking of Brazilian cities with
total population between 500,000 and 1 million inhabitants.
Conclusion: This
study showed that it is possible to serve the users of sistem health in a
universal, humane and quality and therefore it is required steadfast
determination and willingness of managers on taking this commitment to society,
despite the great planing challenge that involves making decisions on the
location and extension of these services, which always ends up happening in
political decisions branch, having a lot more aspects towards resource
allocation than to epidemiological models or mathematical and population
concentrations, without even respecting the characteristics of each area, or
their peculiarities. The nurse in managing position, while fulfilling health
planning, must perform their actions guided by the epidemiology and health
surveillance in order to grow with resolvability, increasing technological
complexity in the organization and work processes, even thou nursing
profession, historically
characterized by commitment to health and society, has social branchs and is
present in all actions undertaken in the health axis of this country. Despite
the number of units found in Nova Iguaçu county (n=72), there are still
numerical deficits to attend all healthcare coverage predicted by law;
Presented deficit varies between 25% and 80%. Support obtained from the
collective subject discourse, allowed us to reveal other aspects of the study,
which indicates the completion of additional studies. Therefore we can conclude
that the health network in Nova Iguaçu despite being composed of 72 units is
still insufficient to provide full health care coverage to residents when
compared to the parameters established by the Ministry of Health.
Keywords: Health Systems, Health Planning, Delivery of Health
Care, Nursing Administration Research
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publication must be of the undergraduate research planning: Online Braz J Nurs [online] 2007; 6(0): available at http://www.uff.br/objnursing/index.php.
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Oliveira RS, Andrade M. Describe
the network helth care in the Nova Iguaçu county:
strategy for access to users of the global helath care system. [preview note] Online Braz J. Nurs [online] 2009; 8(1):
available at: http://www.objnursing.uff.br/index.php/nursing/article/view/j.1676-4285.2009.2241.
Address for correspondence: Roberto Santos de Oliveira, Av. Atlântica nº 928 apart. 511, Copacabana. Rio de Janeiro
(RJ), Brazil. CEP: 22010-000. Telefone: 55 (21)
78145919. Email: rsoliver@hotmail.com.