Abstract
The article aims to analyze the results of a performance assessment model for health councils. The theoretical and methodological frame of reference was the spider graph method, adapted to the reality of health councils. The assessment matrix considered five dimensions with the greatest influence on participation: autonomy, organization, representativeness, community involvement, and political influence. Based on assessment of the indicators, we estimated the performance value for each dimension and located it on the five-axis graph. The matrix was applied to the Health Council in Vitória da Conquista, Bahia State, Brazil. We used document analysis, observation of meetings, and interviews with 18 council members as the data collection techniques. The results show an advanced level of the council's autonomy with adequate structural conditions, but with limitations in financial independence. The organizational dimension reached the maximum level of performance, with regular meetings, availability of information for council members, and functioning of thematic commissions. Representativeness was the dimension with the worst performance, displayed by the weak relationship between the representatives and the organizations. The community involvement dimension displayed an advanced level with high participation by council and non-council members in the meetings and action with numerous proposals. The political influence dimension showed intermediate performance. We observed greater influence by the social representatives on the decision-making process and low capacity for follow-up on policies. The matrix proved adequate and feasible for performance assessment of health councils.
Highlights
The results show an advanced level of the council’s autonomy with adequate structural conditions, but with limitations in financial independence
Representações sociais dos conselheiros municipais acerca do controle social em saúde no SUS
Summary
O artigo tem por objetivo apresentar e analisar os resultados de um modelo de avaliação de desempenho de conselhos de saúde. A avaliação dos mecanismos de envolvimento comunitário se destaca como elemento fundamental para a promoção da efetividade participativa 12. Embora o envolvimento público seja defendido como meio para melhorar a capacidade de resposta dos sistemas de saúde, os benefícios esperados são justificados muito mais em pressupostos teóricos e normativos do que em resultados avaliativos consistentes 4,15,16. A dimensão influência política contempla as relações de poder nos espaços interno (relações estabelecidas entre os conselheiros) e externo (capacidade em acompanhar a implantação das políticas de saúde) do conselho. Os indicadores foram: poder de agenda dos representantes sociais (amplo, moderado, restrito ou insuficiente); conteúdo dos temas pautados e deliberados (prestação de contas e aprovação de relatórios; participação social; organização e funcionamento dos serviços de saúde; estado de saúde da população e políticas públicas abrangentes) e acompanhamento da implantação das políticas (elevado, intermediário ou baixo). Quadro 1 Níveis e características das dimensões avaliativas dos conselhos de saúde
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