Abstract
Abstract The implementation of a medical course in a city in the Brazilian northeastern region to expand and decentralize medical education as a result of the Project More Doctors for Brazil includes the institutionalization process that takes into consideration cultural and organizational aspects that facilitate or hinder the accomplishment of innovative practices. This study analyzed the implementation process according to key categories: pedagogical project, teaching-service integration, teacher development and infrastructure. The results showed facilitating elements and barriers that depend on the movement among the proposal’s instituted forces, instituting forces and the institutionalization process. A strategy for greater feasibility can be found in autonomous movements triggered by subjects who are committed to the objectives of the involved courses and institutions that work towards making legislations and intentions real.
Highlights
In 2011, Decree no. 75081 was ratified, regulating the law that created the Brazilian National Health System (SUS)
Care gaps were identified in several Brazilian regions, among states and cities, aggravating the social vulnerability of people who live in those places
In the implementation of innovative proposals, it is possible to identify moments in the process that, according to Lourau14, contemplate universality aspects. They are: the preestablished justification, rules, regulations and conditions to the implementation related to the total number of implemented courses in Brazil; the particularity moment related to different contexts presented by each institution as structural, functional and mission effectiveness conditions; the singularity moment or aspects resulting from local strategies and movement that build tools for the success or failure of the implementation of what is suggested
Summary
In 2011, Decree no. 75081 was ratified, regulating the law that created the Brazilian National Health System (SUS). 75081 was ratified, regulating the law that created the Brazilian National Health System (SUS) It determined organizational concepts, such as health regions and territories, and regulated the relationship among managers in the promotion of universal access to the system’s health services. These questions provide results that base the article’s contribution, i.e., to analyze the existing barriers and easiness in the institutional culture established in the structures, processes, relationships and social imaginary These barriers and easiness become visible upon the implementation of a policy related to the education and distribution of doctors in Brazil, according to the logic of equal access
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