Abstract
Abstract Objectives: To evaluate the performance of the regionalization of the Vigilância em Saúde (VS) (Health Surveillance) in a region in Sao Paulo State. Methods: a quantitative cross-sectional study was carried out at the V Diretoria Regional de Saúde da Secretaria de Saúde do Estado de São Paulo (V Board of the Regional Health Secretary of São Paulo State Health Department). A structured questionnaire was developed from the three dimensions of the research (Policy, Structure and Organization). The escore médio (EM) (average score) was used as the central tendency and for each dimension and attributes, the synthetic indices were constructed. Three cutoff points for assessing the performance were assigned: values equal to or below 4.99 were considered unsatisfactory; between 5.00 and 6.99, intermediaries; and equal to or above 7.00, satisfactory. Results: The performance of the regionalization of the VS was considered satisfactory, with emphasis on the 'Policy' (EM 8.51) and 'Organization' (EM 8.18) dimensions. The ‘Structure’ obtained intermediate performance (EM 6.78). The proposed methodology demonstrated to be appropriate to evaluate the performance of the regionalization of VS, because its strengths and weaknesses were allowed to be identified. Conclusions: despite of the regionalization is an ongoing process, it is necessary for the establishment of a political project that will take up effectively as a strategy for the reorganization of the healthcare in Brazil.
Highlights
In Brazil, during the 1990s, the prioritized strategy by the National policy to construct a universal health system, equitable and integral was the decentralization, having as its main focus the city
The balance that made this decentralization model adopted by the Sistema Único de Saúde (SUS) (Public Health System) is that, initially, it was important for the expansion of coverage in services and public resources from the State and City spheres, but they were not able to provide the integration of services, institutional and practices in the territories, nor the arrangements of the most cooperative formation in health.[1]
In Brazil, despite the large number of initiatives destined to SUS consolidation and the existence of several projects driven toward the evaluation of innovations that have been deployed, there is no initiative to assess the performance of the Sistema Nacional de Vigilância em Saúde (SNVS) regionalization, as a large part of the evaluations of the Vigilância em Saúde (VS) is facing its decentralization process by focusing in the city
Summary
In Brazil, during the 1990s, the prioritized strategy by the National policy to construct a universal health system, equitable and integral was the decentralization, having as its main focus the city. The balance that made this decentralization model adopted by the Sistema Único de Saúde (SUS) (Public Health System) is that, initially, it was important for the expansion of coverage in services and public resources from the State and City spheres, but they were not able to provide the integration of services, institutional and practices in the territories, nor the arrangements of the most cooperative formation in health.[1] the conditions for a decentralization project that adhered to the purposes of the National health policy were not achieved. It is known that the characteristics of the decentralized health systems are quite heterogeneous in National territory, and they reflect on different financial, administrative and operational capacities for the healthcare provision and the distinct policy provisions of the governments.[4]
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