O apoio institucional como método de intervenção no processo de trabalho da gestão estadual da Atenção Primária do Rio de Janeiro

Abstract

Institutional support is a methodological resource aimed at diversify traditional management mechanisms by working with the assumption of co-management. The first implications of the institutional support methodology appeared in the municipality of Campinas/SP, developed by Campos (2000) and later the Ministry of Health began the process of formulating and implementing institutional support in the states and municipalities. In the state of Rio de Janeiro, with the change in the organization chart of the State Health Secretariat (SES) in 2007, the Primary Health Care Superintendence was created, one of the pillars of which was the work of co-management and the Institutional Support methodology as a strategy for the state's Primary Health Care Policy. The research is based on a case study of the author's experience within the work process of the Primary Health Care Superintendence (SAPS) of the Rio de Janeiro State Health Department, delving into the Coordination of management support and the work process carried out by the team. The aim of this study was to analyze the trajectory of the Primary Care Superintendence at the SES/RJ and trace the historical path of the construction of the Coordination of Primary Health Care (PHC) management support, from 2007 to 2022, to understand how this institutional support has been presented over the years. To this end, official documents were analyzed, such as resolutions on state co-financing of PHC and all the material produced by the team related to co-management strategies, such as the Permanent PHC Forums, PHC technical group meetings, visits to municipalities and SAPS team meeting reports. The results showed that the power of the institutional supporter can facilitate dialog, broaden the possibilities for reflection and bring relevant offers to the work process and co-management. Permanent education is also an important process in the transformation of the institutional supporter. A priori, it is important to emphasize that an isolated analysis of the management strategy adopted by SAPS/RJ is insufficient to understand an institution's management methods. It is necessary to encourage new studies in this area to improve work management at the SES/RJ. Individuals are influenced and determined by the macro-structure, including the state, with a dispute over hegemony in the institutions as a whole