A sustentabilidade de iniciativas na gestão do SUS a partir da experiência de Aracaju: entre o instituinte e o instituido

Abstract

This study has as the object the strategies for the sustainability construction of the project Saúde Todo Dia , in the health system of Aracaju, Northeast of Brazil. The aspects studied were the Health Municipality Project, the Permanent Education in Health Policy, the Emergency Medical Mobile Service (SAMU), and the Mental Health Policy, in the period from 2001 to middle 2008. The approach of the object of study was performed through semi-structured interviews with members of the three health administrations of the period, who were connected to the four aspects described. Different trajectories were observed in the studied aspects throughout the administrations, with continuances and discontinuances from which some analysis axis were constructed, such as: Relations between Health Policies and Municipal Policy Dynamics, Acting Ways of Formal Management, Mediations between Management and Health Workers, Articulation between Health Sector Project and Civil Society, and Sustainability Perspectives. Following as the reference concept the Instituting Sustainability , produced during the study, it was concluded that in the Projeto Saúde Todo Dia countless innovations in the care and manegement models were produced, and triggered some construction strategies of sustainability. However, the micropolitics construction initiatives with health workers and community members were more limited, as well as the attempts of the constitution of collective and movements networks with these segments.