Gestão do trabalho e da educação na saúde: uma reconstrução histórica e política

Abstract

The current study tries to evaluate if the managerial processes and organizational structure of the human resources sector in the state and municipal Health Departments address the technical, political and financial investments made by the health work and education managers at national level. It also aims to identify successes and failures, critical points and ways for strengthening this area. It is based in the principle that human resources are a central theme in the development agenda of public health policies and that they are a critical and essential factor for achieving the targets proposed in the planning and implementation of more efficient national health systems. The fact is that, in Brazil, human resources for health managers are facing problems that exist since the establishment of the Unified Health System (SUS). In the recent years, the Ministry of Health, through the Department of Management of Work and Education in Health, is establishing national policy guidelines in this field and is implementing strategies to promote and qualify the management of health labour and education in states and municipalities. This thesis started with a bibliographic and desk review, then used primary data from a survey carried out by the Workstation of IMS/UERJ - Observatory of Human Resources for Health Network. After that, a focus group was formed with those responsible for human resources units in health state departments and their capital cities´ Also, semi -structured interviews were carried out, with national human resources managers and policymakers. It also analyzed the case study of the State of Rio de Janeiro, which first led the organizational model of this area in SUS. The results showed that efforts to implement human resources policy by the federal level have not been able to readdress in a more sustainable way the training and labour processes in the other levels of the health system, within the objectives of the Brazilian health system. Although there were specific changes, the gap between theory and practice remains, which determines a low institutional capacity of the area, both in policies and management.