Um olhar sobre o Conselho Municipal de Saúde de Juiz de Fora: desafios da participação social no contexto do Estado brasileiro

• Ano de defesa: 2014
• Autor(a) principal: Fernando Santana de Paiva
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Minas Gerais; UFMG
• Palavras-chave em Português: Democracia; Conselho de saúde; Política pública de saúde; Participação social; Saúde pública; Psicologia
• Link de acesso: http://hdl.handle.net/1843/BUOS-9QUHCG

The process of (re) democratization of the Brazilian State has contributed to the emergence of the so-called managers councils of public policies, which present as a central feature the inclusion of the civil society actors in the processes of deliberation regarding the social policies. From this scenario, it is necessary to highlight the management councils coming from the health sector, that were formed from the building of the Brazilian Unified Health System (Sistema Único de Saúde - SUS), which has at its core social participation - entered via councils / conferences - as a prime directive. Despite complying as arenas composed by democratic matrices and with deliberative functions in matters related to planning, evaluation and implementation of public policies in this area, such arrangements have faced a number of limitations and challenges to their real concretion. In the essence of the existing different barriers, it is important to note that such experiences are inscribed in a sociopolitical context still permeated by clientelistic and authoritarian characteristics existing within the Brazilian state that pervade such arenas. Furthermore, the councilist spaces - in the health sector - are traversed by problems from the planning and management processes in SUS, eventually forming themselves as obstacles to the exercise itself of participation and democratic deliberation. From what was exposed, the purpose of this study was to understand how the local health council (CMS) of Juiz de Fora conforms as the democratic and deliberative public space in the decision making process, bearing in mind the existence of clientelistic and authoritarian characteristics of the Brazilian state that materialize at the local level, as well as the difficulties regarding the management of SUS that challenge the councilist arena. Therefore, a qualitative research approach took place, having been employed as privileged techniques of data collection the accomplishment of semi-structured interviews with directors and administrators of health, and also document analysis (36 minutes of the meetings of the CMS (2009-2012). The material was analyzed from the content analysis, and the results were presented and discussed from two main categories: a) The board as a democratic public space: among the traditional clientelism and the inclusion of new actors on the political scene; b) The management of SUS and the effects on CMS. From the found results, it was inferred that the CMS health of Juiz de Fora can still live with clientelistic and authoritarian practices that focus on this democratic and deliberative public space. Moreover, the obstacles of the public administration itself may hinder the process of concretion of these arenas in SUS, since its deliberative capacity may be constrained by the lack of planning within the SUS management. Finally, it is considered that the councilist area, in spite of setting up as a public space endowed with democratic potential, still faces factual barriers to its realization, being important to make progress in the training of counselors in relation to deliberate issues within the council, and also strengthen such spaces as opposed to the permanence of "backward" practices which perhaps may still persist in surviving, hindering the materialization of these innovative experiences of Brazilian public management.