Análise do processo de implementação de políticas de saúde : um estudo de caso baseado no enfoque da política institucional

Abstract

The process of implementation of public policies has emerged as the missing link of government action. Although some studies recognize the importance of this process, this is still a poor stage of analysis methods that give account of its complexity as a way to guarantee him a key position within the public policy analysis cycle. From the adaptation of the institutional policy framework proposed by the French group Strategor, which analyzes an institution under four determinants - strategy, structure, decision and identity -, this study investigates the process of implementing a municipal health policy focused on Hypertensive Diabetics in the city of Venda Nova do Imigrante/ES, evaluated as a successful strategy. As a result, this study showed that the process of policy implementation must be participatory and collegiate decision, with recognition and appreciation of professional autonomy and democratic discussion. Pointed out that the institutional structure should provide a less normative coordination that allows moments of encounter between the core strategic and the operational centers, breaking with the traditional vertical structures. The identity pointed to an appropriation of values and institutional mission and involvement of actors indicating strengthening internal synergies and partnership. The implementation strategy for this municipal policy was considered potent to reverse the logic of the model of care in a learning process, which is the main competitive advantage of success. From these results the Strategor referential proved have potential to analyze this implementation the process indicating matters that collaborate to ensure the implementation stage a prominent position within the public policy cycle.