As relações produzidas no cotidiano da gestão na Estratégia Saúde da Família num dos municípios da Região Metropolitana da Grande Vitória : os discursos dos gestores

Abstract

This paper discusses aspects related to the production of the work process in the daily management of the Family Health Strategy (FHS) in a county of the Espírito Santo, from the speeches of the managers themselves involved in the process. This study also enhances the discussion of the production of the institutional relationships in this context. In this context, are also addressed issues that relate to the work process on the day of this service. The methodological approach was guided by the qualitative approach. Thus, it was used as a methodological tool for data collection a direct observation of a team work of FHS, a construction of a field journal and also individual semistructured interviews with managers (health commissioner, basic health care coordinator, a FHS core member and the family health center coordinator) of FHS that municipality. From the fieldwork and analysis of the material that was produced, we can learn a routine marked by own subjectivities of each professional, a routine that is built from the relationships produced in each activity scenario between managers and health professionals and between managers and users. In general, the speeches of the managers show a complex day-to-day operation. Moreover, it is observed that the activities for decision making are focusing on the role of formal health institution manager. The organization chart of the county health department reinforces the hierarchy of relationships, especially those relating to decision making, so that it can be observed that it is a day-to-day marked by tensions, conflicts and control. The relations produced are based on power relations, perpetuating characteristics of a classic management, despite the designing and the attempting to perform a management based on co-management.