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The production of micro-policies in the work process in oral health: a socio-analytical approach

Oral health care has been gradually consolidated into the Brazilian public health system, though different know-how and practices in the oral health area continue to coexist in the institutions involved, creating an environment of constant dispute. The scope of this paper is to discuss the meanings and effects brought about by an institutional proposal evaluated by a group of professionals in the city of Campinas, State of São Paulo, Brazil, involved in primary oral health care. Based on their everyday work, these professionals evaluated the care they provide and sought to adapt it better to the real needs of the service users and to make it more accessible. The socio-analytical institutional analysis method was used and the results indicated that micro-policies arise from the balance of forces that are established and from the subjectivities that are generated. The most serious challenge for the projects of intervention analyzed by the group was how to overcome "dentalizing" approaches that are highly prevalent in the day-t-to-day activities of oral health care in the Brazilian Unified Health System, not only among its professionals and managers, but also its users as well.

Oral health; Primary health care; Institutional analysis; Public health


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