Democratization and continuing education: perception of former QualiConselhos students about its contribution to the improvement of health councils

Ouverney, Assis Mafort; Moreira, Marcelo Rasga; Ribeiro, José Mendes

doi:10.1590/0103-11042016S16

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ORIGINAL ARTICLE • Saúde debate 40 (spe) • Dec 2016 • https://doi.org/10.1590/0103-11042016S16 copy

Democratization and continuing education: perception of former QualiConselhos students about its contribution to the improvement of health councils

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

This article examines the extent to which the process of continuing education initiated by the Support Program for the National Policy of Continuing Education for Social Control in the Brazilian Unified Health System - QualiConselhos (Health Council Qualification) has contributed to the improvement of participation in health councils. The research focused on the profile and the context of the health councils, as well as on the knowledge and the daily practice of 1,859 advisors in 26 states. The data was collected through an on-line survey on the course's website. We have concluded that qualification processes are essential for health advisors to better comprehend and improve their performance in health policy decision-making.

KEYWORDS:
Health councils; Citizen participation; Education continuing; Democracy; Health care reform

Analysis Dimensions	Variables
Advisor profile	Segment represented in the council Time active on the council (terms) Participation in elaboration of city health plan Role performed on the council
Context of practice	Perception of the level of council influence on health policy Council participation at the last city health conference Discussion frequency of the city health plan by the council Form of utilization of the city health plan by the council
Objective knowledge of the health plan and conference	Function of the city health plan Content of the city health plan Function of the city health conference Role of the council in relation to the city health plan Evaluation of the city health plan by the council
Council and advisor practice	Enablement for debate on the city health plan with their segment Enablement for discussion of Municipal Health Council (CMS) agendas with the represented segment Enablement for debate on regionalization (Decree 7.508/11) Enablement for use of the Public Health Budget Information System (Siops) as an instrument of social control Enablement to guide the debate at the CMS on intersectoriality Enablement to guide the debate at the CMS on networking with other councils

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E-mail: revista@saudeemdebate.org.br

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[1] Conflict of interests: non-existent

Segment Represented	%	Elaboration of PMS	%
Workers	35,4	Did not participate	40,5
Users	30,6	Once	30,8
No longer an advisor	15,9	Twice	12,4
Managers	13,4	More than twice	16,3
Service providers	4,8
TOTAL	100,0	TOTAL	100,0
Number of Terms	%	Role Performed on the CMS	%
First	39,1	Didn’t have a specific role	25,3
Second	25,4	Participated on committees	26,4
Third	6,5	No longer an advisor/others	18,0
More than 3 terms	9,6	President	11,8
Didn’t respond	3,5	Executive Secretary	8,8
No longer an advisor	15,9	Vice-President	4,4
		Coordinates/directs committees	5,3
TOTAL	100,0	TOTAL	100,0

Influence of the CMS	%	Inclusion of the PMS in meeting agendas	%
High	17,1	At least once	26,3
Low	21,4	Twice	12,8
Average	41,4	More than twice	27,4
None	17,5	Never	8,6
No longer an advisor/didn’t respond	2,6	No longer an advisor/didn’t know how to respond /other	24,9
TOTAL	100,0	TOTAL	100,0
CMS Participation at the last conference	%	Use of the PMS by councils	%
Organized in partnership w/ SMS	44,3	Guides the action of the CMS	8,2
Organized in partnership w/ SMS and social movements	12,8	In the supervision of the SMS	9,3
Elaborated theses/organized by themselves	3	Coordinated with management reports	18,3
Organized in partnership w/ social movements	5	The three previous ways together	8,3
Didn’t participate	4,4	Not taken into account	15
No longer an advisor/didn’t know how to respond /other	30,5	No longer an advisor/didn’t know how to respond /other	40,9
TOTAL	100,0	TOTAL	100,0

Objective of the City Health Plan	%	Role of the CMS in relation to the City Health Plan	%
It guarantees the resources necessary to the health system	10,6	To fund it	0,8
It guides the annual schedule of health actions and services	70,9	To regulate it	4,8
It establishes rules for council action	3,1	To accompany and monitor it	86,4
It presents the achieved results	7,5	To execute it	3,2
Didn’t know how to respond	7,9	Didn’t know how to respond	4,8
TOTAL	100	TOTAL	100
Basis of the City Health Plan	%	Instrument of Evaluation of the City Health Plan	%
Multi-Annual Plan (PPA)	22,8	Annual Management Report	70,7
Meeting minutes of the council	4,9	Budget Directives Law (LDO)	6,4
Analysis of the health situation	57,2	Multi-Annual Plan (PPA)	8,1
Annual Budget Law (LOA)	7,9	City Health Conference	8,5
Didn’t know how to respond	7,2	Didn’t know how to respond	6,3
TOTAL	100,0	TOTAL	100,0

Debate on PMS with their segment	%	Debate of the CMS agendas with their segment	%
No longer an advisor	15,9	No longer an advisor	15,9
It isn’t necessary	0,7	It isn’t necessary	1,2
No, because this theme isn’t on the CMS agenda	5,8	No, because nobody goes to these meetings	4,1
Other	3,4	Other	3,6
Yes and I’ve already scheduled the meeting(s)	13,4	Yes and I’ve already scheduled the meeting(s)	19,5
Yes, but I haven’t scheduled the meetings yet	30,2	Yes, but I will schedule the meetings later	31,8
Yes, but I don’t know when the meetings will be	30,6	Yes, but I don’t know when the meetings will be	23,9
TOTAL	100,0	TOTAL	100,0
Debate on regionalization (Decree 7.508/11)	%	Use of Siops as an instrument of social control	%
No	24,4	No longer an advisor	15,9
No longer an advisor	15,9	I don’t know what Siops is	5,8
Don’t know how to respond	7,7	No, because it’s very difficult to use	3,4
Other	2,4	No, because it isn’t necessary	1,1
Yes, in two meetings	7,3	Other	3,3
Yes, in more than two meetings	20,1	Yes, I already use it	28,2
Yes, in one meeting	22,2	Yes, but I don’t know how to use it	42,3
Total	100,0	Total	100,0
Debate at the CMS on intersectoriality	%	Debate at the CMS about coordination with other councils	%
No longer an advisor	15,9	No longer an advisor	15,9
It isn’t necessary	1,2	It isn’t necessary	4,2
No, the CMS has already tried and it didn’t work	3,2	It isn’t necessary because the CMS already coordinates with these CMS	11,7
No, because the CMS already coordinates	19,8	No, because the CMS has already tried to coordinate and it didn’t work	4,7
Other	4,1	Other	4,2
Yes, and I’ve already listed it	13,9	Yes, and I’ve already listed it	7,7
Yes, but I will list it later	41,8	Yes, but I will list it later	51,6
Total	100,0	Total	100,0