Case study on institutional support in the federal management of Primary Health Care in Brazil

ABSTRACT

The article analyzes the potentialities and the limits of the institutional support function as a strategy to democratize the management of health policies. This aim was investigated in the National Policy of Primary Health Care, in the period between 2011 and 2015. Qualitative epistemology was adopted as methodological perspective, with the use of in-depth interviews, focus groups, and participant observation. The results were assessed through two interpretative cycles. In the first one, of a descriptive nature, we seek to map out assignments, modes of insertion, intervention strategies, and organization of the institutional support work process. In the second cycle, of an analytical nature, the institutional patterns present in this experiment were explored. The theoretical framework of the study was based on the ergological approach and the concept of institution, according to the tradition of French institutionalism. We observed that the institutional support strategy generated and strengthened socio-technical networks articulated in function of the National Policy of Primary Health Care. However, the necessity of implementation of priority programs demands it to be better considered in the design of this management strategy.

KEYWORDS
Primary Health Care; Health management; Organization and administration; Democracy