目的:分析各机构对地方卫生委员会运行的影响。
方法:定性,描述性和探索性研究。
方法:02圣保罗州内陆城市的初级卫生保健服务,巴西。
方法:24名地方卫生委员会成员和4名关键线人。
方法:由制度分析的理论方法框架支持。数据是通过28次半结构化访谈产生的,观察和参与理事会的活动,并记录在研究日记中。通过转录过程对数据进行组织和分析,换位和重建。
结果:机构在由社会行为者代表的领土上行事,这些社会行为者在初级卫生保健服务中占据职位和职能,证明了等级化的长期存在,专业人员和管理人员的演讲受到了损害,损害了患者和官僚化会议的优势。社会行为者在这些空间中再现了他们所属的集体的理想。
结论:健康管理团队没有认识到在健康领域行动的不同力量,然而,这些力量干扰了所进行的活动和医疗保健。这些团体通过官方代表在正式空间中行事,他们在大学会议和非正式空间中会面和讨论问题,并构成卫生领域的争议力量。
OBJECTIVE: To analyze the influences of the institutions in the operation of the Local Health councils.
METHODS: qualitative, descriptive and exploratory study.
METHODS: 02 Primary Health Care services of a municipality in the inland of the state of São Paulo, Brazil.
METHODS: twenty-four members of the Local Health Councils and 4 key informants.
METHODS: Supported by the theoretical methodological framework of Institutional Analysis. Data were produced through 28 semi-structured interviews, observation and participation in the activities of the councils and recording in the research diary. Data were organized and analyzed by the process of transcription, transposition and reconstitution.
RESULTS: The institutions act in the territories represented by social actors who occupy positions and functions within the Primary Health Care services, evidencing the perpetuation of hierarchization with valorization of the speeches of professionals and managers to the detriment of patients and predominance of bureaucratized meetings. The social actors reproduce the ideals of the collective to which they belong in these spaces.
CONCLUSIONS: The health management teams do not recognize the different forces that act in the health territory, however, these forces interfere in the activities performed and in health care. The groups act both in formal spaces through official representatives who meet and discuss issues in collegiate meetings and in informal spaces, and constitute forces in dispute in the health territory.