Participatory management in SUS through integrating education, and community service: the experience of a family health league as a project of University extension in Fortaleza - Ceará

As a result of the experience of two public universities and a private one, the Extension Project "Family Health League" (LSF) introduced a participative management strategy in the field of education of health professionals, with the support of power-ideas such as permanent education in health, popular education, multiprofessional and interdisciplinary groups, primary health attention, family health strategy, participative methodologies and practice inserted in a live territory. This report aims to introduce an experience of integrating teaching to community service through the Family Health League Extension Project (LSF), in the context of the Health-School Municipal System (SMSE) in the city of Fortaleza, Ceará, Brazil. This experience was planned in the spirit of participative management in the National Health System (SUS). The proposal of LSF emerges, in the SMSE, from a recommendation supported by the city's health system which aimed at improving co-management spaces of education and services and used the methods of circle discussion and inverted tent. The protagonism of the project members and of the community in the organization of the project's activities and the amplification of a critical view over social reality and health work are amongst the major advances which emerged from this experience. This project has made possible the integration of teaching, health service and community, from the perspective of a communicative and participative management.Fruto da experiência de duas universidades públicas e uma privada, o Projeto de Extensão Liga Saúde da Família (LSF) constitui-se numa estratégia de gestão participativa no campo da formação de profissionais da área da saúde, com base nos conceitos de educação permanente em saúde, educação popular em saúde, equipe multiprofissional e interdisciplinar, atenção primária à saúde, promoção da saúde, estratégia saúde da família, metodologias participativas de pesquisa e atuação inserida no território vivo. Este relato apresenta a experiência da integração ensino-serviço-comunidade por meio do Projeto de Extensão Liga Saúde da Família, no contexto do Sistema Municipal de Saúde Escola (SMSE), em Fortaleza-Ceará, que dialoga com a gestão participativa no Sistema Único de Saúde (SUS). Esta proposta do LSF foi implantada no SMSE a partir de uma ação apoiada pelo sistema de saúde de Fortaleza que visa potencializar os espaços de co-gestão docente-assistencial, por meio da proposta do método da roda e da tenda invertida. O protagonismo dos integrantes e da comunidade na construção das atividades do projeto e a ampliação do olhar crítico sobre a realidade social e do trabalho em saúde estão entre os maiores avanços surgidos dessa experiência. Esse projeto permitiu a integração ensino - serviço - comunidade, atendendo a uma perspectiva de gestão participativa e dialógica

Discursos práticos sobre ocorrências, processos decisórios e decorrências de Conferências Municipais de Saúde

Que significados podem ser evidenciados em discursos de participantes de Conferências Municipais de Saúde acerca de tais eventos, seus processos decisórios e decorrências? Para analisar tais discursos práticos, referidos a eventos ocorridos em seis municípios do Ceará em 2007, realizou-se estudo de casos múltiplos, a partir de análise documental, entrevistas e grupos focais, com análise hermenêutica e dialética. Sobre as ocorrências dos eventos, evidenciam-se as oportunidades de expressão e mobilização de alguns grupos de interesses por demandas específicas, em cenários de interlocução competitiva e busca de mediações políticas visando eficácia simbólica eventual. Dentre as decorrências a partir das decisões deliberadas, destacam-se discursos sobre a negligência de governos municipais na incorporação dessas demandas em suas agendas políticas e na implantação de estratégias institucionais correspondentes. Como, também, a ausência de monitoramento a fim por parte dos respectivos Conselhos Municipais de Saúde.What can be elicited from the discourse analysis of Municipal Health Conferences attendees regarding these meetings, its decision-making processes and results? This is a multiple case study of events that took place in six towns in the State of Ceará (Northeast of Brazil) in 2007, based on documental review, interviews and focus groups, with a hermeneutics and dialectic analysis. Throughout these meetings, there are evidences of the voice and the advocacy of groups with specific requests, under a landscape of competitive dialogue and the search of political mediations pursuing symbolical effectiveness. From the decision-making process point of view, the more relevant elements are the statements concerning the negligence of municipal governments on incorporating these resolutions on their political agenda and its corresponding institutional implantation strategies, as well as the absence of supervision by the Municipal Health Councils

Development of interprofessional collaborative practices within undergraduate programs on healthcare: case study on the Family Health Alliance in Fortaleza (Ceará, Brazil)

The authors present the dynamics of mentoring work within the Family Health Alliance (FHA), an extension program that fosters interprofessional collaboration from a social learning perspective. The objective of this study was to describe and evaluate the program dynamics and their repercussions among the participants. The context, basis, objectives and organization of work situations for students from six different undergraduate programs on health sciences were analyzed by means of an exploratory development study conducted between January and December 2008. In the first phase, the participants were two teams consisting of one mentor and four students. In the second phase, there were three mentors and eight students. Thematic analysis on the students discourse emphasized their enthusiasm about the possibility of interprofessional collaboration as an instrument for change. The professional mentors were found to have developed a better understanding of their role and greater teaching awareness

Development of interprofessional collaborative practices within undergraduate programs on healthcare: case study on the Family Health Alliance in Fortaleza (Ceará, Brazil)

The authors present the dynamics of mentoring work within the Family Health Alliance (FHA), an extension program that fosters interprofessional collaboration from a social learning perspective. The objective of this study was to describe and evaluate the program dynamics and their repercussions among the participants. The context, basis, objectives and organization of work situations for students from six different undergraduate programs on health sciences were analyzed by means of an exploratory development study conducted between January and December 2008. In the first phase, the participants were two teams consisting of one mentor and four students. In the second phase, there were three mentors and eight students. Thematic analysis on the students discourse emphasized their enthusiasm about the possibility of interprofessional collaboration as an instrument for change. The professional mentors were found to have developed a better understanding of their role and greater teaching awareness