Coordenação das ações de atenção à saúde bucal na 13ª coordenadoria regional de saúde do Estado do Ceará: percepção da gestão municipal

Abstract

The public health policies, both regional and national, should ensure the effectiveness of aspects to support the integration of actions and coordination of these actions to ensure continuity of care. The purpose of this study was to analyze the perception of oral health coordinators and municipal health secretaries of the seven municipalities that comprise the 13th Coordinating body Regional Health, State of Ceará, in the region of Ibiapaba, about the coordination of actions of oral health care during the year 2010. To this end, we carried out a field study of qualitative approach by applying semi-structured interviews using the technique of Dialectical Hermeneutic Circle with the municipal health and municipal coordinators of oral health, and hermeneutic-dialectical analysis. The study was approved by the Ethics Committee of Universidade Estadual Vale do Acaraú – UVA with number 434369 , and then presented to the Inter-Regional Commission (CIR) for the subject in question knew about the proposal and were then articulated times for meetings. The interviews were conducted from August to September 2011. The results show that: the coordination is carried out in most municipalities partially analyzed, and no dedication of the coordinator. There is a clear lack of integration, commitment, team spirit, leadership and articulation. The oral health coordinators had no knowledge about the management skills necessary for the operation of health practices. The Secretaries of Health believe that the coordination of oral health is very important, but needs much improvement, and signaled the need for the coordinator to improve their relationships with other colleagues and work as a team, and really exert a leadership role. Knowledge of managers influences the dynamic mode of operation and the actions of oral health in primary and secondary. Low wages, poor working conditions, the focus in school, not using medical records, the absence of a policy of continuing education, lack of clinical protocols, bonding and integration shows that it is urgent a break with the old paradigm of health to make a more extended and that paradigm is concerned with the Collective Buccal Health.