A importância das pactuações para a consolidação do sus o pacto pela saúde a evolução dos indicadores do fortalecimento da atenção básica

Abstract

After twenty years of its implementation, the SUS is consolidating itself as the most important public health policy in Brazil. There have been many attempts to establish norms and agreements over goals in order to develop improvements on the quality of health of the population. The “Pact for Health” of 2006 is a national instrument of negotiation between the three levels –federal, state and municipal- of management of the SUS, established in 2007. The present study uses the Statistical Process Control methodology to evaluate the influence of the “Pact for Health” 2006 on the indicators monitoring the goal of strengthening Primary Care in the city of Sobral, computing the results from five years before and after the implementation of the Pact. The selected six indicators comprise the goal of strengthening Primary Care: the proportion of the population registered by the Family Health Strategy; the proportion of births to mothers with four or more prenatal consultations; the rate of hospitalizations for diabetes mellitus and its complications; the rate of hospitalizations for stroke; and the number of visits by the Health Community Agent. The results reveal different situations after the Statistical Process Control analysis: the proportion of the population registered by the Family Health Strategy and the number of visits by the Health Community Agent showed no change comparing the periods before and after the “Pact for Health”. The Statistical Process Control charts of the remaining four indicators showed non-random variations demonstrating process changes.