A promoção da saúde em Belo Horizonte: a visão dos gestores

Abstract

Health promotion is a theoretical field that aggregates a plurality of concepts, meanings, and proposals which influence the implementation of policies in the area of public health. The managers of the municipal health offices are responsible for developing guidelines and actions for the teams working in the public health system. The present study analyzed the understanding of managers of the Municipal Health Department and the Primary Health Care Centers about health promotion in Belo Horizonte city, Brazil. The managers reported the theory and practices of health promotion adopted in the unities under their supervision. The descriptive-exploratory approach using the quantitative-qualitative method was used to carry out this research. The data were collected using self-filled questionnaires which were sent electronically to all managers of Health Department and Health Center in the city. Simultaneously semi-structured interviews were conducted with six managers that were responsible for the coordination of projects in the health promotion field. Of the total of 150 managers in the city, 68 joined the survey. The participants were mostly female, between the ages of 35 and 50, with a postgraduate level of education. The results pointed out that the perception of the health promotion exhibited by the managers is predominantly theoretical with an individualistic point of view, focusing on behavioral and lifestyle change and also on the prevention of diseases and injuries. The managers also recognized the contribution of the social aspects as part of health promotion policy, however, they do not have the same prominence as those associated with the individualistic and behavioral perspective. Thus, a challenge lies in transcending traditional approaches so that health promotion policy can fulfill its role in reducing social inequalities and inequities. A proposal to improve the manager perception would be to incorporate in the spaces of management and health promotion practices, the problematization on topics such as Social Determinants of Health, integrality of care, social participation, citizenship, autonomy, defense of rights, and intersectionality.