A intersetorialidade no Programa Saúde na Escola no município de Belo Horizonte, MG

Abstract

Intersectoriality is nowadays one of the most debated subjects in the field of public policies. It is general agreement the importance of building a privileged strategy to face complex social problems. This paper has studied the development of an intersectoral policy the School Health Program (PSE) (Programa Saúde na Escola) at Belo Horizonte, Minas Gerais, Brazil. A case study was performed using the triangulation of methods in order to understand intersectoriality in the field of management as well as in the development of the proposed actions. At first our focus was on the federal and municipal rules concerning the Municipal intersectoral Working Group (GTI-M) which plays a role in the intersectoral management of the program. The rules were published on governmental journals from January 2008 to March 2014. Data published on Diário Oficial do Município from January 2007 to October 2014 concerning the PSE were reviewed in order to understand the settlement and the evolution of PSE in the municipality. An online semi-structured questionnaire was distributed to the members of the GTI-M and to the regional coordinators in order to check their point of view on the program. For the qualitative data a descriptive analysis was carried out. Quantitative data were analysed using the technique of content analysis and the NVivo 10 software. Our results show that GTI-M acts as a potentially promoting instance of the intersectoriality through their composition, way of acting, management and capacity. Published data on PSE showed its relevant role as an institution either because of the great amount of published articles (n=54) in the forementioned period or because it is part of health improvement programmes namely BH objectives and results (BH Metas e Resultados) and the other called improving education (Melhoria da Qualidade da Educação). Nevertheless, not much emphasis is given on the role of the teachers, members of the Family Health Team, students or their family in actively planning and developing the strategies. Those gaps led us to ask which fundamental of intersectoriality supports the planning and performance of the program. The analysis of the questionnaire answers show an emptying of the GTI-M. Only 52.2% of its members take part regularly on the activities, which shows fragility on the management and development of intersectoral actions in the PSE. The great potential of the GTI-M coming from its formal structure and the so called institutional importance of the PSE don´t echo on is its management nor on the actions developed. There was no synergy between the actors and sectors. Innovation on the health policy actions was not seen. There is a gap between the written rules and the settlement of the PSE. An intersectoral thinking and acting is still in its very beginning.