Sistema de Informação da Atenção Básica (SIAB) como instrumento de poder

Abstract

The Informational System of Primary Health Care (SIAB) is used by Family Health Teams(ESF) across the country, generating a large quantity of data. However, since its creation,the ISPC has shown many weaknesses that compromise its efficiency. It is believed that theinefficiency of this system may reflect the power relations established in their informationalpractice. This study aims to analyze the consequences of these power relations on the SIAB.We interviewed managers, technicians and administrative professionals who use andanalyze the data from SIAB, at federal, state and municipal levels. The organization and dataanalysis was based on "Thematic content analysis." Six categories emerged after theanalysis, and they are: Category 1: The use of the SIAB for exercise and maintenance ofpower relations / biopower at different levels of management at Primary Health Care,Category 2: SIAB and its inefficiency: Consequences of relations of power / biopowerestablished; Category 3: The information flow SIAB: actors and processes under the aegis offorces modulating, Category 4: Manipulation of data in the information flow of the SIAB: thepower play, Category 5: Training of professionals for use of the SIAB: maintaining the statusquo informational, Category 6: Improvements needed in the SIAB: beyond the technologicalimperative. In the first one was found that the SIAB has been used as a tool to maintainpower / biopower relations that are hegemonic in the health field. This occurs through theuse of SIAB information in the discipline of the individual body and in the regulation ofpopulations. The second category shows the centralization of SIAB information at the federallevel, which leads to a scenario of less local planning and interventions. In category 3 theinformation flow of the SIAB was described and shown to be directed in order to favor stateand federal management. In category 4 it was found that data manipulation of SIAB occursmainly at the local level to ensure compliance with the agreed goals, but, indirectly, isstimulated by other levels of management. In Category 5 it was observed that the training ofprofessionals related to the SIAB does not happen systematically and it is usually nonexistent.This has contributed to maintain the status quo of information. Finally, in category 6,it is shown the needs for improving the SIAB and the processes attached to it. Weemphasize that the need for changes in this system goes beyond reformulation guided by theprevailing technology. You have to adapt the SIAB to local conditions, the model of care andsocial changes. It is necessary to appreciate the centrality of people in the information flow ofthe SIAB. Here may be the opportunity to form a counter-power that balances the forcecrossed the informational flow system and the practice of this informational Brazil. Inconclusion, the informational practice related to SIAB has nurtured dominant interests in thecontext of primary health care. In one hand, SIAB has been used to enlarge the watchful eyeof several management levels, and on the other, it has been used as an instrument to denythe populations reality, as well as a technological device used to maintain political andeconomic interests.