A universidade e as políticas de educação permanente para a estratégia saúde da família: um estudo de caso

Abstract

This paper presents an exploratory, descriptive case study about seven initiatives of Continuing Education for Family Health professionals, which have been offered by the Federal University of Minas Gerais between 1999 and 2010 as postgraduate courses in response to national policies for massive specialization of Brazilian Primary Health Care workforce. It aimed to describe their general characteristics as well as their background in terms of design, development and implementation. We observed the existence of seven initiatives within four different university units during those years. The Brazilian Ministry of Health is the major inducer of PHC postgraduate courses at the university: it funded, both directly or indirectly, 97.77% of the vacancies during that period. Several mechanisms for transferring resources have been used, despite some issues and transfer delays which have been observed on a recurring basis. The processing of the initiatives' projects in the competent bodies of the university shows issues between the university and health management institutions, such as the Ministry of Health and municipal health departments, since they usually need the courses to be launched in a timely manner, despite the time required to develop them within the university. Integration with services occurs sometimes, especially through service professionals hired as teachers, mentors or tutors. There is no permanent integration among undergraduate courses and the analyzed initiatives. Interaction among PHC postgraduate courses is low, occurring mainly through the coexistence of teachers in two or more initiatives. There are no university policies to stimulate knowledge exchange or experience sharing among the courses. All the studied initiatives stated that problematization is their method of structuring activities, although none of them mentioned a theoretical framework to support it. Evaluative actions have been also observed in all the initiatives, usually aiming to support specific changes or accountability actions, in a non-systematic way and without a specific theoretical framework. None of them performed outcome evaluations. There are no studies within the university about the very policy for massive specialization in family health.