A distribuição do poder nos Conselhos Municipais de Saúde: o caso dos municípios de Ubá e de Viçosa MG

• Ano de defesa: 2010
• Autor(a) principal: Martins, Marcelo Feijó
• Orientador(a): Oliveira, Adriel Rodrigues de
• Banca de defesa: Caetano, Sidney Martins , Ferreira, Victor Cláudio Paradela
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal de Viçosa
• Programa de Pós-Graduação: Mestrado em Administração
• Departamento: Administração Pública
• País: BR
• Palavras-chave em Português: Conselhos gestores; Poder; Método posicional; Método decisional
• Palavras-chave em Inglês: Management councils; Power; Positional method; Decision method
• Área do conhecimento CNPq: CNPQ::CIENCIAS SOCIAIS APLICADAS::ADMINISTRACAO::ADMINISTRACAO PUBLICA
• Link de acesso: http://locus.ufv.br/handle/123456789/1945

The advent of new channels of communication between people and the state has become a fundamental instrument of public management, highlighting aspects of the political dynamics of civil society. In this context, there are Public Policies Management Councils. Present in most Brazilian cities, articulated since the federal level, these councils cover a wide range of topics, representing an achievement in terms of building a democratic institutionality. Therefore, while discussing a certain policy, the function of individual institutions, or various meanings of democracy, whatever form or purpose, is to know, most of the time, "who has the power." Considering the critical moment, which the Health sector is going through in this country, this paper aims to analyze power, identifying the groups of advisors who wield power within the decision-making of the Municipal Health Councils of Viçosa and Ubá. In this way, we have identified groups of advisers whose preferences in decision- making prevail over the other, their perception, thecorrelation between possession of material resources, information and staff mobilized by advisers and the power to decide, is the correlation between the institutional positions and strategic power to make decisions. For this analysis, the sample selection of advisers has come through stratified random sampling, where the studied population is divided into homogeneous subgroups. The population of the medical advisers of Viçosa and Ubá (CMS) corresponds, respectively, to 28 and 23 directors, representing a total amount of 61 members. The selected sample for the application of questionnaires in the CMS Viçosa comprised 19 members, and the CMS Uba, 20 counselors, totalling 39 sampling units. The primary collection of data was done through the application of semi-structured questionnaires and direct observation of monthly meetings of the board. The statistical analysis software SPSS was used for the treatment of the obtained data by questionnaire. The appropriate descriptive statistics (frequencies and correlations) for variables in study (examined issues) were obtained, as well as the Chi-square test to verify the relationships of dependence between certain variables. The research made use of the positional methods and decisions to identify the strategic positions and mobilized resources, as well as groups of advisers whose preferences take precedence over those in decision making. The positions, requirements for the exercise of power, according to the positional method, have been identified as the municipal health secretary, president and members of the board of directors, counselors, heads of providers of health services and counselors leaders of organizations and associations in society. In inferential statistical analysis performed by chi-square test, the null hypotheses were rejected, which means that there was no independence between the variables analyzed. Therefore, it is concluded that the decisions are influenced by the preferences of a particular group, which is also responsible for determining the course of action to be followed, and that the larger the resources possessed, the greater is the power to influence those in positions in institutional strategic decisions of the board. In CMS Viçosa, this is the group of health managers, and in CMS Ubá are the representatives of public health insurance patients. The reality of the municipal councils of health in Viçosa and Ubá are quite different, presenting better infrastructure, organization and quality of participation of civil society within the council. The lack of organized social movements in Viçosa's health sector characterizes a relationship without conflict within the council, where the power of decision rests quietly in the hands ofcentralized government. On the other hand, in Ubá, there is a history of struggles of social movements, trade unions, and associations because of the industrial profile of the city. A more articulated society in CMS Ubá results in a higher quality of participation, reflecting its power in decision-making within the Council.