Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS
Ano de defesa: | 2021 |
---|---|
Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Tese |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de São Carlos
Câmpus São Carlos |
Programa de Pós-Graduação: |
Programa de Pós-Graduação em Ciência, Tecnologia e Sociedade - PPGCTS
|
Departamento: |
Não Informado pela instituição
|
País: |
Não Informado pela instituição
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | https://repositorio.ufscar.br/handle/ufscar/14262 |
Resumo: | This thesis assumes that the practice of the actions of municipal pharmaceutical services is not articulated with the conception of public policies conquered to guarantee access and the rational use of medicines. The review of the historical trajectory of pharmaceutical services policies in Brazil indicated an attempt to change the conformation of the logistic arrangement, when the perspective of pharmaceutical care was instituted with the user, already established in other countries, as a right to comprehensive health care. The need to guarantee inputs and medicines for the country's care, especially in situations such as public health emergencies, as in the recent COVID-19 pandemic, waved to the importance of the pharmaceutical area in ensuring the biopsychosocial aspects. Several actions have been institutionalized by the Ministry of Health and other interconnected sectors, with investments and guidelines to set up pharmaceutical services management in all government spheres and levels of care of the Unified Health System. In São Carlos, in the state of São Paulo, observations and experiences have shown that many of these policies have not achieved their intended results. This study aimed to analyze the public policies for pharmaceutical assistance in this city, under the perception of its actors and the view of the Science, Technology and Society (STS) field, as a way to investigate the subjective meanings, little detected in this scenario. The qualitative health research method was used in two stages: the consultation of the information provided by the official website of the municipality and the fieldwork. As a data collection tool, it was used a semi-structured interview with twelve public service workers of municipal pharmacy, followed by a dialectical hermeneutic analysis. We obtained the approval of the Ethical Committee on Human Research of the Federal University of São Carlos for the survey. The results indicate that most participants are women and permanent employees of City Hall. Five categories of analysis emerged and were able to be visualized from a cloud of words with the corpus of interviews. Not much information was found on the official website, making the path of the citizen difficult. It emerged in this context the existence of deficient human resources, precarious physical structure, little polished computerized system, numerous demands, lack of orientation and care to the user, dissatisfaction with the way of working, delimitation in the adjustment programs, and not full adequacy to the norms imposed by the pandemic, causing risks to the workers and users. The Pharmacy and Therapeutics Commission and the Municipal List of Essential Medicines were achievements, with several pharmaceutical specialties, ensuring access to treatment for many health problems. They have also been ineffective as instruments for the rational use of medicinal products. The analysis reveals differences in the structure, organization, management, and practices of local pharmaceutical services concerning the guidelines that shape public policy in the region in Brazil. It is essential that the needs of the population have priority over political interests, and it is up to public managers to direct efforts towards this achievement. The configuration of the actors involved in a network, supported by multi-professional actions in primary care, participatory management in the system, and pharmaceutical care contribute to the strengthening and (re)orientation to an adequate practice, deconstructing the approach of pharmaceutical services, public policy as simple drug delivery, with activity planning, effective technical conducts, health education, defense of the integrality of assistance and the right to life. |
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Chenchi, Luiz HenriqueMachado, Maria Lúcia Teixeirahttp://lattes.cnpq.br/5703683100332513http://lattes.cnpq.br/1892228305258753b13c75c2-c25a-4a27-8fbd-e80dc06a0ef42021-05-14T17:13:35Z2021-05-14T17:13:35Z2021-02-25CHENCHI, Luiz Henrique. Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS. 2021. Tese (Doutorado em Ciência, Tecnologia e Sociedade) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/14262.https://repositorio.ufscar.br/handle/ufscar/14262This thesis assumes that the practice of the actions of municipal pharmaceutical services is not articulated with the conception of public policies conquered to guarantee access and the rational use of medicines. The review of the historical trajectory of pharmaceutical services policies in Brazil indicated an attempt to change the conformation of the logistic arrangement, when the perspective of pharmaceutical care was instituted with the user, already established in other countries, as a right to comprehensive health care. The need to guarantee inputs and medicines for the country's care, especially in situations such as public health emergencies, as in the recent COVID-19 pandemic, waved to the importance of the pharmaceutical area in ensuring the biopsychosocial aspects. Several actions have been institutionalized by the Ministry of Health and other interconnected sectors, with investments and guidelines to set up pharmaceutical services management in all government spheres and levels of care of the Unified Health System. In São Carlos, in the state of São Paulo, observations and experiences have shown that many of these policies have not achieved their intended results. This study aimed to analyze the public policies for pharmaceutical assistance in this city, under the perception of its actors and the view of the Science, Technology and Society (STS) field, as a way to investigate the subjective meanings, little detected in this scenario. The qualitative health research method was used in two stages: the consultation of the information provided by the official website of the municipality and the fieldwork. As a data collection tool, it was used a semi-structured interview with twelve public service workers of municipal pharmacy, followed by a dialectical hermeneutic analysis. We obtained the approval of the Ethical Committee on Human Research of the Federal University of São Carlos for the survey. The results indicate that most participants are women and permanent employees of City Hall. Five categories of analysis emerged and were able to be visualized from a cloud of words with the corpus of interviews. Not much information was found on the official website, making the path of the citizen difficult. It emerged in this context the existence of deficient human resources, precarious physical structure, little polished computerized system, numerous demands, lack of orientation and care to the user, dissatisfaction with the way of working, delimitation in the adjustment programs, and not full adequacy to the norms imposed by the pandemic, causing risks to the workers and users. The Pharmacy and Therapeutics Commission and the Municipal List of Essential Medicines were achievements, with several pharmaceutical specialties, ensuring access to treatment for many health problems. They have also been ineffective as instruments for the rational use of medicinal products. The analysis reveals differences in the structure, organization, management, and practices of local pharmaceutical services concerning the guidelines that shape public policy in the region in Brazil. It is essential that the needs of the population have priority over political interests, and it is up to public managers to direct efforts towards this achievement. The configuration of the actors involved in a network, supported by multi-professional actions in primary care, participatory management in the system, and pharmaceutical care contribute to the strengthening and (re)orientation to an adequate practice, deconstructing the approach of pharmaceutical services, public policy as simple drug delivery, with activity planning, effective technical conducts, health education, defense of the integrality of assistance and the right to life.Esta tese pressupõe que a prática das ações da assistência farmacêutica (AF) municipal não se articula com a concepção das políticas públicas conquistadas para garantia de acesso e uso racional de medicamentos. A retomada da trajetória histórica das políticas de AF no Brasil indicou uma tentativa de mudança de conformação do arranjo logístico, ao se instituir a perspectiva do cuidado farmacêutico com o usuário, já estabelecida em outros países, como direito à atenção integral em saúde. A necessidade de garantir insumos e medicamentos para atendimento do país, despontada principalmente em situações como as de emergência em saúde pública, como na recente pandemia COVID-19, acenaram para a importância da área farmacêutica em assegurar os aspectos biopsicossociais. Várias ações se institucionalizaram pelo Ministério da Saúde (MS) e outros setores interligados, com investimentos e diretrizes para configurar a gestão da AF em todas as esferas de governo e níveis de atenção do Sistema Único de Saúde (SUS). Na cidade de São Carlos-SP, observações e vivências permitiram perceber que muitas dessas políticas não alcançavam os resultados. Assim, este estudo teve como objetivo analisar as políticas públicas de assistência farmacêutica nesse município, sob a percepção de seus atores e o olhar do campo Ciência, Tecnologia e Sociedade (CTS), como caminho de investigação das acepções subjetivas, pouco detectadas neste cenário. Utilizou-se o método de pesquisa qualitativa em saúde, em duas etapas da investigação: consulta das informações disponibilizadas pelo site oficial do município e o trabalho de campo. Empregou-se, como instrumento de coleta de dados, a entrevista semiestruturada com doze sujeitos trabalhadores de serviços públicos de farmácia municipal, seguida da análise hermenêutica dialética. Obteve-se a aprovação do Comitê de Ética em Pesquisa em Seres Humanos da Universidade Federal de São Carlos (CEP/UFSCar) para a investigação. Os resultados indicaram que a maior parte dos participantes é do sexo feminino e concursados efetivos da Prefeitura Municipal. Cinco categorias de análise emergiram e puderam ser visualizadas a partir de uma nuvem de palavras com o corpus das entrevistas. Poucas informações foram localizadas no site oficial, dificultando o caminho do cidadão. Emergiram neste contexto a existência de: recursos humanos deficientes, estrutura física precária, sistema informatizado pouco lapidado, demanda numerosa, falta de orientação e cuidado ao usuário, descontentamento com a forma de trabalho, delimitação no ajustamento dos programas e não adequação plena às normas impostas pela pandemia, acarretando riscos aos trabalhadores e usuários. A Comissão de Farmácia e Terapêutica (CFT) e a Relação Municipal de Medicamentos Essenciais (REMUME) se revelaram conquistas bem-sucedidas, com diversas especialidades farmacêuticas, garantindo acesso ao tratamento a amplo número de agravos à saúde. Por outro lado, não se efetivaram enquanto instrumentos ao uso racional de medicamentos. A análise revela discrepâncias na estrutura, organização, gestão e práticas da AF local, em relação aos norteamentos que configuram as políticas públicas da área no Brasil. É fundamental que o atendimento às necessidades da população se sobreponha a interesses políticos, cabendo aos gestores públicos direcionar esforços para esse cumprimento. A configuração dos atores envolvidos em rede, apoiada nas ações multiprofissionais na atenção básica, gestão participativa no sistema e cuidados farmacêuticos contribuem para o fortalecimento e (re)orientação à uma prática adequada, desconstruindo o enfoque de política pública de AF como simples entrega de medicamentos, com planejamento das atividades, condutas técnicas eficazes, educação em saúde, defesa da integralidade da assistência e do direito à vida.Não recebi financiamentoporUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Ciência, Tecnologia e Sociedade - PPGCTSUFSCarAttribution-NonCommercial-NoDerivs 3.0 Brazilhttp://creativecommons.org/licenses/by-nc-nd/3.0/br/info:eu-repo/semantics/openAccessCiência, Tecnologia e SociedadePolíticas públicas de saúdeConhecimentos, atitudes e práticas em saúdeServiços de assistência farmacêuticaScience, Technology and SocietyPublic health policyHealth knowledge, attitudes, practicePharmaceutical servicesCIENCIAS DA SAUDE::FARMACIAOUTROS::CIENCIASCIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICAAssistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTSPharmaceutical services as a public policy in São Carlos state of São Paulo: a view through the STS fieldinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/doctoralThesis600600ce98a879-a956-475f-869c-79c3b7f65421reponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARORIGINALTESE DOUTORADO PPGCTS LUIZ HENRIQUE CHENCHI.pdfTESE DOUTORADO PPGCTS LUIZ HENRIQUE CHENCHI.pdfTese de Doutorado pelo Programa de Pós-graduação em Ciência, Tecnologia e Sociedadeapplication/pdf2664313https://repositorio.ufscar.br/bitstream/ufscar/14262/4/TESE%20DOUTORADO%20PPGCTS%20LUIZ%20HENRIQUE%20CHENCHI.pdf1bd3b297c89f21837b09a2eb81000714MD54Carta_Comprovante_Tese_V.final_Luiz H Chenchi.pdfCarta_Comprovante_Tese_V.final_Luiz H Chenchi.pdfCarta Comprovante do Texto Final da Tese de Luiz Henrique Chenchiapplication/pdf123133https://repositorio.ufscar.br/bitstream/ufscar/14262/2/Carta_Comprovante_Tese_V.final_Luiz%20H%20Chenchi.pdf32c3ff5d793abbb9ece00e097cfb876bMD52CC-LICENSElicense_rdflicense_rdfapplication/rdf+xml; charset=utf-8811https://repositorio.ufscar.br/bitstream/ufscar/14262/5/license_rdfe39d27027a6cc9cb039ad269a5db8e34MD55TEXTTESE DOUTORADO PPGCTS LUIZ HENRIQUE CHENCHI.pdf.txtTESE DOUTORADO PPGCTS LUIZ HENRIQUE CHENCHI.pdf.txtExtracted texttext/plain335577https://repositorio.ufscar.br/bitstream/ufscar/14262/6/TESE%20DOUTORADO%20PPGCTS%20LUIZ%20HENRIQUE%20CHENCHI.pdf.txt50111a34fd4ccd8ce13069bd6f965499MD56Carta_Comprovante_Tese_V.final_Luiz H Chenchi.pdf.txtCarta_Comprovante_Tese_V.final_Luiz H Chenchi.pdf.txtExtracted texttext/plain1235https://repositorio.ufscar.br/bitstream/ufscar/14262/8/Carta_Comprovante_Tese_V.final_Luiz%20H%20Chenchi.pdf.txt4c74b5fa841d6fe6dd57d959f5c842c8MD58THUMBNAILTESE DOUTORADO PPGCTS LUIZ HENRIQUE CHENCHI.pdf.jpgTESE DOUTORADO PPGCTS LUIZ HENRIQUE CHENCHI.pdf.jpgIM Thumbnailimage/jpeg6447https://repositorio.ufscar.br/bitstream/ufscar/14262/7/TESE%20DOUTORADO%20PPGCTS%20LUIZ%20HENRIQUE%20CHENCHI.pdf.jpgf1de6ebd131e0e0311242b406411a336MD57Carta_Comprovante_Tese_V.final_Luiz H Chenchi.pdf.jpgCarta_Comprovante_Tese_V.final_Luiz H Chenchi.pdf.jpgIM Thumbnailimage/jpeg13146https://repositorio.ufscar.br/bitstream/ufscar/14262/9/Carta_Comprovante_Tese_V.final_Luiz%20H%20Chenchi.pdf.jpg717aeca527c7f82dcf235719f54534edMD59ufscar/142622023-09-18 18:32:10.75oai:repositorio.ufscar.br:ufscar/14262Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-09-18T18:32:10Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false |
dc.title.por.fl_str_mv |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
dc.title.alternative.eng.fl_str_mv |
Pharmaceutical services as a public policy in São Carlos state of São Paulo: a view through the STS field |
title |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
spellingShingle |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS Chenchi, Luiz Henrique Ciência, Tecnologia e Sociedade Políticas públicas de saúde Conhecimentos, atitudes e práticas em saúde Serviços de assistência farmacêutica Science, Technology and Society Public health policy Health knowledge, attitudes, practice Pharmaceutical services CIENCIAS DA SAUDE::FARMACIA OUTROS::CIENCIAS CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA |
title_short |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
title_full |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
title_fullStr |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
title_full_unstemmed |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
title_sort |
Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS |
author |
Chenchi, Luiz Henrique |
author_facet |
Chenchi, Luiz Henrique |
author_role |
author |
dc.contributor.authorlattes.por.fl_str_mv |
http://lattes.cnpq.br/1892228305258753 |
dc.contributor.author.fl_str_mv |
Chenchi, Luiz Henrique |
dc.contributor.advisor1.fl_str_mv |
Machado, Maria Lúcia Teixeira |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5703683100332513 |
dc.contributor.authorID.fl_str_mv |
b13c75c2-c25a-4a27-8fbd-e80dc06a0ef4 |
contributor_str_mv |
Machado, Maria Lúcia Teixeira |
dc.subject.por.fl_str_mv |
Ciência, Tecnologia e Sociedade Políticas públicas de saúde Conhecimentos, atitudes e práticas em saúde Serviços de assistência farmacêutica |
topic |
Ciência, Tecnologia e Sociedade Políticas públicas de saúde Conhecimentos, atitudes e práticas em saúde Serviços de assistência farmacêutica Science, Technology and Society Public health policy Health knowledge, attitudes, practice Pharmaceutical services CIENCIAS DA SAUDE::FARMACIA OUTROS::CIENCIAS CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA |
dc.subject.eng.fl_str_mv |
Science, Technology and Society Public health policy Health knowledge, attitudes, practice Pharmaceutical services |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::FARMACIA OUTROS::CIENCIAS CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA |
description |
This thesis assumes that the practice of the actions of municipal pharmaceutical services is not articulated with the conception of public policies conquered to guarantee access and the rational use of medicines. The review of the historical trajectory of pharmaceutical services policies in Brazil indicated an attempt to change the conformation of the logistic arrangement, when the perspective of pharmaceutical care was instituted with the user, already established in other countries, as a right to comprehensive health care. The need to guarantee inputs and medicines for the country's care, especially in situations such as public health emergencies, as in the recent COVID-19 pandemic, waved to the importance of the pharmaceutical area in ensuring the biopsychosocial aspects. Several actions have been institutionalized by the Ministry of Health and other interconnected sectors, with investments and guidelines to set up pharmaceutical services management in all government spheres and levels of care of the Unified Health System. In São Carlos, in the state of São Paulo, observations and experiences have shown that many of these policies have not achieved their intended results. This study aimed to analyze the public policies for pharmaceutical assistance in this city, under the perception of its actors and the view of the Science, Technology and Society (STS) field, as a way to investigate the subjective meanings, little detected in this scenario. The qualitative health research method was used in two stages: the consultation of the information provided by the official website of the municipality and the fieldwork. As a data collection tool, it was used a semi-structured interview with twelve public service workers of municipal pharmacy, followed by a dialectical hermeneutic analysis. We obtained the approval of the Ethical Committee on Human Research of the Federal University of São Carlos for the survey. The results indicate that most participants are women and permanent employees of City Hall. Five categories of analysis emerged and were able to be visualized from a cloud of words with the corpus of interviews. Not much information was found on the official website, making the path of the citizen difficult. It emerged in this context the existence of deficient human resources, precarious physical structure, little polished computerized system, numerous demands, lack of orientation and care to the user, dissatisfaction with the way of working, delimitation in the adjustment programs, and not full adequacy to the norms imposed by the pandemic, causing risks to the workers and users. The Pharmacy and Therapeutics Commission and the Municipal List of Essential Medicines were achievements, with several pharmaceutical specialties, ensuring access to treatment for many health problems. They have also been ineffective as instruments for the rational use of medicinal products. The analysis reveals differences in the structure, organization, management, and practices of local pharmaceutical services concerning the guidelines that shape public policy in the region in Brazil. It is essential that the needs of the population have priority over political interests, and it is up to public managers to direct efforts towards this achievement. The configuration of the actors involved in a network, supported by multi-professional actions in primary care, participatory management in the system, and pharmaceutical care contribute to the strengthening and (re)orientation to an adequate practice, deconstructing the approach of pharmaceutical services, public policy as simple drug delivery, with activity planning, effective technical conducts, health education, defense of the integrality of assistance and the right to life. |
publishDate |
2021 |
dc.date.accessioned.fl_str_mv |
2021-05-14T17:13:35Z |
dc.date.available.fl_str_mv |
2021-05-14T17:13:35Z |
dc.date.issued.fl_str_mv |
2021-02-25 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/doctoralThesis |
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dc.identifier.citation.fl_str_mv |
CHENCHI, Luiz Henrique. Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS. 2021. Tese (Doutorado em Ciência, Tecnologia e Sociedade) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/14262. |
dc.identifier.uri.fl_str_mv |
https://repositorio.ufscar.br/handle/ufscar/14262 |
identifier_str_mv |
CHENCHI, Luiz Henrique. Assistência farmacêutica enquanto política pública no município de São Carlos-SP: um olhar a partir do campo CTS. 2021. Tese (Doutorado em Ciência, Tecnologia e Sociedade) – Universidade Federal de São Carlos, São Carlos, 2021. Disponível em: https://repositorio.ufscar.br/handle/ufscar/14262. |
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Attribution-NonCommercial-NoDerivs 3.0 Brazil http://creativecommons.org/licenses/by-nc-nd/3.0/br/ |
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openAccess |
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Universidade Federal de São Carlos Câmpus São Carlos |
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Universidade Federal de São Carlos Câmpus São Carlos |
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