Conselhos Municipais de Saúde da 15ª Regional de Saúde do Paraná : potencialidades e fragilidades

Abstract

The creation of the Municipal Health Councils (CMS) was a battle of Brazilian society that became a legal requirement, which demonstrates the importance of community participation in organization of health policies. The objective of this study was to evaluate the performance of the Municipal Health Councils of the 15th Regional Health of the State of Paraná. An exploratory and descriptive study in the field of evaluative research conducted in different stages, however complementary. In Stage 1 we analyzed the data of 399 CMS Paraná, available in the database of the National Register of Health Councils, of the years 2007 and 2008. We used information from 319 (79.9%) of the municipalities, because one had not completed the registration and 79 (19.8%) were inconsistent. The median total number of counselors in municipalities with populations of up to 20 thousand inhabitants was 12, between 20 to 50 thousand inhabitants were 16 and above 50 thousand were 22 counselors. In all municipalities, user representatives presented a rate consistent with the law, as in 39.3% of those with up to 20 thousand did not have 25% of employee representation. In 72.2% of the municipalities, the meetings were held monthly. In 50.6% of the municipalities, the directors received no training to take office. In Stage 2, interviews were conducted with representatives of segment of users of the CMS 15 (50%) municipalities of the 15th Regional Health (RS) of PR. There was a predominance of females over males in the population interviewed, and the average age by sex, 54.6 to 52.7, respectively. Most of them had graduation and only one had training in healthcare. Nine of them said they had received training course for counselors. As for the area that was being applied most resources from municipalities to health, seven respondents agreed that was being allocated to primary care. In Stage 3, was the non-participant observation, analysis of the minutes of three ordinary meetings and interview with a representative of the municipality CMS headquarters of the 15th RS - PR. The CMS had a total of 32 members, board composed by: President, Vice-President, 1st and 2nd Secretary. The minutes of meetings were signed by 71.88%, 68.75% and 75% of the holders, respectively. The president was representative of users and leading meetings. However, there was an informal leadership group, which represented the segment of workers. There were counselors who were not verbally expressed, only voted when necessary. The internal committees were comprised of members of the CMS entities and other institutions that used the spaces for meetings to issue opinions on matters relevant to them. We conclude that given the breadth of the role of counselors, there is a need to be able to perform such a function. Thinking about health care professionals in this context, it is realizes the need for an academic education with a curriculum focused on content that will insert him into the issues of citizenship and social control.