https://repositorio.ufpb.br/jspui/handle/123456789/21690 PPGSC 2026-07-25T23:04:06Z https://repositorio.ufpb.br/jspui/handle/123456789/38396 Título: Modelos tecnoassistenciais em disputa na atenção primária à saúde no governo Lula 3: crítica a partir da categoria de neoliberalismo Autor(es): Neves, Lucas Lobo Alcântara Orientador: Gomes, Luciano Bezerra Abstract: This dissertation analyzes the federal Primary Health Care (PHC) policies of Lula’s third administration, from 2023 to 2025, as a field of dispute between techno-healthcare models within the neoliberal totality that permeates health policy in contemporary Brazil. Neoliberalism is understood as a historical determination of capitalism in crisis, expressed simultaneously as a class project and as a governmental rationality. The study adopts a qualitative, exploratory approach, in the form of a critical essay, grounded theoretically and methodologically in historical-dialectical materialism. The category of techno-healthcare model is mobilized to understand disputes concerning the organization of care, financing, labor management, institutional configurations, and the relations between the State, the market, and society in PHC. The empirical corpus was composed predominantly of documentary sources, including programmatic documents, normative acts, ordinances, technical notes, public calls, management reports, administrative databases, historical series, official dashboards, and institutional materials from the Ministry of Health. The analysis focused on Lula’s third administration, mobilizing historical antecedents when necessary to understand the continuities, shifts, and contradictions of the recent period. The findings indicate that the federal administration repositioned PHC as a politically relevant field, with the renewed centrality of the Family Health Strategy, the expansion of the Mais Médicos Program, the reestablishment of multiprofessional teams, changes in federal co-financing, the strengthening of infrastructure agendas, and reconfigurations in oral health. However, this recomposition took place in a contradictory manner, preserving or reconfiguring elements associated with the neoliberalization of health policy, such as performance-based mechanisms, precarious labor relations, hybrid institutional arrangements, managerial inducements, and new forms of articulation between PHC and specialized care. The dissertation concludes that the policies analyzed express a contradictory recomposition of the PHC techno-care model, marked by partial advances, structural limits, and ongoing disputes over the public, universal, territorially grounded, and democratic meaning of the Brazilian Unified Health System. Editor: Universidade Federal da Paraíba Tipo: Dissertação 2026-05-29T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38269 Título: Parceria entre o terceiro setor e o estado da Paraíba : análise da rede de cardiologia pediátrica Pernambuco – Paraíba Autor(es): Silva, Edjavane da Rocha Rodrigues de Andrade Orientador: Carvalho, André Luis Bonifácio de Abstract: The partnership between the Third Sector and the State has become a consistent practice in the provision of health care in Brazil since the 1990s. The reasons for the growth and consolidation of this practice are from the pressure that social demands apply on the relationship between Society and State, caused by capitalism and its deepening. Also in this period, the Third Sector in Brazil began to take shape through the National Privatization Program, with the assumption of the State's lack of executing capacity, expanding and consolidating its performance in the implementation of public policies, generally in partnership with states or municipalities. In this sense, this research evaluated the implementation strategy of the Pernambuco – Paraíba Pediatric Cardiology Network (RCP), an agreement between the Círculo do Coração Foundation and the State of Paraíba firmed to solve the problem around the lack of assistance to pediatric heart diseases. This is a descriptive and exploratory case study with a qualitative approach. The data collection was guided by the creation of an assessment scheme for the Network implementation strategy, which considered aspects of the social, political and organizational context and the perception of the actors who participated in the implementation, using a triangulation procedure in the collection of information that occurred through an extensive documentary research, including Documents of the Bipartite Inter-Management Commission and of the State Council of Health as well as semi-structured interviews and questionnaires applied respectively with 3 key management actors and 8 professionals working in the implementation of RCP. After, the stages of the implementation process are presented and the challenges that have been overcome have potentialized the implementation of RCP from the perception of the actors, at another time, Discourse Analysis was used to analyze the partnership between the Third Sector and the State during the process inducing the implementation of RCP. The results point to an implementation strategy of unidirectional coordination and regionalization of the Network, with the possibility of being replicated to other health services, but qualifying the democratization of the implementation process, through the spaces of management and social control. Furthermore, the cooperation between the Círculo do Coração Foundation and the State of Paraíba provided effective changes in comprehensive care for children with congenital heart disease, eliminating the waiting list for surgery and diagnosis, known as "the death row", it also has characteristics that differentiate it from the relationships established with other Non-Governmental Organizations for the management of health services in the state. However, the discourse that circumscribes the relationship between the Third Sector and the State is a product of historically constituted relationships, pointing to the conflicts that this relationship presupposes.; RESUMEN La alianza entre el Tercer Sector y el Estado se ha convertido en una práctica constante en la prestación de servicios de salud en Brasil desde la década de 1990. Las razones del crecimiento y consolidación de esta práctica provienen de la presión que ejercen las demandas sociales sobre la relación entre Sociedad y Estado, provocado por el capitalismo y su profundización. También en este período, el Tercer Sector en Brasil comenzó a gestarse a través del Programa Nacional de Privatización, con la suposición de la falta de capacidad ejecutora del Estado, ampliando y consolidando su desempeño en la implementación de políticas públicas, generalmente en alianza con estados o municipios. . En este sentido, esta investigación evaluó la estrategia de implementación de la Red de Cardiología Pediátrica Pernambuco - Paraíba (RCP), un convenio entre la Fundación Círculo do Coração y el Estado de Paraíba,firmado para actuar en la solución del problema en torno a la falta de asistencia a las cardiopatías pediátricas. Se trata de un estudio de caso descriptivo y exploratorio con enfoque cualitativo. La recolección de datos fue guiada por la creación de un esquema de evaluación para la estrategia de implementación de la Red, que consideró aspectos del contexto social, político y organizacional y la percepción de los actores que participaron en la implementación, utilizando un procedimiento de triangulación en la recolección de información que se produjo a través de una extensa investigación documental, incluidas las actas de la Comisión Interamericana Bipartita y del Consejo Estatal de Salud, así como entrevistas semiestructuradas y cuestionarios aplicados respectivamente con 3 actores clave de la gestión y 8 profesionales que trabajan en la implementación de la RCP. En esta ocasión, se presentan las etapas del proceso de implementación y los desafíos que se han superado han potencializado la implementación de la RCP desde la percepción de los actores. En otra ocasión, se utilizó el Análisis del Discurso para analizar la alianza entre el Tercer Sector y el Estado durante el proceso de inducción de la implementación de la RCP. Los resultados apuntan a una estrategia de implementación de coordinación unidireccional y regionalización de la Red, con posibilidad de ser replicada a otros servicios de salud, pero calificando la democratización del proceso de implementación, a través de los espacios de gestión y control social. Además, la cooperación entre la Fundación Círculo do Coração y el Estado de Paraíba brindó cambios efectivos en la atención integral a los niños con cardiopatías congénitas, eliminando la lista de espera para cirugía y diagnóstico, conocida como "la cola de muerte", tiene características que la diferencian de las relaciones establecidas con otras Organizaciones No Gubernamentales para la gestión de los servicios de salud en el estado. Sin embargo, el discurso que circunscribe la relación entre el Tercer Sector y el Estado es producto de relaciones históricamente constituidas, apuntando a los conflictos que esta relación presupone. Editor: Universidade Federal da Paraíba Tipo: Dissertação 2021-10-29T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38219 Título: Prevalência da hipertensão arterial na população brasileira, acesso e utilização dos serviços de saúde: Pesquisa Nacional de Saúde 2019 Autor(es): Alves, Janiele Paulino Orientador: Costa, Filipe Ferreira da Abstract: Introduction: Among the Chronic Noncommunicable Diseases (CNCDs), hypertension stands out, a complex health condition influenced by multiple factors, including genetics, environment, lifestyle, and socioeconomic aspects. Objectives: To identify the prevalence of individuals with systemic arterial hypertension (SAH) and the access to and use of health services based on the 2019 National Health Survey (PNS). Study design: This is a cross-sectional study, with a quantitative approach, using data from the 2019 (PNS). For the analyses, only interviews with residents over 15 years of age were considered, totaling 21,315 individuals. It is worth noting that the percentages of hypertensive individuals were in relation to the total number of individuals according to the groups analyzed within the sociodemographic data of each variable, including only those who declared having hypertension. Variables from the general characteristics module of residents were used for sociodemographic data, and variables from the chronic diseases module (hypertension) and health insurance coverage to verify the prevalence of hypertension and the access to and use of health services. The outcome studied was hypertension obtained by the question: “Has a doctor ever diagnosed you with hypertension?”. The prevalence of hypertension in each group of the chosen variables was calculated together with their respective confidence intervals (95%). All analyses were performed in the statistical program with the aid of the PNSIBGE packages and analyzed in the survey package. Regarding the sociodemographic data of the study participants, there was a predominance of hypertension in female individuals (25.15%), elderly (54.99%), black (24.58%), widowed (55.30%), with a low level of education (32.38%), living in urban areas (22.83%), southeast region (24.64%) followed by the south region (23.33%), with an income between 1 and 3 minimum wages (24.78%) during the research period and unemployed individuals (29.97%). The results describe that access to and use of health services by people with hypertension occurs as follows: 59.47% regularly visit a doctor or health services. Among those who do not seek regular care, 38.69% claimed that their blood pressure was under control and 38.58% did not find it necessary. 95.27% of the interviewees received a prescription for hypertension medication; 59.15% did not obtain the medications through the public service and 54.29% paid for them out of their own pocket. Regarding the place of care, 45.80% were seen at the basic health units (BHU) and 28.78% at a private practice. In addition, 85.25% did not pay for the care, which was provided by the Brazilian Unified Health System (SUS) for 65.64% of them. Finally, 51.90% were seen by the same doctor as their previous consultation. Regarding the use of health insurance, it was found that 23.46% have a private health insurance plan, either from a company or a public agency. Another 32.45% stated that their main health insurance plan is from an institution that assists public servants (municipal, state or military). When asked about the quality of the health insurance plan, 29.77% rated it as poor. Conclusion: The results revealed that SAH has a significant prevalence among certain groups of the Brazilian population. Regarding access to and use of health services, there was a clear increase in demand for care at the BHU. Editor: Universidade Federal da Paraíba Tipo: Dissertação 2024-11-12T00:00:00Z https://repositorio.ufpb.br/jspui/handle/123456789/38074 Título: A educação interprofissional na formação em saúde da Paraíba Autor(es): Lacerda, Gabrielle Mangueira Orientador: Forte, Franklin Delano Soares Abstract: Health care experiences a complex context of new circumstances of vulnerability in health. Interprofessional Education (IPE) stands out as a strategy that can promote a reformulation and regulation of the professional activity with a disposition for collaboration between different professional categories in the service. The aim was to understand the perception of students about training to work in the SUS and investigate experiences and experiences in training, from the perspective of interprofessionalism and collaborative practices in a team. This is an exploratory, descriptive study with a qualitative approach, carried out with students enrolled in the last period of the Nursing, Pharmacy, Dentistry, Physical Education, Physiotherapy and Social Work courses of two Public Education Institutions in northeastern Brazil. The focus group was used as a technique for collecting empirical data, which were transcribed and analyzed from the perspective of thematic content analysis. The study followed the ethical precepts set out in Resolution 466/2012 of the National Health Council, approved by the Ethics Committee of the Federal University of Paraíba under opinion number 3,222,362. The potential of supervised internships as learning scenarios for IPE was observed. Students reported that through teamwork it was possible to learn with, about each other and among themselves. The students highlighted weaknesses in training, which point to the need to institutionalize the EIP in the curricula, permanent education movement in health and teacher development. It is concluded that there are important gaps in training for the achievement of interprofessional training, and despite the potential learning spaces for the EIP, others must be intentionally created in the training path for learning with, about others and among themselves in the direction of production of care in the Unified Health System. Editor: Universidade Federal da Paraíba Tipo: Dissertação 2021-10-27T00:00:00Z