Ouvidoria do SUS como instrumento de participação social nas políticas públicas de saúde

Abstract

Participatory management in the SUS is fundamental to guarantee universality, completeness and equity in access to health services, strengthening social control and promoting a greater approximation between health services and the real needs of the population, especially in a country with the dimensions of Brazil, where epidemiological, social, cultural, educational and sanitation criteria may be different. With the intention of producing inferences from the perspective of contributing to the qualification of guidelines for the implementation and execution of public health policies and aiming to cooperate with possibilities for regional development through an increase in quality of life, this research aimed to analyze whether municipal managers of health, within the scope of the 11th Health Region - Sete Povos das Missões, in the State of Rio Grande do Sul, understand the SUS Ombudsman as an instrument of social participation for the elaboration, management, planning and execution of public health policies. The analysis was carried out based on a literature review and interviews, aiming to understand the context based on the subjectivity of municipal health managers. The investigation employed methodology based on a qualitative, interpretative approach, using the theoretical methodological framework of Thompson's Depth Hermeneutics. The research results were extracted using Bardin's content analysis method, in which five categories of analysis were established: manager profile, activities performed, decision making, SUS ombudsman and social participation. The results pointed to a profile of managers with higher education, in office for a short time, performing the role for the first time and linked to right wing or center-right parties. Regarding daily life, the main activities performed were serving the public, scheduling appointments, exams and procedures, authorizing purchases and uses of public resources, managing health teams and visiting health units. and interior of themunicipalities. Regarding the context of implementing Ombudsman offices, it was found that the majority of municipalities do not have an ombudsman's office designed to receive demands related to health matters and no interviewee reported having already worked directly with ombudsman channels. Regarding the concept of social participation, from the interviewees' statements, it was clear that, in general, they understand the institute as a space to give voice to SUS users. They equate social participation to the space offered to citizens to postulate their needs. In the end, it can be concluded that the Health Secretaries interviewed claim to understand the SUS Ombudsman's Office as an instrument of social participation, although they consider society's lack of culture for the appropriate use of the instrument. Thus, despite the interviewees' answers being affirmative, it is interpreted that the management of social participation in the studied region is still far from being implemented efficiently, as several weaknesses were found in understanding the concept of social participation and at the same time Over time, several cultural issues were raised that could distort the appropriate use of the SUS Ombudsman's Office, in the context of small municipalities. Therefore, it is expected that the study has contributed to the scientific repository on the topic and can assist in the process of building a theoretical framework for the development of public health policies at the regional level, including expanding the debate about social participation with managers and promoting qualification in the use of the SUS Ombudsman by society.