Interface: Comunicação, Saúde, Educação (Sep 2015)

Contextual determinants of decentralization of epidemiological surveillance for the family health team

  • Silvone Santa Barbara da Silva Santos,
  • Cristina Maria Meira de Melo,
  • Clemence Dallaire,
  • Michel Perreault,
  • Edna Maria Araujo,
  • Evanilda Souza de Santana Carvalho,
  • Luciano Marques dos Santos

DOI
https://doi.org/10.1590/1807-57622013.0822
Journal volume & issue
Vol. 19, no. 54
pp. 443 – 454

Abstract

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This study examines the contextual determinants of implementing decentralization of epidemiological surveillance for the family health team, in a municipality in the state of Bahia, Brazil. This was an evaluative study using the political model of implementation analysis. Data were obtained through document analysis and semi-structured interviews with managers and healthcare workers. Five themes emerged: planning; training of human resources; organization of the work process; linkage within institutions; and organization of family healthcare units. The results revealed that there are difficulties such as poor infrastructure of healthcare units, creation of flexibility in labor relations and healthcare worker turnover. The study shows that there is a need for stakeholder participation in the process of implementing the policy of decentralization of epidemiological surveillance for the micro-area of intervention that comprises the family health program.

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