Author:

• Vanessa Costa e Silva - Costa e Silva,V. - Rio de Janeiro, RJ - Fundação Oswaldo Cruz (FIOCRUZ) /ENSP, Escola Nacional de Saúde Pública Sérgio Arouca - ENSP - <vanessa@ensp.fiocruz.br>

Co-author(s):

• Pedro Barbosa - Barbosa, Pedro - Fiocruz, Ensp - <pbarbosa@ensp.fiocruz.br>
• Virginia Alonso Hortale - Virginia Alonso Hortale - Rio de Janeiro, RJ - Fundação Oswaldo Cru (FioCruz), Administração e Planejamento em Saúde ( DAPS) Rio de Janeiro, Rio de Janeiro, 21.041-210, BR - <virginia@ensp.fiocruz.br>
ORCID: https://orcid.org/0000-0002-4224-9838

Thematic Area:

Não Categorizado

Abstract:

A case study conducted in the city of Rio de Janeiro about management by Social Organizations in the Family Health Strategy (FHS) is presented in this paper. The objectives were to characterize and to analyze some aspects of the governance system adopted in order to identify limits and possibilities of this model as an organizational alternative in the Unified Health System. It is a qualitative research through literature review, document analysis and interviews with key informants. There was expansion of access to primary care by increasing the potential coverage of FHS which went from 7.2% of the population in 2008 to 44,8 % in 2015. The results indicated that contracting was established without taking into account important aspects of contractual logic as negotiating and providers responsibility autonomy. The evaluation and control have the processes as focus rather than outcomes and there was no increase of transparency and social control. The performance incentive system was appointed as a promoter of improvements in the work process of health teams. It is concluded that the adopted partnership model is fragile for the management of primary care, however with significant learning in progress.

Keywords:

Family Health Strategy Social Organizations Health Management Private Sector Partnerships Contracts

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