0206/2018 - Rectoría y gobernanza: Dimensiones estructurantes para la implementación de Políticas de Atención Primaria de Salud en el Paraguay. Stewardship and governance: Structuring dimensions for Implementation Primary Health Care policies in Paraguay.
Este estudio analiza las modalidades de conducción en la implementación de la Atención Primaria de Salud (APS) en Paraguay en tres periodos gubernamentales (2008 -2012, 2012 – 2013 y 2013 - 2017) y en tres niveles de gestión (nacional, regional y local). La metodología se basó en el análisis de categorías a priori seleccionadas sobre dimensiones y sub-dimensiones de la Rectoría y gobernanza de esta política pública, con enfoque cualitativo, basada en la teoría fundamentada. Un cuestionario de preguntas abiertas fue dirigido a una muestra de actores sociales, políticos y técnicos: ministros, coordinadores, gerentes, asesores y expertos de organismos internacionales. El procesamiento de los datos se realizó combinando la utilización del software Atlas Ti, complementada con el ordenamiento de hallazgos en una matriz estructurada en Excel. Diferencias de liderazgo, mecanismos regulatorios, capacidades técnicas para la planificación y gestión sanitaria, y modalidades de ejecución financiera han afectado la continuidad de los procesos necesarios para el incremento y fortalecimiento de la APS. Los hallazgos demuestran los límites y posibilidades de implementación de esta política de salud en Paraguay, demostrando la necesidad de mayor cualificación de la gestión y estabilidad política en su conducción.
This study analyzes driving patterns in the implementation of Primary Health Care-PHC in Paraguay, in three government periods (2008 -2012, 2012 - 2013 and 2013 – 2017), and three levels of management (national, regional and local). This is a qualitative study based on grounded theory, with the establishment of a convenience sample of social technicians: Ministers, Coordinators, Managers, Consultants, Politicians and International Organizations Experts. A set of analytical categories were establishedthe literature review on stewardship and governance, ing some dimensions. There was recognition of the importance of technical skills, leadership, planning and interaction of a variety of strategic actors; however, the discontinuity of the steps associated with a strong political influence, has restricted the exercise stewardship in this perspective. It was also identified limited capacity of financial and regulatory management. The findings coincide with the limits and possibilities of implementation of public policies in Paraguay demonstrating the need for more highly qualified management and political stability in driving.
Stewardship and governance: Structuring dimensions for Implementation Primary Health Care policies in Paraguay.
Resumo (abstract):
This study analyzes driving patterns in the implementation of Primary Health Care-PHC in Paraguay, in three government periods (2008 -2012, 2012 - 2013 and 2013 – 2017), and three levels of management (national, regional and local). This is a qualitative study based on grounded theory, with the establishment of a convenience sample of social technicians: Ministers, Coordinators, Managers, Consultants, Politicians and International Organizations Experts. A set of analytical categories were establishedthe literature review on stewardship and governance, ing some dimensions. There was recognition of the importance of technical skills, leadership, planning and interaction of a variety of strategic actors; however, the discontinuity of the steps associated with a strong political influence, has restricted the exercise stewardship in this perspective. It was also identified limited capacity of financial and regulatory management. The findings coincide with the limits and possibilities of implementation of public policies in Paraguay demonstrating the need for more highly qualified management and political stability in driving.
Cabral-Bejarano, MS. Rectoría y gobernanza: Dimensiones estructurantes para la implementación de Políticas de Atención Primaria de Salud en el Paraguay.. Cien Saude Colet [periódico na internet] (2018/Abr). [Citado em 08/11/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/rectoria-y-gobernanza-dimensiones-estructurantes-para-la-implementacion-de-politicas-de-atencion-primaria-de-salud-en-el-paraguay/16739?id=16739
