Apoio institucional do Conselho de Secretarias Municipais de Saúde: um percurso de melhoria no acompanhamento da gestão em saúde nos municípios do Rio Grande do Norte

Abstract

Introduction: in the area of health, the legislation of the Unified Health System defines the conditions for the municipalities, states and union to make feasible their management, the elaboration of health planning instruments: the Health Plan, the Annual Health Program and the Report Annual Management Report (RAG). In the administrative scenario of planning, the RAG stands out as a pillar for evaluation and monitoring of health actions. This document is an instrument for verifying the application of resources, with the purpose of guiding the elaboration of the annual programming, as well as possible redirections necessary in the Health Plan, in the three spheres of direction of the SUS. The RAG must be fed annually in the Management Report Support System (SARGSUS) in a mandatory manner. Objective: to evaluate the institutional compliance of the SARGSUS with the implementation of the RAG through the intervention of the COSEMS-RN, institutional supporter with a view to improving the monitoring of health management in the municipalities of Rio Grande do Norte. Methodology: this is a descriptive research with a quantitative approach, of the type documentary analysis, with the use of SARGSUS secondary data. The methodological steps used consisted of the analysis of the scenario of the health planning instruments of the 167 municipalities, through SARGSUS analysis with data collected and monitored during the course of 2017 and 2018. COSEMS-RN joined the Collaborative Network for Strengthening Project of the Municipal Management of the SUS, in partnership with the National Council of Municipal Health Secretariats (CONASEMS) to count on the performance of institutional support in its framework. It started the process of permanent education by carrying out specific awareness-raising workshops with managers and management teams called "Aplicatory Workshop for the Construction of Management Instruments", approved in the Council's plenary as a priority activity. These meetings took place from May to June of 2017 in the 8 Health Regions. In the aforementioned meetings, the managers were informed and instrumental about their individual and collective responsibility, regarding the management tools for the correct feeding in SARGSUS. Results: a high level of food delinquency was initially identified, where only 27.54% of the municipalities fed the SARGSUS, in the exercise of 2016, which should be at 100% by March 30 of the following year, ie 2017. After appropriate information about the need to feed the system, it was observed that 98.20% of the municipalities fulfilled their responsibilities in elaborating the RAG, among other instruments, and included in SARGSUS. Conclusions: it is believed that this visible improvement was due to the mobilization of COSEMS-RN in providing municipal management with the follow-up of institutional support regarding the need to comply with the normative acts of the SUS system, managers assumed their responsibilities, developed and fed SARGSUS , more specifically the RAG. Thus, the importance and the primary role of the institutional supporter as fundamental to the qualification of municipal management was perceived.