Desafios da municipalização da saúde: evolução do fundo municipal de saúde e perspectivas de implementação de um novo modelo de saúde em Campina Grande.

Abstract

The Sistema Unico de Saude, which was created with the constitution of 1988 as a result of discussion process started by brazilian sanitation movement, has undergone a decisive moment. SUS has evolved slowly and offers a lower assistance at real population's necessities in spite of decree sers, philosophy, and basic precepts have advocated the possibility of offering a good avality service to people. In response to the challenge of making true what was systematically thougt by SUS the Health Ministry made use of the Basic Operational Norm, NOB/96, which states the health system municipality, the social control and basic assistance as the input to the system and as responsible for important changes in health service. Thus, Programmes like Family Health Programme (PSF) and Programa de Agentes Comunitarios de Saude (PACS), bring out like resonsible for a new point of view that favours the health maintenance with preventive activities instead of a mere cure of illness. The borough of C. Grande has faced na indefinite situation since it has been getting ready to join to the decentralized process management from the system and has not outlined any strategy to make SUS an efficient system. In the work the bills referred to a period from 1995-1997 of Munlicipal Health resources were investigated. It was made both a reveve and an expense analysis of the Municipal Health Department so that we coved have a profile of the current priorities of municipal managemente. In order to achieve success in this stage, there was a concomitant work between the collection data and the inspection work carried out by Municipal Health Conuncil, from which the work author and the advisor take part of it. It was checked the economic feasibility of PSF considered to be a good programme under an epidemiological point of view but deficit economicall. The application analysis of health resources reveled a bittle tune with the Health Ministrys percepts, in Campina Grande there was in 1997 a fall in the service number performed by basic asssistance and a stagnation in PSF yearn number. At the same time it was noticed a considerable expense in gratuities (some of the with no council's knowledge) lease on cars besides other questionable results from populations health. On the other hand the analysis of PSF revenve and cost, showed that the shortfall of the programme is smaller than it was officially published and there is a surplus possibility i f we consider the incentive given by the Health Ministry. A short coming definition of a proper strategy for a clear and spread change, is one of the biggest hindrance to consollidate this process as responsable for important changes in the attention that is given to the health in the borough.