Spontaneous demand and Situational Strategic Planning in the Family Health Program of Pindamonhangaba, São Paulo, Brazil

Abstract

From a qualitative research based on a method triangulation, this paper focused on evaluating the perception of managers, technicians and users of four Primary Care Health Centers of Pindamonhangaba, São Paulo, Brazil, as to the spontaneous demand conduct, in order to analyze if they have been pondered on the Situational Strategic Planning. The following analysis structures were found related to the spontaneous demand conduction: user embracement, work process, records, priorities, plans, communication and permanent education. The explanative, normative, strategic and operational moments were the themes pertinent to the strategic planning. The speech analysis suggests that the work process is fragmented, hierarchical and focused on the nurse. The assistance priorities do not occur by means of technical criteria, but by common sense, which results in a discontented user and in a poor quality assistance. The professionals involved do not promote a communicative process able to unify the language, useful in the elaboration of a common aim. There is not, therefore, a team synergy to achieve the best ways of conducting the spontaneous demand, which result from a mental plan, from “attempt and failure” and from everyday experience, to the detriment of a strategic thought. The study reveals that the present management model needs to be reviewed, under the risk of compromising the social regional development and it proposes the permanent education implantation to the health workers in the municipality, emphasizing the strategic planning, the appropriation and reinterpretation of the territory features and experienced situations.