Abstract
Background: This abstract is based on the article by Pereira and Feuerwerker (2023)¹, which highlights the dynamics, strengths, and challenges of care management in small municipalities. It examines care management experiences that can inform practices within Brazil's National Health System (SUS).
Approach: A cartographic method was employed, emphasising the co-production of knowledge through interactions among various actors in SUS². From 2018 to 2020, the research explored both formal and informal health and intersectoral settings identified by managers and workers, reflecting on the diverse care strategies and arrangements. Field experiences informed the analysis, contextualised in the light of the micropolitics of work and of health care, giving visibility to the fields of dispute, challenges, and powers of small municipalities. articulated with the problematization on the axis of integrated care.
Results: The study mapped key care management devices driven by health needs, shaping the management team's agenda through their actions at municipal and regional levels. Various organisational arrangements were identified, including: Multi-professional health teams as lenses for needs and management; Multi-professional teams using mental health as a catalyst for network care; The public prosecutor's office as a facilitator in mental health and social care; Shared home care between the municipal emergency room and primary care networks.
Implications: Effective management arrangements are vital for prioritising care. The work environment is dynamic, influenced by established norms and dominant medical practices. This research reveals vibrant interactions and disruptive forces, highlighting devices that enhance networked care. To improve care management, it's essential to create systems that extend beyond service delivery and institutional roles.
1.Pereira PBA, Feuerwerker LCM. The world of work is not automatic: what can operate as a device for managing care in small municipalities? . Saúde Soc. [Internet]. 2024 May 10 [cited 2024 Oct. 30];32(4):e220849pt. Available from: https://www.revistas.usp.br/sausoc/article/view/225044
2.Lima F, Merhy EE. Produção de conhecimento, ciência nômade e máquinas de guerra: devires ambulantes em uma investigação no campo da saúde coletiva. In: Merhy EE, et al., editors. Avaliação compartilhada do cuidado em saúde: surpreendendo o instituído nas redes. Rio de Janeiro: Hexis; 2016. p. 18-21.