The resumption of the implementation process of the National Permanent Health Education Policy in Brazil

Gonçalves, Cláudia Brandão; Pinto, Isabela Cardoso de Matos; França, Tania; Teixeira, Carmen Fontes

doi:10.1590/0103-11042019S101

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ORIGINAL ARTICLE • Saúde debate 43 (spe1) • Aug 2019 • https://doi.org/10.1590/0103-11042019S101 copy

The resumption of the implementation process of the National Permanent Health Education Policy in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

This work aimed to describe and to analyze the most recent initiatives carried out, within the scope of federal management, for the implementation of the National Permanent Health Education Policy (PNEPS). It takes as reference the Kingdon public policy cycle, describing how the topic was included in the government agenda in 2003, and analyzes the content of the documents that materialize the proposals of the Policy. Subsequently, it focuses on the description and analysis of the movement triggered in 2017-2018, with the accomplishment of a series of regional events, which resulted in the identification of the weaknesses faced in the implementation process of the PNEPS, subsidizing a set of proposals that referenced the initiatives triggered, aiming at the effective implementation of the PNEPS in the scope of the Unified Health System (SUS).

KEYWORDS
Public policy; Education continuing; Unified Health System; Human resources

Workshop	Accomplishment date	Participating States	Place
Northeast Region	October 5/6	Bahia, Alagoas, Sergipe, Ceará, Rio Grande do Norte, Piauí Pernambuco, Paraíba, Maranhão	Salvador/BA
North Region 1	October 19/20	Amazônia, Pará, Acre, Rondônia	Belém/PA
North Region 2	November 9/10	Roraima, Amapá and Tocantins	Palmas/TO
Central-Western Region	November 23/24	Distrito Federal, Goiás, Mato Grosso, Mato Grosso do Sul	Brasília/DF
Southeast Region	November 30 and December 1st	Espírito Santo, Minas Gerais Rio de Janeiro and São Paulo	Belo Horizonte/MG
South Region	December 4/5	Paraná, Santa Catarina and Rio Grande do Sul	Florianópolis/SC

Area-problem	Proposals
Management of the PHE Policy	• Support from the MS to promote the elaboration of the state Plans of PHE and regional action Plans • Link management and planning instruments of the SUS to PHE • Implement information/management system of PHE actions • Create the role of regional supporters in the area of PHE • Include and articulate the training actions promoted by the Ministry of Health in the PNEPS, for example: Coapes, Training Program for High-Level Professionals for Health (Profaps) etc.
Funding	• Return of federal funding for PHE actions • Ensure the participation of States and Municipalities in financing the actions of permanent education • Discuss and present plans to enable the execution of resources • Ensure resources for funding and investment for continuing education actions • Ensure in the Multiannual Plan/Annual Budgetary Law (PPA/LOA) the budgetary and financial transfer of a minimum percentage to be agreed, exclusive for the execution of the PHE policy actions, by the Union, States and Municipalities
Training model	• Support reflection on innovative Teaching methods • Link pedagogical offers to training needs • Hold seminars based on successful experiences • Better articulate the educational institutions in the PNEPS implementation process. Think of mechanisms to reinforce the participation of IES within Cies • Establish strategies for managers and educational institutions to commit to effectively build and participate in the actions of PHE • Recognize the mentoring in the processes of functional progression of the servers • Define the counterparts in the teaching service articulation • Qualify strategic pedagogical processes/designs aimed at problematization, transformation of reality and qualification for the SUS • Implement a system for regulating training practices and PHE in services
Infrastructure of the Cies	• Stimulate the creation of spaces in the State and Municipal Secretariats for PHE and Cies • Ensure that the sector responsible for Permanent Health Education (PHE) is present in the official organization chart of the State Health Department (SHD) and has its own physical structure • Strengthen the Regions of Health through the Cies
Concept PHE	• Promote the conceptual alignment on PNEPS, especially the design of PHE • Hold workshops with managers and technicians for conceptual alignment around PHE • Strengthen the teams of SUS Schools and members of Cies to facilitate discussion on the concept of PHE • Include the discussion on the concept of PHE in Regional Interagency Committees (CIR)
Monitoring and evaluation of PHE actions	• Establish monitoring and evaluation mechanisms of the implementation of the state and regional plans of PHE with process and results indicators • Encourage the technical areas to register and disclose the actions of PHE • Dimension/map the education points of the state network
Interfederative articulation (MS/SES/SMS)	• Greater articulation MS/MEC • Promote within the PNEPS the organization of regional Cies • Sensitization of collegiate instances on the importance of PHE processes • Promote better coordination between the CIR and the regional Cies • Recompose the Regional and State Cies • Include in the state management agenda of the SUS the PHE as permanent staff of the CIR, Bipartite Interagency Commission (CIB), State Health Council (CES) • Promote the qualification of Cies members in PHE • Discuss the importance of the Coapes for articulation among the different instances • Establish regional Cies as a member of the local management committee of the Coapes • Potentialize the Education Network in Collective Health/Permanent Education in Health • Ensure spaces for dialogue between the various actors of the PNEPS, through forums, workshops, seminars, among others • Form municipal and/or microregional centers of PHE and Humanization. Maintain notices (research and/or structuring PHE policy) and ordinances that value this articulation

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[1] Collaborators

Gonçalves CB (0000-0002-7644-9440)^* * Orcid (Open Researcher and Contributor ID). participated substantially in the design, planning, analysis and interpretation of the data, participated significantly in the critical review of the content and participated in the approval of the final version of the manuscript. Pinto ICM (0000-0002-1636-2909)^* * Orcid (Open Researcher and Contributor ID). participated substantially in the design, planning, analysis and interpretation of the data and participated significantly in the elaboration of the draft and critically reviewing the content. France T (0000-0002-8209-9811)^* * Orcid (Open Researcher and Contributor ID). and Teixeira CF (0000-0002-8080-9146)^* * Orcid (Open Researcher and Contributor ID). participated substantially in the design, planning, analysis and interpretation of the data, participated significantly in the critical review of the content and participated in the approval of the final version of the manuscript.