Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.

Administrative professionals in the management of the Unified Health System

  • Francini Lube Guizardi
  • Maria Luiza Silva Cunha
  • Francini Lube Guizardi

    Professora-pesquisadora da Escola Politécnica de Saúde Joaquim Venâncio, da Fundação Oswaldo Cruz (EPSJV/Fiocruz), Rio de Janeiro, Brasil. Doutora em Saúde Coletiva pelo Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro (IMS/Uerj).

    Maria Luiza Silva Cunha



Abstract

The article analyzes the insertion of mid-level administrative professionals in health services aiming at discussing the roles they play in the power structures and relations that make up such institutions. Data are presented concerning the workers' understanding of their roles and the relations they envision between their work processes and the management of the Unified Health System. The study was carried out in a health region of the city of Rio de Janeiro, and involved mapping the middle-level administrative work processes at the different public health institutions in this territory. In total, 44 semi-structured interviews were conducted, covering the different processes that were identified. The results show that decision-making prioritization is associated with the devaluation of these professionals, who see themselves as mere implementers of definitions set out by higher hierarchical levels. We conclude that instrumental administrative rationality remains hegemonic in the territory. These aspects lead to reflection on whether or not it is possible to further consolidate SUS without the active participation of the social actors involved in building it, among whom we highlight the administrative agents due to the strategic role they play in the management processes.

Keywords

health work,
health management,
institutional democracy,
autonomy

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