Capacidades estatais e aprendizagem durante a pandemia do COVID-19: em unidade hospitalar gerida por Organização Social em Goiânia
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2022-12-14
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Universidade Federal de Goiás
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The arrival of the COVID-19 pandemic challenged political authorities, public agencies and citizens. In the area of health policy, the ability to respond to the crisis involved the ability to manage health units, state capacity and the performance of street-level bureaucrats. This work aims to understand how complex processes of formulation and implementation of public policies and state capacities may have impacted the level of learning of the public policy to combat COVID-19 between the two waves of the pandemic, in a hospital unit governed by the Social Health Organization – OSS -, in Goiânia/Goiás. Surveys were carried out with: the managers of the Association for Management, Innovation and Health Results – AGIR (managing entity of the co-participating units in the research), the Hospital de Urgências Governador Otávio Lage de Siqueira – HUGOL, and the Hospital de Campanha to face the COVID-19 – HCAMP; to the frontline professionals who work at HUGOL; and members of the State Health Council. The quantitative descriptive and qualitative methods (thematic and exploratory analysis) were adopted in the data analysis. A bibliographic review was also carried out on topics related to public policies, state capacities and learning. The result of the thematic analysis shows, for example, that during the implementation, the participation of the actors took place with involvement, often in training/capacity building and with the engagement of frontline professionals in patient care actions and clarifications to the population about the COVID-19 (ways of prevention). It was also verified that the state capacities – resources, abilities and competences of the State that are mobilized for the production of public policies – were carried out, for example, with the participation of the involved actors integrating Commissions of the COE - Center of Emergency Operations in Health (organizational structure that aims to promote a coordinated response through the articulation and integration of the actors involved) and editing of normative acts. Learning, on the other hand, occurred quickly, reinvented, resilient and in the midst of “overcrowding”. The issues that appeared in the thematic analysis also show that there is a relationship between public policy processes - formulation and implementation, state capacities and learning. This relationship shows that the policy formulation/implementation process is sustained by state capacities, despite implementation challenges and critical capacities for some factors. Among the implementation challenges are: illness (physical and psychological) of the team and work overload, fear of contagion of the disease, and critical state capacities (deficient number of professionals, insufficient structure and lack of inputs). Both capacity and policy processes positively influence the learning process. This, however, does not occur uniformly among the actors, as it was classified as: “natural”, “difficult” and “resilient”. Despite the implementation challenges, critical abilities and varied learning, it is concluded that there was a level of learning that positively impacted the policy and this is associated with the existence of a State capacity to maintain professionalized bureaucracies and expand channels of inclusion, interlocution and negotiation with the various actors involved in public policy.
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TEIXEIRA, W. M. Capacidades estatais e aprendizagem durante a pandemia do COVID-19: em unidade hospitalar gerida por Organização Social em Goiânia. 2023. 109 f. Dissertação (Mestrado em Ciência Politica) - Universidade Federal de Goiás, Goiânia, 2022.