Banca de DEFESA: DANILA AUGUSTA ACCIOLY VARELLA BARCA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : DANILA AUGUSTA ACCIOLY VARELLA BARCA
DATE: 17/02/2022
TIME: 08:30
LOCAL: Remoto - video conferencia
TITLE:

META-EVALUATION OF PHC IN BRAZIL: THE CASE OF THE EXTERNAL EVALUATION OF THE PROGRAM TO IMPROVE THE ACCESS AND QUALITY OF PRIMARY CARE – PMAQ-AB

KEY WORDS:

Validation Study. Health Evaluation. Meta-evaluation. Primary Health Care.

PAGES: 134
BIG AREA: Ciências da Saúde
AREA: Saúde Coletiva
SUMMARY:

 

The Primary Care Access and Quality Improvement Program (PMAQ-AB) implemented in 3 evaluation cycles (2011/2019), represents a turning point in the performance evaluation of Primary Health Care (PHC) in Brazil. The Program has 3 components: Voluntary adhesion of municipal managers and Contracting of teams; the External Assessment (AE/PMAQ-AB) and Certification; and Recontractualization, in addition to a transversal development axis. This study aims to assess the quality of AE/PMAQ-AB in light of internationally recognized standards. This is a summative meta-assessment using the qualitative Case Study method, preceded by an Indicator Content Validation Study. The matrix of indicators was prepared based on the 4 principles/standards of the Joint Committee on Standards for Educational Evaluations (utility, feasibility, propriety and accuracy) and articulated at each stage of the evaluation (stakeholder engagement, program description, evaluation design , systematization and analysis of evidence, justification of conclusions and sharing of lessons learned). Validation used the intentional sample with 2 groups of judges (7 experts and 16 evaluators) in 2 rounds of the Delphi technique with each group and analysis through agreement indices. The Case Study, between July/2018 and December/2019, had 54 participants. Semi-structured interviews (01 with a coordinator from the Ministry of Health (MS) and 6 from the universities) and focus groups (01 with a technical team from the MS and 6 from the universities) were used, in addition to the analysis of 07 formal documents of the Program. Data were categorized by dimensions and standards and their respective criteria/indicators adapted to the context of AE/PMAQ-AB. Categorization was performed using the Atlas ti software. 8.4.24 and followed by Bardin's content analysis. The “Involvement of Stakeholders” presented an agreement in the instances of the Unified Health System, expansion of the adhesion of the municipalities in the cycles, credibility of the evaluator and conciliation by the federal government of the interests of certification of the municipalities and of research by the universities, as strengths; and as a deficiency, the absence of users in the decision-making processes of formulating and executing the program. The “Program Description” was positive in the consistency of the AE/PMAQ-AB with the National Primary Care Policy/2011. The “Evaluation Design” portrayed the Brazilian PHC and construction of comparable standards and certification criteria. The use of Information Technology, logistics and guidelines for training the interviewers gave the collection homogeneity, pointing to the usefulness and feasibility. The "Systematization and Analysis of Evidence" had as strengths the online validation systems, offer of micro data, availability of electronic reports to stakeholders, but there were weaknesses in the transmission of the methodology to municipal managers, incipient strategies of technical empowerment for interpretation and applicability of results impacting negatively on the dimension “Justification of Conclusions”. In the “Sharing Lessons Learned”, the utility of AE/PMAQ-AB prevailed for a culture of evaluation in management, services, and academia. The meta-assessment presents a systemic view of the AE/PMAQ-AB, helping managers and professionals in the PHC assessment process. It raises awareness of user engagement in policy and program evaluations, making them more plural, participatory and democratic.

BANKING MEMBERS:
Presidente - 1245215 - SEVERINA ALICE DA COSTA UCHOA
Interno - 1149540 - ANGELO GIUSEPPE RONCALLI DA COSTA OLIVEIRA
Externa à Instituição - Cinthia Kalyne de Almeida Alves - UFPE
Externa à Instituição - Luciana Santos Dubeux
Externo à Instituição - MARCO AKERMAN
Externa à Instituição - Tania Cristina Morais Santa Barbara Rehem