The user's voice in the family health strategy in Salvador/Bahia-Brazil: Ombudsman offices

Abstract

The Ombudsman's Office is part of the improvement processes of public institutions that must have channels to listen and respond to citizens' demands. Along this path, this research chose the Family Health Units in the municipality of Salvador - State of Bahia, understanding this as the organizer of the health care network and coordinator of care, as the stage for evaluating the participation of users in the ombudsman's office in this municipality, using it as a social management instrument. This is an exploratory case study with a qualitative and quantitative approach. Data collection resulted from semi-structured interviews with 120 users who have been using Family Health Strategy (ESF) services for around 2 years and who, randomly, used or not the municipality's Ombudsman's Office from January 2018 to December 2018. 2019. An exploratory and documentary research was initially carried out on the management reports of the Ombudsman's Offices during this period, understanding the manifestations recorded in the computerized system. In addition, 12 focus groups were held (71 participants) which allowed a more in-depth view of social management constructed with the participants in a discursive process of varied and pertinent statements. For data analysis, we opted for data triangulation based on categories made possible for the interpretative process. In view of this, this research showed that although the Ombudsman's Office of the municipality of Salvador is resolute in the registered requests, it represents a space for social participation that does not consider its political dimension, in which the citizen is not clear that their participation should interfere in the decision-making process of public health policies. Thus, the records made at the Salvador Ombudsman's Office regarding ESF services are mostly complaints and requests. There were few records regarding suggestions and praise. In the interviews and focus groups it was clear that users understand that the Ombudsman's Office is an instrument for complaints and not for social participation. It was still possible to understand that users do not recognize themselves as participants in the management of the SUS, they believe they are citizens with rights and not duties.