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Monitoring and evaluation of the actions of the Street Clinic (eCR) team in the city of Suzano - São Paulo: proposition of intra and intersectoral guidelines

Grant number: 23/09191-5
Support Opportunities:Research Grants - Research in Public Policies
Duration: August 01, 2024 - July 31, 2028
Field of knowledge:Health Sciences - Collective Health - Public Health
Principal Investigator:Chennyfer Dobbins Abi Rached
Grantee:Chennyfer Dobbins Abi Rached
Host Institution: Escola de Enfermagem (EE). Universidade de São Paulo (USP). São Paulo , SP, Brazil
Associated researchers: Débora Rodrigues Vaz ; Eduardo Sodré de Souza ; Flávio Adriano Borges Melo ; Flávio Tayra ; Juliana Pereira Tavares de Melo ; Márcia Mello Costa De Liberal ; Maristela Santini Martins

Abstract

Introduction: The nature of this project is Policy in Execution (PEX), a quick science of monitoring and evaluating the actions of the Consultório na Rua (eCR) team in the city of Suzano - São Paulo. The Street Office is a Primary Care strategy for the benefit of life that emerged in Brazil in the 1990s as a response to the health demands of the homeless population. As a strategy of the National Primary Care Policy (PNAB), the Street Clinic (eCR) team seeks to bring health services to this vulnerable population, who often face difficulties accessing conventional health services1,2. Objectives: To identify whether the current modality is adequate to the characteristics of the people to be served; Survey the needs of the respective population and also of the health workers involved in the eCR, Oral Health, and the Family Health Support Centers (NASF) of the territory and reference services where these people are concentrated; To analyze the production of primary health care for the homeless population, provided by the team at the Street Clinic (eCR) in Suzano; Identify strengths and difficulties, characterizing care coordination arrangements and actions developed, to present the panorama of analysis on the work process in access organization models; describe the activities carried out by professionals, users' satisfaction, the balance or imbalance of supply and demand, breaking down reception barriers and expanding the reach of health services. Method - This is action research with a sequential explanatory mixed methods approach (QUAN-qual). Action research is a research method that involves collaboration between researchers and participants to identify problems, implement actions and evaluate results. The mixed methods approach in action research allows for collecting and analyzing qualitative and quantitative data to obtain a more comprehensive understanding of the phenomenon under study. The sample for this study will be professionals from the eCR, Oral Health, the Family Health Support Centers (NASF), Basic Health Units (UBS), and Emergency Room from the network of services at the municipal level of Suzano where People in Situations of Rua are concentrated and members of social movements that represent this group from the city of Suzano-SP. The choice of this city was due to the bond of the master's researcher student to work in this scenario. In the quantitative phase, the following instruments will be used: sociodemographic form to characterize the PRS in the municipality of Suzano, format for epidemiological data, document analysis of the services provided by eCR Suzano since its implementation, seeking to describe the population served and quantify the number of actions of the Consultório na Rua (eCR) team carried out so far, proposing future monitoring indicators to increase the current Policy. A checklist will be made to facilitate the collection of data related to the actions carried out by the health professionals of the Street Office. In the qualitative phase, focus groups will be held with representatives of the "homeless people" segment and members of social movements that represent this group. The purpose of these meetings will be to identify health needs and analyze perceptions about the care of these people. Still, this technique will strengthen this segment for active participation and representativeness in the elaboration, implementation, and evaluation process. The public management component should provide access to health professionals and accompany, monitor, evaluate, disseminate, and manage actions and services through intersectoral strategic articulation, seeking to guarantee broad, simplified, and safe access for this population to health services and programs. (AU)

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