O procedimento do Contrato Organizativo de Ação Pública Ensino-Saúde (COAPES) nas 4ª e 5ª regiões de saúde do Rio Grande do Norte

Abstract

This paper explores the contractual procedure and the discussions that resulted in the signing of the Organizational Contract of Public Action for Teaching-Health (COAPES) in the 4th and 5th health regions of the state of Rio Grande do Norte, aiming to make possible the structuring of health services in conditions to offer sufficient field of practice and with quality to the courses and residencies of the health area, allowing the strengthening of the teaching-service-community integration. The qualitative theory of interpretation is used, observing the ethical and political positions of the various parts involved in the contractual process, seeking, from them, to understand in an interpretative way the decisions deriving from human nature, at first guided by social interests, as also political, and at what level the desired change was achieved. The analysis of the information collected is promoted through an integrative review of the literature, involving a descriptive deepening of the COAPES and its foundations; analysis of documents and instruments, such as minutes of meetings, letters, ordinances, decrees and laws; and the interpretation and discussion of the results, with the supervenient purpose of generating a product that presents relevance to other institutions interested in starting the process of contracting. The importance of the agreement, discussion and qualification of the insertion of students in the territory stands out during the contractual procedure. Procedural non-linearity is verified during the problematization, against the orientation present in the Unified Health System (SUS) guides, stagnating with the change in administrative management during and after the period of municipal elections. It is possible, then, to affirm that the COAPES production process under study still needs to progress as a dialogical process with recognition, commitment and participation of the involved actors, in a constant search for the qualification of health care in an integrated way to the process of in-service training and permanent education of the health network.