Português

Abstract

This study presents an analysis of the response of services to proposals made by the Ministry of Health (MH) to address the COVID-19 pandemic within the scope of Primary Health Care (PHC), taking into account the governance model for the formulation and implementation of such policies. It is a policy analysis study using mixed methods, with documentary research and analysis of production data from PHC teams, based on the publication of 6 ordinances containing proposals linked to financial transfers, aimed at stimulating the implementation of priority actions by the teams during the pandemic. These variables allowed an analysis of the PHC response to these proposals, legitimizing or not the MH as coordinator of the SUS governance network in the pandemic scenario. Observing the effect on team production at the 3rd month and the average between the 4th and 6th months after the publication of the ordinances, it was noticed that, in most situations, the regulations did not produce any outcome of increased production by the teams in the variables listed. Considering that more than R$1.7 billion was allocated through the ordinances, a substantial increase in the teams' output was expected. However, despite the good governance for the government and the Ministry of Health's actions, it is believed that the denialist, omissive, conflictive stance and the rupture of the federal pact with states and municipalities led to a deterioration of the governance network to the point of eroding the legitimacy of the MH in conducting the pandemic response policy in Primary Health Care.