Os desafios na implementação de políticas públicas no município de Vitória de Santo Antão: experiências de discricionariedade no programa Saúde Até Mais Tarde

Abstract

This study stands out in the field of public policy by analyzing the implementation phase with a focus on the discretion exercised by street-level bureaucrats. The general objective of this research is to understand the process of implementing the 'Saúde Até Mais Tarde' program and the role played by street-level bureaucracy in the realization of this public policy in two Basic Health Units in Vitória de Santo Antão-PE. To achieve this, it was essential to have a theoretical framework that underpinned the discussion of the topics. A qualitative research approach was adopted, with a descriptive and analytical character; this approach allowed for an in-depth exploration of the experiences and perceptions of the professionals involved through semi-structured interviews, providing a descriptive analysis of how bureaucrats perceive the program in question and an interpretive analysis of their practices and adaptations made in the daily execution of the program through three analytical categories: action, reason, and form. The results demonstrate a positive outlook on the implementation of the program in the UBS while revealing the challenges of discretion in maintaining the program, adapting services to patients' needs, resource scarcity, emotional impact, the need for harmony in the work environment, among others. The experience of the BNRs in Vitória de Santo Antão shows how discretion is crucial for overcoming daily challenges by adapting health services to local realities and the needs of the population.