Validação do plano de indicadores para avaliação da implantação da política nacional de saúde integral da população negra

Abstract

The National Policy of Integral Health for the Black Population (PNSIPN) is presented as a tool for the reduction of inequities produced throughout history in the Brazilian society, being these producers of social differences. It is understood that health policies must have, in addition to sound principles and guidelines for their effectiveness, the means capable of measuring their application and use in health services, once their actions become part of the day-to-day management and assistance in the states and cities. Therefore, it is necessary to have health indicators that can measure their practical application. The objective of this study was to review and validate an indicators plan to evaluate the implementation of the PNSIPN in Brazilian cities. This is a methodological study, for review and validation of an indicators plan, using a quantitative approach for its validation. The review of those indicators was made based on the analysis of a preliminary plan, the reports of the System for the Control, Monitoring and Results Evaluation (e-CAR) about the actions of Health Ministry, from a logical model for the construction of the indicators plan, and from workshops. The validation process of the indicators was carried out with the analysis of seven specialists from health care of black people, from the area of validation and evaluation in health, through the application of the concordance rate and the Index of Content Validity (IVC), to validate the plan of indicators divided into three dimensions: access to actions and health services, management, and education and research. It was used as a cut-off point for the 90% concordance rate, and 0.8 for the IVC. For the construction of the results of this study, the preliminary indicators plan, proposed in a larger project of which this study is part, was analyzed with a total of 11 indicators in the dimension "Access to health actions and services", 6 indicators in the "Management" dimension, and 2 indicators in the "Education and research" dimension. After the analysis of a logical model with the originals indicators to evaluate the implementation of the PNSIPN and the appreciation of the e-CAR reports, the indicators were restructured into: 27 indicators in the dimension "Access to the actions and services of health ", being 16 quantitative, and 11 qualitative; 7 indicators in "Management" dimension, being 6 quantitative and 1 qualitative; and 2 indicators in the "Education and research" dimension with a quantitative nature. Among the 27 indicators related to the dimension of "Access to actions and health service", 26 presented percentage of concordance of 100% and 1 presented a percentage of 71.4%. The 7 indicators in management dimension and the 2 indicators in the "Education and research" dimension obtained 100% agreement. In the general assessment, the indicators plan obtained an IVC of 0.86. With this study, we concluded that the process of review and validation of the indicators plan was essential to provide the consistency, relevance and clarity necessary for the evaluation about implementation of the PNSIPN. However, it is necessary to give continuity to its improvement in subsequent phases