Décentralisation et allocation des ressources : les détours de la municipalisation du système de santé brésilien

Dans cette thèse, nous avons analysé le déroulement d’un processus de municipalisation du système de santé, effectué au Rio Grande do Norte (RN), un des états fédérés du nord-est du Brésil. En tenant compte des contextes historiques d’implantation, nous avons centré notre attention sur la contribution des acteurs impliqués dans ce processus, spécialement dans l’allocation des ressources financières du système. Les croyances, perceptions, attentes, représentations, connaissances, intérêts, l’ensemble des facteurs qui contribuent à la constitution des capacités cognitives de ces acteurs, favorise la réflexivité sur leurs actions et la définition de stratégies diverses de façon à poursuivre leurs objectifs dans le système de santé. Ils sont vus ainsi comme des agents compétents et réflexifs, capables de s’approprier des propriétés structurelles du système de santé (règles et ressources), de façon à prendre position dans l’espace social de ce système pour favoriser le changement ou la permanence du statu quo. Au cours du processus de structuration du Système unique de santé brésilien, le SUS, la municipalisation a été l’axe le plus développé d’un projet de réforme de la santé. Face aux contraintes contextuelles et de la dynamique complexe des espaces sociaux de la santé, les acteurs réformistes n’ont pas pu suivre le chemin de l’utopie idéalisée; quelques détours ont été parcourus. Au RN, la municipalisation de la santé a constitué un processus très complexe où la triade centralisation/décentralisation/recentralisation a suivi son cours au milieu de négociations, de conflits, d’alliances, de disputes, de coopérations, de compétitions. Malgré les contraintes des contextes successifs, des propriétés structurelles du système et des dynamiques sociales dans le système de santé, quelques changements sont intervenus : la construction de leaderships collectifs; l’émergence d’une culture de négociation; la création des structures et des espaces sociaux du système, favorisant les rencontres des acteurs dans chaque municipalité et au niveau de l’état fédéré; un apprentissage collectif sur le processus de structuration du SUS; une grande croissance des services de première ligne permettant d’envisager une inversion de tendance du modèle de prestation des services; les premiers pas vers la rupture avec la culture bureaucratique du système. Le SUS reste prisonnier de quelques enjeux institutionnalisés dans ce système de santé : la dépendance du secteur privé et de quelques groupes de professionnels; le financement insuffisant et instable; la situation des ressources humaines. Les changements arrivés sont convergents, incrémentiels, lents; ils résultent d’actions normatives, délibérées, formalisées. Elles aussi sont issues de l’inattendu, de l’informel, du paradoxe; quelques-unes plus localisées, d’autres plus généralisées, pour une courte ou une plus longue durée.

Tackling health inequalities in primary care: an exploration of GPs’ experience at the frontline

In Scotland, life expectancy and health outcomes are strongly tied to socioeconomic status. Specifically, socioeconomically deprived areas suffer disproportionately from high levels of premature multimorbidity and mortality. To tackle these inequalities in health, challenges in the most deprived areas must be addressed. One avenue that merits attention is the potential role of general medical practitioners (GPs) in helping to address health inequalities, particularly due to their long-term presence in deprived communities, their role in improving patient and population health, and their potential advocacy role on behalf of their patients. GPs can be seen as what Lipsky calls ‘street-level bureaucrats’ due to their considerable autonomy in the decisions they make surrounding individual patient needs, yet practising under the bureaucratic structure of the NHS. While previous research has examined the applicability of Lipsky’s framework to the role of GPs, there has been very little research exploring how GPs negotiate between the multiple identities in their work, how GPs ‘socially construct’ their patients, how GPs view their potential role as ‘advocate’, and what this means in terms of the contribution of GPs to addressing existing inequalities in health. Using semi-structured interviews, this study explored the experience and views of 24 GPs working in some of Scotland’s most deprived practices to understand how they might combat this growing health divide via the mitigation (and potential prevention) of existing health inequalities. Participants were selected based on several criteria including practice deprivation level and their individual involvement in the Deep End project, which is an informal network comprising the 100 most deprived general practices in Scotland. The research focused on understanding GPs’ perceptions of their work including its broader implications, within their practice, the communities within which they practise, and the health system as a whole. The concept of street-level bureaucracy proved to be useful in understanding GPs’ frontline work and how they negotiate dilemmas. However, this research demonstrated the need to look beyond Lipsky’s framework in order to understand how GPs reconcile their multiple identities, including advocate and manager. As a result, the term ‘street-level professional’ is offered to capture more fully the multiple identities which GPs inhabit and to explain how GPs’ elite status positions them to engage in political and policy advocacy. This study also provides evidence that GPs’ social constructions of patients are linked not only to how GPs conceptualise the causes of health inequalities, but also to how they view their role in tackling them. In line with this, the interviews established that many GPs felt they could make a difference through advocacy efforts at individual, community and policy/political levels. Furthermore, the study draws attention to the importance of practitioner-led groups—such as the Deep End project—in supporting GPs’ efforts and providing a platform for their advocacy. Within this study, a range of GPs’ views have been explored based on the sample. While it is unclear how common these views are amongst GPs in general, the study revealed that there is considerable scope for ‘political GPs’ who choose to exercise discretion in their communities and beyond. Consequently, GPs working in deprived areas should be encouraged to use their professional status and political clout not only to strengthen local communities, but also to advocate for policy change that might potentially affect the degree of disadvantage of their patients, and levels of social and health inequalities more generally.

A política de gestão de pessoas da UFPA: em sintonia com o gerencialismo?

This research examined the personnel policies of the Federal University of Pará (UFPA), aimed at the middle area, implemented by the President's Office of Personnel Management (PROGEP), through the Performance Management and Development from 2006 to 2009 period, in which Institutional Plan was implemented for Technical and administrative (PIDT) with a view to ascertaining whether these actions were developed in line with the ideas of managerialism or New Public Management (NPM). The study opted for qualitative research using interview as a tool to collect data. The informants were managers PROGEP / UFPA who acted in that period. Data interpretation was based on analysis of content from the collation of speeches and documents produced during the period with the managerial categories. Data analysis revealed that the management of people, UFPA has the characteristics of a hybrid management, observing the period studied two models of management: a bureaucratic, rational, focused on processes, contemporary face of public organizations, and other managerialist, adopted by PROGEP in obedience to the mandatory policies of the federal government, being much more present the characteristics of a personnel policy-oriented processes. Concludes that the personnel policy of the UFPA has not been fully tuned to managerialism in the surveyed period

Caracterização da economia solidária à luz do ambiente isonômico de Guerreiro Ramos: um estudo no Grupo Mulheres Decididas a Vencer

The Solidary Economy is an area that has shown unusual traits to what is preached in the traditional economic organizations, even organizations that have very similar principles, as some cooperatives. This trait is approaching the concept of isonomy proposed by Ramos (1989). Given this context, and the notion that the isonomy is like a ideal type, the objective this work was to evidence particulars of isonomic environment the in economic and solidarity experiences, taking as an empirical research area the Grupo de Mulheres Decididas a Vencer, considered a solidary economic enterprise. For this, we used the descriptive-exploratory research of qualitative nature, where the object of such research is the know enterprise, therefore, also characterized as a case study, which were taken as research subjects six associates, they being the most active in the enterprise. From the five categories that characterize isonomy - minimum standards prescribing, self-gratifying activity, activities undertaken as a vocation, wide system of making decision and primaries interpersonal relations - and from the traits of a solidary economic enterprise the data analysis was built, through content analysis, specifically the categorial analysis. Given this context and reality in which it is Grupo de Mulheres Decididas a Vencer, with minimal rules and procedures for conducting activities, comparing them to a therapy, women choosing to insert in that environment, faced with a democratic space and unfettered bureaucracy in professional interpersonal relationships, in others words, an organizational space where they were shown signs of substantive rationality was possible to conclude that the Group will share experiences and characteristics of isonomy. This disclosure meets the multidimensional social that presupposes Paraecomomic Paradigm, enabling man to enter in different social environments of the economy in order to search for self-actualization

Factors that influence entrepreneurship activity by gender in the European Union

This research work aims to discuss the gender issue concerning entrepreneurship in European Union countries in a period of nine years, from 2007 to 2015, identifying the factors which drive individuals to be entrepreneurs. The study mainly concentrates on identifying and quantifying the personal, social, political and economic features which are motivating individuals, especially women, to be entrepreneurs, as well as the main difficulties they feel during the process of business creation. In order to explore the entrepreneurial activity across a set of developed countries the econometric methodology of panel data (in particular the fixed effects and random effects models) is applied to a data set of entrepreneurial statistical indicators calculated and made available by the Global Entrepreneurship Monitor. The results show that the knowledge of other start-up entrepreneurs, a desired career choice, the governmental support and the existence of public policies that promote entrepreneurship (specially within the framework of small and medium sized firms) and the transfer of R&D are factors influencing negatively on the rate of female entrepreneurship. None of the observed variables are barriers for male entrepreneurs. The perceived capabilities and opportunities, the entrepreneurial intention, the policies to lower taxes and bureaucracy and the social and cultural norms are identified drives for women for engaging in a process of running their own ventures. These findings offer a set of valid knowledge to understand which measures could be implemented or should be changed and improved at a political and managerial level for stimulating entrepreneurship, especially for women.

Fatores influenciadores do comportamento de decisão e ação dos implementadores do serviço de Proteção e Atendimento Integral à Família (PAIF)

Tese (doutorado)—Universidade de Brasília, Faculdade de Economia, Administração e Contabilidade, Programa de Pós-Graduação em Administração, 2016.

Gestão compartilhada de P&D em petróleo:a interação entre a Petrobrás e a Universidade Federal do Rio Grande do Norte

This work addresses the relationship between University-Firm aims to understand the model of shared management of R&D in petroleum of Petrobras with UFRN. This is a case study which sought to investigate whether the model of cooperation established by the two institutions brings innovation to generate technical-scientific knowledge and contribute to the coordination with other actors in the promotion of technological innovation. In addition to desk research the necessary data for analysis were obtained by sending questionnaires to the coordinators of projects in R&D at the company and university. Also, interviews were conducted with subjects who participated in the study since its inception to the present day. This case study were analysed through the Resource-Based View and Interorganizational Networks theory. The sample data also stands that: searches were aligned to the strategic planning and that 29% of R&D projects have been successful on the scope of the proposed objectives (of which 11% were incorporated into business processes); which was produced technical and scientific knowledge caracterized by hundreds of national and international publications; thesis, dissertations, eleven patents, and radical and incremental innovations; the partnership has also brought benefits to the academic processes induced by the improved infrastructure UFRN and changing the "attitude" of the university (currently with national prominence in research and staff training for the oil sector). As for the model, the technical point of view, although it has some problems, it follows that it is appropriate. From the viewpoint of the management model is criticized for containing an excess of bureaucracy. From the standpoint of strategic allocation of resources from the legal framework needs to be reassessed, because it is focused only on the college level and it is understood that should also reach the high school given the new reality of the oil sector in Brazil. For this it is desirable to add the local government to this partnership. The set of information leads to the conclusion that the model is identified and named as a innovation of organizational arrangement here known as Shared Management of R&D in petroleum of Petrobras with UFRN. It is said that the shared management model it is possible to exist, which is a simple and effective way to manage partnerships between firms and Science and Technology Institutions. It was created by contingencies arising from regulatory stand points and resource dependence. The partnership is the result of a process of Convergence, Construction and Evaluation supported by the tripod Simplicity, Systematization and Continuity, important factors for its consolidation. In practice an organizational arrangement was built to manage innovative university-industry partnership that is defined by a dyadic relationship on two levels (institutional and technical, therefore governance is hybrid), by measuring the quarterly meetings of systematic and standardized financial contribution proportional to the advancement of research. These details have led to the establishment of a point of interaction between the scientific and technological-business dimension, demystifying they are two worlds apart

De plano piloto a metrópole : entraves e desafios da política habitacional de Brasília

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Economia, Administração e Contabilidade, Programa de Pós-Graduação em Administração, Mestrado Profissional em Administração Pública, 2015.

Les réseaux de corruption à Laval et Montréal : un essai d'interprétation de la corruption municipale québécoise

Dans les dernières années, la corruption municipale a constitué un enjeu d’importance au Québec, posant des questions majeures sur la qualité de la gouvernance municipale. Ce mémoire vise à comprendre comment fonctionnait le système de corruption découvert au niveau des municipalités. En premier lieu, l’aspect historique de la corruption municipale sera examiné pour identifier l’héritage ayant influencé les pratiques actuelles. Surtout, ce phénomène sera abordé pour décrire la structure de gouvernance informelle qui s’est développée au sein des institutions municipales, plus spécifiquement dans les cas de Laval et Montréal. Le modèle théorique de Della Porta et Vannucci (2012) permettra d’illustrer la façon dont les acteurs internalisent les normes de la corruption, comment ils développent des relations de confiance entre eux et, enfin, comment l’action de régulateurs vient cimenter l’institutionnalisation de réseaux de corruption. Enfin, le mémoire vise à déceler quels aspects inhérents aux institutions municipales québécoises les ont rendues vulnérables à la corruption. La faiblesse et la capacité limitée des institutions formelles à structurer avec succès les incitatifs sera mise de l’avant. On examinera les limites des institutions visant à établir une surveillance externe des municipalités, pour ensuite se pencher sur les institutions internes pouvant prévenir la corruption, soit la bureaucratie et la démocratie municipale. En bref, le mémoire vise à identifier les structures de gouvernance des réseaux de corruption à Laval et Montréal, puis à en expliquer la provenance par la faiblesse d’institutions qui auraient pu l’endiguer.

Les réseaux de corruption à Laval et Montréal : un essai d'interprétation de la corruption municipale québécoise

Dans les dernières années, la corruption municipale a constitué un enjeu d’importance au Québec, posant des questions majeures sur la qualité de la gouvernance municipale. Ce mémoire vise à comprendre comment fonctionnait le système de corruption découvert au niveau des municipalités. En premier lieu, l’aspect historique de la corruption municipale sera examiné pour identifier l’héritage ayant influencé les pratiques actuelles. Surtout, ce phénomène sera abordé pour décrire la structure de gouvernance informelle qui s’est développée au sein des institutions municipales, plus spécifiquement dans les cas de Laval et Montréal. Le modèle théorique de Della Porta et Vannucci (2012) permettra d’illustrer la façon dont les acteurs internalisent les normes de la corruption, comment ils développent des relations de confiance entre eux et, enfin, comment l’action de régulateurs vient cimenter l’institutionnalisation de réseaux de corruption. Enfin, le mémoire vise à déceler quels aspects inhérents aux institutions municipales québécoises les ont rendues vulnérables à la corruption. La faiblesse et la capacité limitée des institutions formelles à structurer avec succès les incitatifs sera mise de l’avant. On examinera les limites des institutions visant à établir une surveillance externe des municipalités, pour ensuite se pencher sur les institutions internes pouvant prévenir la corruption, soit la bureaucratie et la démocratie municipale. En bref, le mémoire vise à identifier les structures de gouvernance des réseaux de corruption à Laval et Montréal, puis à en expliquer la provenance par la faiblesse d’institutions qui auraient pu l’endiguer.

EQUASS Assurance Certification: The View of Pioneer Adopters

Purpose – The paper examines from a practitioner’s perspective the European Quality in Social Services (EQUASS) Assurance standard, a certification programme for European social service organisations to implement a sector-specific Quality Management System. In particular, it analyses the adoption motives, the internalisation of the standard, the impacts, the satisfaction and the renew intentions. Design/methodology/approach – This study uses a cross-sectional, questionnaire-based survey methodology. From the 381 organisations emailed, 196 responses coming from eight different European countries were considered valid (51.4%). Data from closed-ended questions were analysed using simple descriptive statistical techniques. Content analysis was employed to analyse practitioner’s comments to open-ended questions. Findings – It shows that social service providers typically implement the certification for internal reasons, and internalise EQUASS principles and practices in daily usage. EQUASS Assurance produces benefits mainly at the operational and customer levels, whereas its main pitfalls include increased workload and bureaucracy. The majority of respondents (85.2%) are very satisfied or satisfied with the certification, suggesting that it meets their expectations. Certification renewal intentions are also high but some respondents report that the final decision depends on several factors. The insights gained through the qualitative data are also described. Practical implications – It can be helpful to managers, consultants and Local License Holders working (or planning to work) with this standard. It can inform the work of the EQUASS Technical Working Group in the forthcoming revision of the standard. Originality/value – This is the largest survey conducted so far about EQUASS Assurance in terms of number of respondents, participating countries and topics covered.

Initiative huronne-wendat de création d’une aire protégée : Mobilisation des savoirs et affirmation territoriale

Ce mémoire traite du projet de création de l’aire protégée Ya’nienhonhndeh de la Nation huronne-wendat. À travers l’exploration de la production, de la circulation et de l’utilisation des savoirs relatifs à ce projet, nous cherchons à éclairer les dynamiques constitutives des relations entre la Nation huronne-wendat et l’État québécois dans le cadre de la gestion du territoire traditionnel huron-wendat, le Nionwentsïo. Ce mémoire vise d’abord à mettre en lumière les aspirations de la Nation huronne-wendat concernant l’avenir de son territoire ancestral ainsi qu’à documenter les types de savoirs produits pour les faire valoir. Ensuite, à partir de la cartographie du cheminement de ces savoirs, sont exposés les obstacles structurels qui entravent la réalisation de ces aspirations lorsqu’elles doivent passer par la bureaucratie québécoise. Puis, en s’appuyant sur quelques-unes des diverses utilisations qui furent faites de ces savoirs, la réflexion est élargie pour porter sur les rapports de pouvoir établis entre la Nation huronne-wendat et l’État québécois dans le cadre de questions territoriales. Mots clés : aire protégée, Hurons-Wendat, projet autochtone, aspirations autochtones, bureaucratie, institutions, rapports de pouvoir, État québécois

Itinerarios burocráticos y ciudadanía transitoria: un acercamiento al desplazamiento Emberá en Bogotá.

Del año 2013 al 2015, los indígenas Emberá desplazados en Bogotá, a causa del reconocimiento que el estado les dio por ser sujetos del desplazamiento, estuvieron obligados a encarar dos formas de gubernamentalidad estatal que tuvieron múltiples consecuencias en su vida cotidiana. La primera de estas formas de gubernamentalidad se manifestó en una ciudadanía multicultural (aquí llamada ciudadanía transitoria) la cual, desde el subsidio de vivienda reconocido con albergues en la ciudad, limitó diferentes derechos Emberá bajo el argumento multicultural de que en la ciudad la cultura y, ellos mismos físicamente, eran vulnerables. La consecuencia de este discurso, con el que se les permitió dormir en un techo digno, fue la de obligarlos en buena medida a asumir su vida en la ciudad como un transito hacia el retorno a su territorio de origen, desde donde habían salido, sobre todo, huyendo de la violencia. Por otra parte, la segunda forma de gubernamentalidad tuvo que ver con una serie de itinerarios burocráticos que asumían los Emberá una vez llegaban a la ciudad. Estos eran recorridos que emprendían por diferentes burocracias de los gobiernos nacional y local con el propósito de exigirle al estado el reconocimiento de sus derechos. En cada uno de estos recorridos se desenmascaraba una forma de violencia estatal (característica del funcionamiento de las burocracias) que, como se puede ver en esta tesis, tenía profundas repercusiones en el día a día de los indígenas Emberá dentro de la urbe.

¿Meritocracia o presión gubernamental? una aproximación desde la sociología de las organizaciones a la burocracia de la ONU en la OESG (2015)

El interés de esta monografía es realizar una mirada crítica a la burocracia de Las Naciones Unidas, tomando como fracción representativa a aquellos funcionarios que hacen parte de la Oficina Ejecutiva del Secretario General. Para ello se toma como guía algunos conocimientos y herramientas de la sociología de las organizaciones. Este texto presenta las normas del juego relativas a la función pública de la organización; así como las prácticas organizacionales en general, y más específicamente en los aspectos del ingreso, permanencia y retiro de los funcionarios. Como resultado se conoce el aparato burocrático de Las Naciones Unidas. El ejercicio consiste en abordar la sociología de las organizaciones como meta-valor de la sociología y como esquema metodológico para el investigador social. Consecutivamente, en conocer la dimensión formal de esta organización y, no sólo su dimensión informal, sino su comportamiento cotidiano en su estructura real.

Nova Talenta: 2015-2016

Introducción -- Liderazgo transformacional e inteligencia emocional: una revisión / Gina Paola Cortés Agudelo, Olga Lucia Lacouture -- El liderazgo transformacional y sus implicaciones en la cultura organizacional: una revisión de la literatura / Alejandro Arévalo, Iván Suárez, Jhon Zuluaga -- Liderazgo femenino: una revisión a la literatura / David Leonardo Méndez Sarmiento, María José Cruz Mancheno -- Liderazgo adaptativo y las relaciones de aprendizaje: implicaciones para las organizaciones actuales / María Alejandra Avella Torres, Laura Katherine Umaña Roa -- Inteligencia emocional y su relación con el liderazgo de rango total / Diego Stiven García Morales, Mohamed zakaria el arksoussi fakih -- Influencia del liderazgo transformacional y transaccional sobre la calidad de vida laboral en las empresas / María Paula Ordoñez Valencia -- Discriminación y desigualdad de género : situación actual de las mujeres en el mundo empresarial / Daniela Andrade Palau / Natalia Villarreal Rodríguez -- Competitividad: análisis comparativo entre Colombia y chile desde la perspectiva de la innovación / Álvaro David Buenaventura Maya.