1000 resultados para Universidade publica
Resumo:
The groundwater represents the most important freshwater supply of planet. Dailly, in all world a great amount of toxic and genotoxic material reaches the aquatic systems, mainly the aquifers. The Barreiras aquifer through of five water wells is responsible for the supplying of Universidade Federal do Rio Grande do Norte (UFRN). All water wells are polluted with nitrate and some heavy metals, two of them were disabled. The genotoxicity of groundwater samples from Barreiras Aquifer in UFRN was assessed using the Allium cepa test, the Ames test and the Salmonella typhymurium microsuspension test (Kado test). For the Allium cepa test the influence of the groundwater samples collected on macroscopic (root length, colour and form) and microscopic (root tip mitotic index, chromosome aberrations and micronucleus) parameters was examined. All water samples caused a significant increase of the chromosome and mitotic aberration frequency and reduction on the rooth growth compared to negative control. Bridges and chromosome stickness were the most frequent kind of aberration in dividing cells. Furthermore, breaks were also observed. No significant increase in the number of micronuclei was found in relation to the negative controls. For Ames test were used the Salmonella typhymurium strains TA98 and TA100 without metabolic activation, applying the direct method. Prior to the Kado test, organic fractions from the water samples were obtained through XAD resin concentration. The mutagenicity organic extracts were evaluated by Kado test using TA98 and TA100 strains, in the absence and presence of S9 mix (metabolic activation). The concentrations of seven heavy metal ions were measured in water samples, but only Ni, Cu and Cr levels exceeded the permissible maximum concentration for the natural reservoirs. The results obtained for mutagenic activity using the Ames test were negative in all raw water samples analyzed. Positive results in XAD4 extracts of water samples were obtained for TA98 in the presence of S9 mix for two stations. Concentrations of heavy metals and nitrate can be correlated with the toxicity and genotoxicity of water analyzed. The mutagenic effect detected with TA98 strain suggested that organic compounds (after metabolization) are involved with the mutagenicity detected in the samples analyzed. The data set obtained in this work indicated the presence of at least two classes of mutagens: organic and inorganic compounds
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The inventory management in hospitals is of paramount importance, since the supply materials and drugs interruption can cause irreparable damage to human lives while excess inventories involves immobilization of capital. Hospitals should use techniques of inventory management to perform replenishment in shorter and shorter intervals, in order to reduce inventories and fixed assets and meet citizens requirements properly. The inventory management can be an even bigger problem for public hospitals, which have restrictions on the use of resources and decisionmaking structure more bureaucratized. Currently the University Hospital Onofre Lopes (HUOL) uses a periodic replacement policy for hospital medical supplies and medicines, which involves one moment surplus stock replenishment, the next out of stock items. This study aims to propose a system for continuous replenishment through order point for inventory of medical supplies and medicines to the hospital HUOL. Therefore, a literature review of Federal University Hospitals Management, Logistics, Inventory Management and Replenishment System in Hospitals was performed, emphasizing the demand forecast, classification or ABC curve and order point system. And also, policies of inventory management and the current proposal were described, dealing with profile of the mentioned institution, the current policy of inventory management and simulation for continuous replenishment order point. For the simulation, the sample consisted of 102 and 44 items of medical and hospital drugs, respectively, selected using the ABC classification of inventory, prioritizing items of Class A, which contains the most relevant items in added value, representing 80 % of the financial value in 2012 fiscal year. Considering that it is a public organization, subject to the laws, we performed two simulations: the first, following the signs for inventory management of Instruction No. 205 (IN 205 ), from Secretary of Public Administration of the Presidency ( SEDAP / PR ), and the second, based on the literature specializing in inventory management hospital. The results of two simulations were compared to the current policy of replenishment system. Among these results are: an indication that the system for continuous replenishment reorder point based on IN 205 provides lower levels of safety stock and maximum stock, enables a 17% reduction in the amount spent for the full replenishment of inventories, in other words, decreasing capital assets, as well as reduction in stock quantity, also the simulation made from the literature has indicated parameters that prevent the application of this technique to all items of the sample. Hence, a change in inventory management of HUOL, with the application of the continuous replenishment according to IN 205, provides a significant reduction in acquisition costs of medical and hospital medicine
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The deficit of water and sewerage services is a historic problem in Brazil. The introduction of a new regulatory framework, in 2007, presented ways intending to overcome these deficits, among them, the providers efficiency improvement. This thesis aims to analyze the regulators performance regarding its ability to induce the efficiency of the Brazilian water and sewerage services providers. To this end, an analytical approach based on a sequential explanatory strategy was used, and it consists of three steps. In the first step, the Data Envelopment Analysis ( DEA ) was used to measure the providers efficiency in 2006 and 2011. The results show that the average efficiency may be considered high; however significant inefficiencies among the 29 analyzed providers were detected. The ones in the Southeast region showed better performance level and Northeast had the lowest. The local and the private providers were more efficient on average. In 2006 and 2011 the average performance was higher among non-regulated providers. In 2006 the group regulated by local agencies had the best average performance, in 2011, the best performance was the group regulated by the consortium agencies. To analyse the second step was used the Malmquist Index, it pointed that the productivity between 2006 and 2011 dropped. The analysis through decomposing Malmquist Index showed a shift of technical efficiency frontier to a lower level, however was detected a small provider s advance towards the frontier. Only the Midwest region recorded progress in overall productivity. The deterioration in the total factor productivity was higher among regional providers but the local ones and the private agencies moved quickly to the frontier level. The providers regulated from 2007 showed less decrease on the total productivity and the results of the catch up effect were more meaningful. In the last step, the regulators standardization activity analyses noted that there are agencies that had not issued rules until 2011. The most standards topics discussed in the issued rules were the tariff adjustments and the setting of general conditions for the provision and use of services; in another hand, the least covered topics were new technologies incentive and the introduction of efficiency-inducing regulatory mechanisms and productivity gains for price reviews. Regulators created from 2007 were more active proportionately. Even with the advent of the regulatory framework and the creation of new regulatory bodies, the evidence points to a reality in which the actions of these agencies have not been ensuring that providers of water and sewage, regulated by them, has achieved better performance. The non- achievement of regulatory goals can be explained by the incipient level of performance of the Brazilian regulatory authorities, which should be strengthened because of its potential contribution to the Brazilian basic sanitation department
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The considerable expansion of Distance Education registered in recent years in Brazil raises the importance of debate about how the implementation of this policy has been happening so that formulators and implementers make better informed decisions, maximizing results, identifying successes and overcoming bottlenecks. This study aims to evaluate the implementation process of Distance Education policy by Secretary of Distance Education of the Federal University of Rio Grande do Norte. For this, we sought to use an evaluation proposal consistent with this policy, and came to the one developed by Sonia Draibe (2001), which suggests an analysis called anatomy of evaluation general process. To achieve the objectives, we made a qualitative research, case study type, using documentary research and semi-structured interviews with three groups of subjects who belong to the policy: managers, technicians and beneficiaries. It was concluded that: the implementation process needs a open contact channel between the management and technicians and beneficiaries; the lack of clarity in the dissemination of information between technicians produces noises that affects the outcomes; the absence of dissemination of internal and external actions contributes to the perpetuation of prejudice in relation to Distance Education; using selection criteria based on competence and merit contributes to form a team of skilled technicians to perform their function within the policy; an institution that do not enable technicians generates gaps that possibly will turn into policy implementation failures; all subjects involved in politics need internal evaluations to contribute to improvements in the implementation process, however, a gap is opened between the subjects if there is no socialization of results; the existence of an internal structure that manipulates financial resources and balances the budget from different maintainer programs is essencial; the consortium between IES and municipalities in presential support poles are bottlenecks in the process, since beneficiaries are exposed to inconsistency and lack of commitment of these local municipalities
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Outsourcing has emerged as one of the new ways of guiding the work. For its advantages and be consistent with the paradigms of managerial reform, outsourcing also started to be used in the Public Administration. However, taking into account the particularities of the latter, some issues are relevant when outsourcing concluded with the State. Gains notoriety, for example, the step of monitoring these contracts, to the extent that, from this activity, we can avoid the negative effects of outsourcing like the fact that the state will pay for labor and wage liens that are obligation of the company providing the services. This study aims to understand the perception that this process is under the Federal University of Rio Grande do Norte, from the point of view of different stakeholders, also explaining the motivations that these agents have to perform the supervisory process. As a theoretical basis was used the Agency Theory, which reinforces the supervisory activities as a necessary means to minimize moral hazard and adverse selection, seeking to understand not only the different motivations tax contracts to properly perform their duties, but also analyze other phenomena arising from this contractual relationship. To achieve the proposed objectives, were taken a literature review and a presentation of how to organize the management and oversight of contracts in UFRN. The methodological procedures included questionnaires and interviews with those involved in the process. After analyzing the results obtained in the survey instruments , and also based on the laws, regulations and instructions governing the procurement process within the UFRN, it was concluded that the process of overseeing the outsourcing of labor contracts in UFRN is not fully institutionalized, some points should be strengthened in order to have the consolidation of this process, highlighting the need for training of UFRN servers that act as tax, the knowledge that the contractual penalties are applied effectively, the need that there is a supervisor of tax of contractors and also the realization of the rotation system of outsourced employees
Resumo:
In recent decades higher education in Brazil has gone through several changes. The Programa de Reestruturação e Expansão das Universidades Federais REUNI has been the greatest overhaul performed by the government in public universities in the last years. REUNI is presented as the biggest reform in tertiary education in contemporary times, having as the main goal a gradual increase in the average rate of conclusion in live learning graduation courses up to 90%, as well as a rate expansion of graduating students in face to face classes per professor. This research aims at studying the perception of professors from UFRN concerning the REUNI program in execution from 2008 until 2012. The study seeks to understand how professors evaluate the program and what the dimensions that most influence in this evaluation are. The study made use of a research tool (survey) which was sent through the internal system of the university, SIGAdmin, to all professors of superior teaching from UFRN. The answers generated by the survey were processed using SPSS statistical software (Statistical Package for Social Science). Factorial Analysis and Multiple Linear Regression were used as an analysis technique. 180 answers were obtained, reaching all UFRN Centers and some academic units, as well as some campuses in the countryside of the state. Through the research was possible to analyze how professors from UFRN perceive the REUNI program implemented in the institution. The results point to the program approval by the professors. Statistical tests showed that the average values obtained in the Centers and academic units are basically the same. It was demonstrated that the extent that most influenced in the answers is linked to practical outcomes of the program, whereas the knowledge of REUNI goals was the least that impacted on the marks given to the program. Another dimension which influenced the perception of professors relates to the influence of REUNI in their activities. It was observed that professors from UFRN don t see REUNI as an impediment to them
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The nature of this thesis is interventionist and aims to create an alternative on how to control and evaluate the public policies implementation developed at the Institute for Technical Assistance and Rural Extension of Rio Grande do Norte State. The cenarium takes place in a public institution , classified as a municipality that belongs to the Rio Grande do Norte government and adopts the design science research methodology , where it generates a set of artifacts that guide the development of a computerized information system . To ensure the decisions, the literature was reviewed aiming to bring and highlight concepts that will be used as base to build the intervention. The use of an effective methodology called Iconix systems analysis , provides a software development process in a short time . As a result of many artifacts created by the methodology there is a software computer able of running on the Internet environment with G2C behavior, it is suggested as a management tool for monitoring artifacts generated by the various methods. Moreover, it reveals barriers faced in the public companies environment such as lack of infrastructure , the strength of the workforce and the executives behavior
Resumo:
The information tecnology (IT) has, over the years, gaining prominence as a strategic element and competitive edge in organizations, public or private. In the judiciary, with the implementation of actions related to Judiciário Eletrônico, information technology (IT), definitely earns its status as a strategic element and significantly raises the level of dependence of the organs of their services and products. Increasingly, the quality of services provided by IT has direct impact on the quality of services provided by the agency as a whole. The Ministério Público do Estado do Rio Grande do Norte (MPRN) deployments shares of Electronic Government, along with an administrative reform, beyond these issues raised, caused a large increase in institutional demand for products and services provided by the Diretoria de Tecnologia da Informação (DTI), a sector responsible for the provision of IT services. Taking as starting point strategic goal set by MPRN to reach a 85% level of user satisfaction in four years, we seek to propose a method that assists in meeting the goal, respecting the capacity constraints of the IT sector. To achieve the proposed objective, we conducted a work in two distinct and complementary stages. In the first step we conducted a case study in MPRN, in which, through an internal and external diagnosis of DTI, accomplished by an action of internal consulting and one research of the user satisfaction, we seek to identify opportunities of change seeking to raise the quality perceived of the services provided by the DTI , from the viewpoint of their customers. The situational report, drawn from the data collected, fostered changes in DTI, which were then evaluated with the managers. In the second stage, with the results obtained in the initial process, empirical observation, evaluation of side projects of quality improvement in the sector, and validation with the managers, of the initial model, we developed an improved process, gazing beyond the identification of gaps in service a strategy for the selection of best management practices and deployment of these, in a incremental and adaptive way, allowing the application of the process in organs with little staff allocated to the provision of information technology services
Resumo:
Trata-se do relato de uma experiência desenvolvida em cursos de pós-graduação, sobre o processo de investigação e desenvolvimento de um programa para a disciplina Didática Geral. Descreve: 1) o objetivo - transformação do fazer docente na Universidade; 2) o conteúdo - fundamentos teóricos do ensino superior e planejamento de ensino; 3) o método - tomada de consciência e micro-aulas. 4) a avaliação - diagnóstica, formativa e somativa.
Resumo:
A tese se propôs a avaliar a relação entre saúde psíquica e condições de trabalho em dois hospitais da Universidade Federal do Rio Grande do Norte, a saber: Hospital Universitário Onofre Lopes e Hospital Universitário Ana Bezerra. Adotou como ponto de partida epistemológico a abordagem psicossociológica, considerando que a compreensão sócio-histórica do contexto é indispensável para entender os fenômenos em análise. As condições de trabalho e a saúde psíquica foram abordadas interdisciplinarmente, fundamentando a construção de um modelo compreensivo de saúde psíquica que orientou a investigação. O caminho metodológico utilizado foi a pesquisação. Essa foi desenvolvida, utilizando técnicas como análise documental, observação participante, entrevistas não estruturadas, grupo focal e aplicação de um protocolo de pesquisa composto pelo questionário de condições de trabalho, pelo Questionário de Saúde Geral (QSG-60), pela Escala de Bem-Estar Afetivo no Trabalho (JAWS-12) e por questões sociodemográficas. A análise dos resultados mostrou que os escores sintomáticos de saúde psíquica variam por hospitais e que a saúde psíquica sofre influência das condições de trabalho, sobretudo em aspectos referentes a três dimensões: condições físicas e materiais; processos e características do trabalho e o ambiente sociogerencial. Em referência à primeira dessas dimensões, destacaram-se a exposição aos riscos psicobiológicos e de acidentes, bem como as exigências de esforço físico. Na segunda dimensão, a complexidade das atividades e a responsabilidade implicada nas mesmas. E, na última, os fatores de organização da atividade, violência e ambiente conflitivo. Como a relação do indivíduo com seu contexto é dialética, os resultados encontrados corroboraram que quanto mais as condições de trabalho são desfavoráveis, maior a afetação da saúde psíquica e dos afetos com relação ao trabalho, repercutindo novamente no ambiente de trabalho. Portanto, ações de melhoria das condições de trabalho precisam ser estabelecidas para resultar, no efeito inverso, proporcionando o aumento dos afetos positivos e a redução dos sintomas psíquicos
Resumo:
This work deals with organizational support perception-OSP. This is done considering staff global beliefs, value of their contributions, care and well being related of individuals in an organization. These issues has been have been present in many researches since the 80s. It is important to analyze this matter considering all the changes that occurred nationally and internationally in the academic environment, characterized as being diversified in academic and managerial level. This occurs especially in Brazil since Federal Universities and their agents have suffered impact and restructuring. The research has emphasized the technical-managerial as well as professor staff level at Universidade Federal do Rio Grande do Norte aiming to deal with their unsatisfaction upon social political support. Thus, there was participation of 259 staff that were admitted from 2003 to 2005 in many sectors and units of the university. These subjects were submitted to a social and demographical query through an application of a scale of organizational support perception-OSP. Descriptive and multivariate analysis was done considering factors (management style of higher command), material support, wages, work overload, social support at work and ascending levels). Results show that there a hierarchy of the analyzed factors, the factor social support at work as being the first one with 3,31%, the factor management style of the higher command in second with 3,30%, then followed by the factor social support at work with 2,92%, in a sequence the factor material support, factor overload with 2,49% in the fourth position, and in the fifth place, the factor ascending with an average of 2,33% and in last the factor wages with 2,20%. It is concluded that the factors related to the more positive attributions of the OSP (social support at work), in a sequence material support opposing from the most negative factors of the OSP (wages, overload, ascending) reveal a reality that points out that the OSP is very much related to the individualized actions of the members of the organization (leader-member-group) rather than on structure and institutionalized actions carried out at UFRN
Resumo:
O presente estudo tem por objetivo avaliar a satisfação dos usuários em relação à qualidade da Atenção Primária à Saúde no Rio Grande do Norte. Trata-se de Pesquisa Avaliativa observacional transversal, com abordagem quantitativa, a qual faz parte da Avaliação Externa do Programa de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ), da Universidade Federal do Rio Grande do Norte. Foram utilizados dados secundários de todas as entrevistas com usuários das equipes que participaram da Avaliação Externa do PMAQ no Estado do RN. A pesquisa foi realizada em 167 municípios do Estado do Rio Grande do Norte, na qual a população foi composta por 1.650 usuários. A amostra se deu por conveniência a partir dos seguintes critérios: usuários que estavam presentes na Unidade Básica de Saúde (UBS) para realizar qualquer tipo de procedimento e que consentisse em participar da avaliação. Foram excluídos os que tinham ido pela primeira vez na unidade e aqueles que não frequentaram há mais de 12 meses. A coleta dos dados foi realizada no período de setembro a novembro de 2013. Para tanto, foi elaborado um protocolo de pesquisa contendo as seguintes dimensões: organizacional, interpessoal e estrutural. Em relação à dimensão organizacional os resultados mostram que a marcação de consultas tem se configurado em empecilho ao acesso do usuário ao serviço de saúde, uma vez que se faz necessário para o atendimento, enfrentar filas, antes da abertura da unidade para pegar fichas. No tocante ao funcionamento da unidade, se destaca o fato dos usuários referirem que o horário de funcionamento da unidade atende à suas necessidades, apesar de funcionar 5 (cinco) dias por semana, a maioria das unidades permanece fechada no horário de almoço. Outro dado importante refere-se à coordenação do cuidado, cujos resultados apresentam diferenças maiores entre os usuários da região metropolitana e do interior do Estado em relação à Capital. Essa diferença se expressa principalmente em relação de marcação de consulta com outros profissionais especialistas. A dimensão interpessoal, no que diz respeito à categorias interação usuário-serviço-equipe e vínculo, demonstraram alguns avanços, contudo os melhores resultados foram observados em relação a satisfação com o cuidado, onde mais de 50% dos usuários se mostraram satisfeitos com o cuidado recebido nas unidades. Em contrapartida, o estudo mostrou que, na opinião de 56% dos usuários da capital, a falta de materiais e equipamentos influencia negativamente no cuidado. Por fim, o estudo contribuiu para reforçar a ideia de que a avaliação da satisfação dos usuários dos serviços de saúde pode ser uma ferramenta importante para subsidiar o processo de decisão compartilhada, de forma a se repensar as práticas profissionais, reorganizar o processo de trabalho desenvolvido, realocar recursos, readequar ações e redefinir objetivos que estejam coerentes com o projeto de saúde estabelecido
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This dissertation aimed to analyze the perception of students about (EPW Health) Education Program at Work for Health Training in the area of Health. It discusses the proposed theme from the perception of students graduating from the EPW- Health courses participants (dentistry, medicine, physiotherapy, nursing, nutrition, physical education) who have developed their school activities in family health units in the city of João Pessoa between 2009/2011.The program aims policies curricular changes as a potential route of contributions to training in healthcare. Attention is drawn to the new possibilities of working health training contextualized, ethically grounded, socially endorsed. It is pointed out in this process the need to adapt to the demands of professional profiles of SUS (Sistema Único de Saúde). This is an exploratory, descriptive study within a qualitative approach, conducted in the city of João Pessoa in the context of health care courses at the Federal University of Paraiba. The empirical material of this study was treated by the use of technical analysis "Categorical Content Theme" by Bardin. The results indicate prospects for promoting new practices and curricular changes, which highlights the EPW- Health, which has been presenting important experiences in teaching -community -service- with the inclusion of students in the municipal health network. We conclude that the path from collection to data analysis, corroborated with the literature to reaffirm the importance and urgency of change in educational processes with a view to greater proximity to the health needs and the SUS. The EPW- Health project is incipient and requires further investigation in terms of effective interdisciplinary and multidisciplinary character of its proposal
Resumo:
Popular Health Education in its emancipatory dimension refers to individuals and groups to exchange knowledge and experiences, allowing them to associate health to the outcomes of their living conditions. Under this view, health workers and health users are subjects of the educative process. Thus, this study aims to identify the key clinical and socio sanitary attributes and promote educational activities with patients with Diabetes Mellitus (DM) in a Family Health Care Unit of the Western Sanitary District, in the city of Natal / RN. It is an action research which uses the references of the Theory of Liberating Education, which is based on a problem-solving pedagogy and that values dialogue in the process of understanding oneself and the world. Thirty-six diabetics, who are residents of the area covered by the health care unit, and thirty health workers participated in the survey. Each group had an average of twelve participants, and the meetings took place at the Unit´s hall, using conversation wheels, group dynamics, life narratives, experiences telling, movie exhibition and discussions, music, knowledge telling, desires, limitations, beliefs and values socially constructed. Data collection took place during the second half of two thousand and thirteen through Free Word Association Technique (FWAT), recordings of conversation wheels, participative observation, group dynamics, testimonies, questionnaires, life narratives and photographs. The empirical material was organized and subjected to three analyzes: thematic content (Bardin), textual statistics analysis by software IRAMUTEQ (Ratinaud), and photographic analysis (Edmund Feldman). The data analyses originated words, expressions, categories, themes and creative situations showing that popular health education is in process of construction, but still very incipient in primary care. The National Policy on Popular Health Education shows us the necessary ways for the transformation of health practices and the build of a more shared and solidary society. The meetings could be place to reverse that normative logic that has been happening over the years in primary care, but that by itself is not enough. It is possible to conclude that the use of active practices, increasing of listening and training on Popular Health Education will enable changes in the scenario where users and health workers deal with diabetes mellitus. Thus we see the popular health education is being timidly incorporated to the educational process of the subjects involved in this study, and far away from the principles of participation, organization of political work, increase opportunities for dialogue, respect, solidarity and tolerance among different actors involved in addressing the health problems that are fundamental to the improvement in building healthy practices of primary care
Limites e possibilidades da educação em saúde na estratégia de saúde da família de Pau dos Ferros/RN
Resumo:
A Estratégia Saúde da Família (ESF) apresenta-se como um espaço privilegiado para a efetivação de práticas de educação em saúde orientadas pelo diálogo entre o saber científico e o saber popular, uma vez que é nesse espaço de saúde que profissionais e indivíduos/família se interrelacionam, criam vínculos, dialogam e constroem soluções para o enfrentamento dos problemas de saúde da população. O objetivo geral deste estudo foi analisar os limites e as possibilidades de efetivação da educação em saúde voltada para a coletividade na ESF de Pau dos Ferros/RN. Nesse sentido, buscou-se conhecer as concepções de educação em saúde dos profissionais de nível universitário da ESF; observar onde as práticas de educação eram desenvolvidas; conhecer os conteúdos e metodologias utilizadas para a efetivação das práticas de educação em saúde e caracterizar os espaços onde tais práticas eram desenvolvidas. Trata-se de uma pesquisa qualitativa, de caráter descritivo-exploratório realizada junto a nove equipes localizadas na zona urbana do município. Foram investigados 28 profissionais que atuam nessas equipes, dentre os quais elencamos: quatro médicos, oito enfermeiros e dezesseis cirurgiões dentistas. Fez-se uso da entrevista semiestruturada e da observação baseada em princípios etnográficos. Os dados foram analisados com base na técnica de análise de conteúdo de Bardin. O estudo obedeceu aos aspectos éticos contidos na Resolução 196/96 que regulamenta as Pesquisas Envolvendo Seres Humanos. Os resultados apontam que as concepções e práticas de educação em saúde dos profissionais da ESF são orientadas por uma educação bancária , pautadas pela transmissão e reprodução de conhecimentos. As temáticas são desenvolvidas de forma verticalizada, dissonantes da realidade de vida e saúde dos usuários. As práticas educativas são ofertadas majoritariamente por enfermeiros e estudantes de graduação em estágio na USF. Em sua maioria não são planejadas em equipe, e estão direcionadas à prevenção de doenças, distanciando-se da promoção da saúde. As principais dificuldades apontadas para a efetivação da educação em saúde dizem respeito à dificuldade de trabalhar em equipe, à falta de apoio da gestão, à estrutura física inadequada e a pouca adesão dos profissionais as práticas educativas. Portanto, a educação em saúde praticada na ESF não consegue instrumentalizar os sujeitos para que estes tenham autonomia e possam tornar-se sujeitos de suas vidas, de sua história. A prática educativa centrada na transmissão de conhecimentos ainda é uma realidade presente na ESF, constituindo-se em um desafio a ser superado