Challenges in implementing, developing and sustaining the policy of permanent education in health in Paraná, Brazil

Abstract

This paper approaches the implementation, development and sustainability of the Policy of Permanent Education in Health (PEH) in the estate of Paraná, Brazil. Data was collected during nine focal groups that took place in municipalities located on the macro-regions of Paraná. Seventy-seven individuals took part in the groups; they were recruited at the Regional Nucleus of Permanent Education in Health (RNPEH). The decentralized implementation of twenty-two RNPEH increased the capillarity and valued loco-regional spaces. Educational institutions played a relevant role in that process. There was broad articulation regarding training and development of health professionals, especially regarding the training of PEH facilitating agents. Difficulties and facilities were experienced during this process. Managers' commitment to the policy, assessment implementation and changes in the vertical management model were reported as conditions to sustain the PEH. Operative strategies of this policy were applied/experimented in a unique way at Paraná State. As its original design sets it, the PEH must be a policy and not a government program.