Describe the network health care in the Nova Iguaçu county: Situational analysis.

Author: Roberto Santos Oliveira, RN, Nursing Teacher. Nursing Administration Department, Iguaçu University, Rio de Janeiro, Brazil

Advisor: Marilda Andrade, RN. PhD. Teacher at Professional and Academic Master Degree in Nursing School of Fluminense Federal University. Rio de Janeiro, Brazil

Bibliografic reference: Oliveira RS. Describe the network health care in the Nova Iguaçu county: Situational analysis. [Dissertation]. Niteroi (RJ), Brazil: Nursing School Aurora de Afonso Costa, Federal Fluminense University; 2010.

Problem: The lack of strategic planning for the deployment of health services, the lack of knowing of own network installed to use the system health in reference strategy and cross-reference between the levels of complexity of health care.

Objective: Describe the own care network's Health System in Nova Iguacu county, by geographic location of health units and their area of healthcare coverage using the tool of geo-processing.

Method: Descriptive study of qualitative approach, using the Collective Subject Discourse as a way of interpreting reality found in study scenario. Descriptive analytical approach, explores the event, correlating the variables without manipulating them. The scenario used was a geographic region known as Nova Iguaçu, and as social actors the health units found. This study is approved  by the Ética Comitê Research as legal guarantee of Resolution 196 of 1996 which deals with research on human beings, having been approved under Protocol No. 014/2008. Registry Nº 0012.0.316.258-08. To collect data we used participant observation supported by a roadmap, identifing the elements of study and the collected information. Using the locator "Google map", available on the web, to the geo-referencing of health units identified in the research. To analyze the information the Collective Subject Discourse, allowed the triangulation of data and construction of indicators to quantify objective dimensions, interpreting subjective facets of the social process studied. Besides expressing characteristics of the social scene, enabling approach to accessibility planning the location and extent of health services.

Results: Nova Iguaçu county operates coverage actions of health facilities through the basic atention, with administrative, managerial, economic and political influence; develops health practices with care actions toward care promotion and health prevention. The interventions on the problems is also about the living conditions of populations. The organization of health services follows regionals and hierarchical principles, defining territorial base for a range of services and actions. We found 72 health units: one General Hospital, 03 Units Mixed, 02 polyclinics, 03 Psychosocial Care Center, 2001 Center Reference Maternal Child; 01 Health Center, 01 Health Post, 24 Basic Health Units, 33 Strategy Family Health Units and 03 Family Units. For contextualized evaluation, we must consider the Human Development Index: comparative measure comprising three dimensions: wealth, education and life expectancy. The use of the Human Development Index has advantages by his potential for comparison between countries, regions, states and municipalities and is important to measure the progress of human development with emphasis on social dimensions such as health and education. Nova Iguaçu county have: Life expectancy at birth: 67.99 years old, giving an index of longevity (IDHM-L): 0.717; readability index at 92.81% school attendance rate: 79.67%, giving a education index (IDHM-E): 0.884; and per capita income (in Real) at R$ 237,50 giving an index of income (IDHM-R): 0.686; which together determine an average for the index Human Development Index (HDI-M) of: 0.762; which puts Nova Iguaçu in the 17th position on the ranking of Brazilian cities with total population between 500,000 and 1 million inhabitants.

Conclusion: This study showed that it is possible to serve the users of sistem health in a universal, humane and quality and therefore it is required steadfast determination and willingness of managers on taking this commitment to society, despite the great planing challenge that involves making decisions on the location and extension of these services, which always ends up happening in political decisions branch, having a lot more aspects towards resource allocation than to epidemiological models or mathematical and population concentrations, without even respecting the characteristics of each area, or their peculiarities. The nurse in managing position, while fulfilling health planning, must perform their actions guided by the epidemiology and health surveillance in order to grow with resolvability, increasing technological complexity in the organization and work processes, even thou nursing profession, historically characterized by commitment to health and society, has social branchs and is present in all actions undertaken in the health axis of this country. Despite the number of units found in Nova Iguaçu county (n=72), there are still numerical deficits to attend all healthcare coverage predicted by law; Presented deficit varies between 25% and 80%. Support obtained from the collective subject discourse, allowed us to reveal other aspects of the study, which indicates the completion of additional studies. Therefore we can conclude that the health network in Nova Iguaçu despite being composed of 72 units is still insufficient to provide full health care coverage to residents when compared to the parameters established by the Ministry of Health. 

Keywords: Health Systems, Health Planning, Delivery of Health Care, Nursing Administration Research 

Main bibliography: 

Mendes EV. O Sistema de Saúde no Brasil: Situação Atual e Perspectiva. 1998. 

Merhy EE. Um dos grandes desafios para os gestores do SUS: apostar em novos modos de fabricar os modelos de atenção. In: Merhy EE, Magalhães Jr HM, Rímoli J, Franco TB, Bueno WS. O trabalho em saúde: olhando e experienciando o SUS no cotidiano. 3.ed. São Paulo: Hucitec; 2006. 

Lefevre F, Lefevre AMC. O sujeito coletivo que fala. Interface - Comunic., Saúde, Educ., Interface 2006; jul-dec 10(20): 517-524.  

Buss PM, Pellegrini Filho A. A saúde e seus determinantes sociais. Physis [periódico online]. Rev. Saúde Coletiva, Rio de Janeiro. 2007; 17(1):77-93. disponível em   

Cruz ICF da. Scientific publication must be of the undergraduate research planning: Online Braz J Nurs [online] 2007; 6(0): available at  

Silva ALA. Atenção primária e o processo de trabalho em saúde. Informe-se em promoção da saúde, 2007; jan-jun 01(03):01-03. acesso em 23/01/2010, disponível emçaodasaude/informe.  

Oliveira RS, Andrade M. Describe the network helth care in the Nova Iguaçu county: strategy for access to users of the global helath care system. [preview note] Online Braz J. Nurs [online] 2009; 8(1): available at:


Address for correspondence: Roberto Santos de Oliveira, Av. Atlântica nº 928 apart. 511, Copacabana. Rio de Janeiro (RJ), Brazil. CEP: 22010-000. Telefone: 55 (21) 78145919. Email:  


Date of examination: August 5, 2010. Nursing School Aurora de Afonso Costa, Federal Fluminense University. Examiners: Marilda Andrade, Sérgio Corrêa Marques, Ana Lucia Abraão da Silva, Dalvani Marques.