Policy transfer of direct observation of therapy for tuberculosis:

primary health care professionals’ speeches

Abstract

Objective: To analyze the speeches of health professionals about the motivational aspects related to the policy transfer of the direct observation of therapy for tuberculosis in the city of João Pessoa, Paraíba, Brazil. Method: Descriptive and qualitative study developed in the Municipal and State Health Departments and in five Sanitary Districts of João Pessoa. The sample consisted of 26 health professionals who participated in a semi-directed interview from June to December 2013. The empirical material produced was analyzed according to the theoretical-analytical basis of the French discourse analysis by Pêcheux. Results: The motivational aspects for the policy transfer were benefits from the decentralization of actions of the direct observation of therapy strategy to the primary care service; reduction of epidemiological indices associated with treatment abandonment; increase in cure percentage and closure of cases; strengthening of therapeutic bond between professionals and users based on shared responsibility for general health care and treatment; and improvements in users' accessibility to health services. Conclusion: Although efforts and political will of the key actors involved in policy transfer are visible, our data tend to support that that the municipal government still needs to implement strategies to overcome the broad challenges posed by the disease and thus achieve diagnosis, treatment and cure of tuberculosis cases.