PRECARIZAÇÃO E FRAGMENTAÇÃO DO TRABALHO NA ESTRATÉGIA SAÚDE DA FAMÍLIA: IMPACTOS EM SANTA MARIA (RS)

The study aimed to understand the Family Health Strategy process implementation and monitoring at a municipality in the state of Rio Grande do Sul, Brazil, using as qualitative research methodology. Sixteen managers were interviewed and documentary sources analyzed in the period ranging from August 2011 to May 2012. The material was submitted to the operative analysis proposal. It was noted that the first management team of the strategy triggered an effervescent process of transformation of a reality considered as fragmented and insufficient, having opted for outsourcing in worker hiring, for community participation, and for permanent education. The second management team chose to strengthen the emergency units, with no participation of social control. Work management and the municipal management's choices were Strategy weaknesses. The restructuring of primary care, which the Strategy aimed at achieving, was postponed. In conclusion, the study showed the complexity of undertaking the municipal management of the Unified Health System and of sedimenting primary care as the citizens' preferred port.