Monitoring and Evaluation in the state management of the SUS: Challenges and potentialities for decision-making in Rio Grande do Sul

Abstract

This study analyzed monitoring and evaluation practices and processes at the Rio Grande do Sul State Health Department. This qualitative research was conducted through document analysis, unsystematic observation, and interviews with health workers. The findings revealed advances in the availability and use of health information, but also challenges, such as the productivist nature of monitoring and evaluation associated with the delivery of management tools required by law. The Planning, Monitoring, and Evaluation Working Group was identified as having potential to break institutional fragmentation, acting as a space for Permanent Health Education. However, a lack of debate was identified, associated with the migration to a virtual format and, above all, the verticalization of decision-making. In terms of organizational learning, there is room to learn lessons from the evidence-production arrangement structured during the pandemic, as well as to expand collective participation. It is concluded that monitoring and evaluation can contribute to the institutional resilience of the SUS, as long as the meanings attributed to practices are expanded from perspectives centered on the user population and health as a non-negotiable right.