Once the instrument of health was validated
September 3, 2020

Once the instrument of health was validated

By admin

In parallel, the information produced from the ASIS (quantitative-qualitative data) that is recorded in governmental institutions or not, which serve as an argument to support and validate the problems analyzed with the population15 is considered.

Based on the instrument developed by the MPPS, in 2003 and 2004 pilot tests were carried out in different states of the country, in which both approaches (PES and ASIS) were applied in an integrated manner. Once the instrument was validated at the national level, in the state of Aragua, experiences of strategic situational planning continued to be generated at the local level, incorporating ASIS strategies, one of which was developed in the parish of Zuata in the state of Aragua in 2004, which we will use as a reference in this article.

Strategies to prioritize and analyze problems

Unit of analysis and key actorsfrom the 50 parishes of the state of Aragua, Zuata was selected for being one of the urban-rural parishes of the municipality “José Félix Ribas”, characterized by great weaknesses in development, generated among other reasons by growth without urban planning and housing demands of the sector.

  1. In addition to being a parish located in the suburbs, distant from the city of Victoria, where most of the social, economic and political of the municipality, to the time of the study was one of the priorities of the Health Corporation of Aragua State.
  2. Are considered key actors: those that dominate critical resources; those who are affected by the problems present in the parish, consisting a total of six groups of key actors of the parish Zuata: chairman of the Board of Parish; Health committees; local planning councils; residents of the parish localities; team of the municipal health directorate; directors of the educational institutions of the parish.

Strategies to prioritize and analyze problemsIn total, 50 key actors from the Zuata Parish participated, who processed the problems through working meetings. Strategies to prioritize and analyze problems identification and selection of problems the first aspect addressed was the definition and prioritization of the problems that most affected the population of Zuata Parish. In the first working meeting with the participation of the key actors of the parish, through the technique “brainstorming” the different actors identified and selected the main health problems most important for them.

Each of the problems was related to the articles of the Constitution of the Bolivarian Republic of Venezuela that were not being fully complied with (Table 1).the discussion about what each actor considered to be a problem of their locality was carried out openly, seeking an understanding between the various opinions and strongly grounded in the argumentation. As it was a discussion on what each actor had, they felt a mastery over the subject that allowed them to accept or refute the arguments of other actors, even when those who expressed a contrary opinion were actors in managing critical resources (for example: health authorities).

The deficiencies in the sewer network

Similarly, the participation of the different groups of actors showed that from the health sector, catering to the consequences of the greater part of the problems identified, that is to say, that a health problem is not restricted to having or not a disease, for example, the deficiencies in the sewer network or in the distribution of drinking water, can generate population-diseases (diarrhea, skin diseases, among others), but these in themselves are not the problem, this point was widely discussed in the work meeting.

  • Also, many of the key actors were aware of the Articles of the Constitution of the Bolivarian Republic of Venezuela and expressed the importance of analyzing the problems linking them to rights that are not being fulfilled comprehensively, where each of these rights represents an area of essential needs for the full development of citizens in all spheres of life that, when respected as a whole, mean quality of life.
  • Subsequently, we prioritized which of the problems identified by the group would be analysed in depth, using the following criteria proposed by Matus: the value of technical and political problems to the actor who plans to (or for the leadership of your organization), to the social forces that support it and the population that they represent;

the resources (political, economic, cognitive and organizational); (3) the level of governance; (4) the cost of delay policy, the economic cost and impact of intervention; and (5) the possibility and opportunity to face them with success, which also depends on the permanent value and current situation that such problems have to other actors, opponents and the weight of the weight and strength of these opponents.Thus, they were prioritized: deficiencies in the distribution of drinking water; poor public transport and poor road conditions.

The deficiencies in the sewer network

The manifestations that best describe the problem

After an arduous discussion the second problem was ruled out, because the municipal government had already approved the financing for the solution of the same, therefore, it was agreed to analyze only the first. The other problems were left in the actors ‘ problem file.An important aspect was the participation of two of the researchers as mediators in the discussion, because to have a look from the outside could provide elements to facilitate the discussion, as well as to serve as a bridge between the knowledge of the community and the health team, trying to build the answers with the group since the meeting of knowledge.

Analysis of the problemafter selecting the problem ” deficiencies in the distribution of drinking water”, we proceeded to analyze it in the second working meeting through the construction of the situational flowchart (based on The Theory of Social production of Matus), where we defined: the manifestations that best describe the problem, expressing it in the form of indicators or descriptors; the consequences of the problem; the multicausal logical chain between the consequences, descriptors and causes of the analyzed problem.

In the situational flowchart for each of the descriptors, the causes closest to the problem (Phenoproduction), the intermediate ones (Phenostructure) and finally the most structural ones (Genostructure) were established, designing the causality network, with the three levels of determination. In order to help in understanding, color cards were designed for each level and the collective described in a general way each cause. The process of constructing the situational flowchart required time, given the complexity of the instrument and the number of actors who participated in the discussion, as well as the need to reach agreements.