Distributive conflict: analysis of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in two Brazilian northeastern capitals

Silva HFR, Gomes LB, Bezerra AFB, Santos MOS, Shimizu HE, Silva KSB, Gurgel GD, Silva EN, Sampaio J. Distributive conflict: analysis of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in two Brazilian northeastern capitals. Interface (Botucatu). 2023; 27:e220436. Doi: https://doi.org/10.1590/interface.220436

Abstract
This article analyzes the implementation of the Program for Improving Access and Quality of Primary Care (PMAQ-AB) in the context of a national political scenario of deep transformations, from the weak reformism that promoted slow extension of rights to the strong counter-reformism of neoliberal restoration. It is a case study with health workers, managers, and counselors in two capital cities in northeastern Brazil, discussing matters of work and distributive disputes of public resources. Results show the intensification of these conflicts in health and the unfavorable outcome for workers after the parliamentary coup in 2016 political context. Local dynamics expose the wage contraction and individualization of labor relations and the reassertion of meritocracy as an ideological ground for precariousness. Workers oppose this, reaffirming their collective class condition, favoring the benefit derived from PMAQ for fully regaining their group wages.

Keywords
Health evaluation; Healthcare financing; Health management; Health workers employee performance appraisal

Access in: https://doi.org/10.1590/interface.220436