Pharmaceutical services in primary health care in light on the ambiguity-conflict model

Abstract

This article aims to analyze the levels of ambiguity and conf lict regarding the objectives and means required for the Pharmaceutical Services (PharmSer) implementation within the Primary Health Care in the city of Rio de Janeiro. Data were collected through semi-structured interviews applied in 2018 with 14 key actors. The results were interpreted based on thematic content analysis and in the light of the ambiguity-conf lict model of implementation analysis. Related to the PharmSer aims, we found high consensus intra key actors categories and low inter categories. Related to the means, we found important inter-categories divergences and consensus regarding relevant aspects as insufficient financial and human resources. The conf licts identified result mainly from low clarity of other actors more distant from the local level or other professionals, about role of PharmSer. We conclude for the predominance of “experimental implementation” characteristics, with high ambiguity regarding the objectives and means of the PharmSer, in a medium conf lict environment and being strongly dependent on the resources available at the local level. It also presented some attributes of “political implementation”, since in certain circumstances the results were inf luenced by the political context, conditioned by conf licts over the means for achieving the PharmSer.