Monitoramento de ação de educação permanente para o enfrentamento da tuberculose no município de Palmas-TO

Abstract

Introduction: Early diagnosis of pulmonary tuberculosis is essential to interrupt the chain of transmission, reduce morbidity and mortality, and address health inequities, given the strong association between the disease and social vulnerability. However, barriers related to access to health services, stigma, resource constraints, and weaknesses in the training of Primary Health Care (PHC) teams still hinder the timely identification of cases. In this context, Permanent Health Education (PHE), when aligned with work-process needs and the local epidemiological profile, constitutes a central strategy to improve tuberculosis care within the primary care net- work. Objective: To develop and monitor Permanent Health Education actions aimed at ad- dressing tuberculosis in the municipality of Palmas, Tocantins. Method: An interventional, de- scriptive-exploratory study with a quantitative approach, linked to the planning and implemen- tation of in-person workshops using mixed educational strategies (interactive lectures, case studies, and gamification) for municipal health professionals. A total of 170 professionals par- ticipated in five workshops (one initial workshop with 90 participants and four subsequent workshops totaling 80), reorganized based on the analysis of the initial workshop to enhance active participation. The evaluation examined four dimensions—satisfaction, learning, institu- tional support, and changes in work processes—applied at two moments: immediately after the workshops (n=85) and six months later, for follow-up monitoring (n=11). Data were analyzed in SPSS using descriptive statistics, comparison tests, and correlation analyses. Results: There was a predominance of women (71.8%), professionals with lato sensu postgraduate training (54.1%), nursing as the most frequent professional background (37.6%), and predominant work in PHC (83.5%). The dimensions satisfaction with the educational activity and learning showed high mean scores (4.26 and 4.33, respectively, on a 1–5 scale), indicating strong acceptance regarding the relevance, organization, and applicability of the intervention. Institutional support obtained a lower mean score (3.39), while changes in work processes reached a mean of 4.14, suggesting that although professionals felt more qualified, organizational limitations persisted for the full incorporation of new practices. Analyses revealed a strong correlation between sat- isfaction and learning, and a moderate correlation between institutional support and changes in work processes. Overall, no statistically significant differences were observed in the general mean scores of satisfaction and learning between the initial workshop and the subsequent ones, although smaller groups showed a trend toward slightly higher results in some specific items. Low adherence to the six-month follow-up (n=11) reflected the high turnover of PHC teams and the fragility of professional contracts. Conclusion: The implemented PHE actions received positive evaluations, with high levels of satisfaction and learning and indications of favorable changes in work processes. However, the sustainability of transformative practices depends on strengthening institutional support, leadership commitment, continuous resource availability, and the integration of PHE into network planning to sustain timely diagnosis, adequate treat- ment, and continuous tuberculosis monitoring in the territory. The findings provide useful in- sights for municipal management, reinforcing the need for articulation between education, workforce management, and service organization to maximize the effectiveness of tuberculosis care.