Evaluation of the initial phase of implementation of the Maior Cuidado Program in the Municipality of Contagem (MG)

In Brazil, population aging occurs in a context of significant family transformations, characterized by a decline in the number of children and an increase in the number of women entering the labour market. These changes challenge traditional gender roles leading to a greater demand for professional care and specialized services to ensure the well-being of the elderly. The Programa Maior Cuidado (Older Adult Care Programme 3 PMC) was implemented in 2011, as an important care initiative, offering support to families of semi-dependent and dependent elderly people who live in vulnerable contexts. In 2023, a pilot project was initiated in the cities of Salvador (BA) and Contagem (MG) to implement the PMC. The aim of this study was to evaluate the initial phase of the deployment of the PMC in the city of Contagem, identifying the challenges and opportunities related to the hiring of caregivers, the selection of elderly individuals, and the maintenance of the programme. This is an evaluative research with a qualitative approach, which used semi-structured interviews for data collection, with the target population being social caregivers and their supervisors, technical health and social assistance workers from the city of Contagem, and representatives of the pilot project team. In the selection process for social caregivers, interviews revealed positive experiences, particularly regarding the training course offered, which facilitated the acquisition of new knowledge and skills. However, the hiring process was perceived as slow. Due to a lack of reserve staff and the departure of some caregivers after the intervention began, six selection processes were conducted, all experiencing low demand, primarily attributed to the compensation provided. The significance of supervisors for the effective operation of the program was emphasized, as they fostered connections between older adults, their families, caregivers, city technicians, and the PMC team. There was also a clear desire for targeted training in people management. Challenges in the selection and placement of older adults included: the lack of experience among those involved in a new program; the need for better coordination between health and social assistance sectors; lack of vehicles to carry out assessments across a large area; the unavailability of certain professionals on the city9s staff at times; high turnover rates in specific positions; and family distrust stemming from the program's novelty. To ensure the sustainability of the PMC, it is crucial to effectively address the challenges encountered during implementation, invest in program promotion, and seek diverse partnerships and funding sources. Despite the obstacles faced during the initial phase of the PMC's implementation, it is believed that the commitment of all involved played a vital role in sustaining the program and benefiting families. This study underscored the importance of evaluating public policies and supporting program advancements, as well as implementing similar strategies in other contexts to enhance the quality of life for older adults and their families. In addition to the research conducted, and taking into account the master's student's experience and affiliation with the Ezequiel Dias Foundation (FUNED), this Master's Thesis developed a health booklet and educational materials on the conscious consumption of medicinal plants as technical products. These resources can enhance care for older adults served by the PMC and can also be adapted for use in other contexts, promoting health and well-being.