Modelo de Avaliação da Capacidade de Implementação da Política de Assistência Farmacêutica Municipal: uma proposta metodológica fundamentada na administração política

Abstract

Introduction (with objective): Research in Pharmaceutical Assistance (PA) shows that many municipalities still face challenges stemming, in part, from the mismatch between policy formulation and the municipal capacity to implement them. In this scenario, Political Administration (PA) offers a relevant theoretical framework for understanding the implementation of public policies, by inextricably integrating the processes of management (formulation) and administration (execution). By proposing a methodology for evaluating the implementation capacity of municipal PA policy based on PA Theory, this work seeks to support strategic actions that strengthen PA in municipalities. The objective of this work is to present a validated model, grounded in Political Administration Theory, for evaluating the capacity of municipalities to implement the PA Policy. Material and Method: An analysis matrix was constructed with PA indicators aligned with the six dimensions of Political Administration validated by Andrade (2022), which are determinants for evaluating the capacity to implement public policies. The dimensions Institutional Design, Intergovernmental Relations, and Social Participation represent management (conception), while Resources for Implementation, Implementing Bureaucrats, and Local Context reflect administration (execution). The instrument's validation used Confirmatory Factor Analysis (CFA) and various statistical methods to ensure methodological rigor, including Comparative Fit Index (CFI), Tucker-Lewis Index (TLI), and Standardized Root Mean Square Residual (SRMR). The Total Omega (ωt) and Revelle's G6 metrics assessed consistency and robustness, while Cronbach's Alpha (α), Chi-square, Fisher's exact test, Shapiro-Wilk test, Wilcoxon-Mann-Whitney test, and Kruskal-Wallis test were applied according to their purposes for the final validation of the model. Results: Initially, the model, which comprised 32 indicators distributed across six dimensions, was compromised by a set of indicators with low validity for measuring the Implementation Capacity of the AF Policy. After a statistical adjustment process, which excluded 11 indicators and the "Intergovernmental Relationship" dimension, a reliable final model was generated, with the indicators showing significant standardized factor loadings (p<0.001) and a substantially high mean magnitude. The CFI and TLI tests reached the threshold of excellence (0.954 and 0.949, respectively); the SRMR was positioned below the limit of 0.08 (0.079); the "G6" coefficient obtained a value of 0.957, reinforcing the robustness of the construct; and the Total Omega (ω) and Cronbach's Alpha (α) tests reported final values of 0.933, whose variance in the score is attributable to the Policy Implementation Capacity. The other statistical tests also obtained excellent statistical performances, within the desired standards, confirming the final validation of a statistically robust model, composed of 21 management indicators distributed across 5 dimensions of public policy evaluation. This result provides a valuable instrument for evaluating the formalization and execution of the Family Farming policy in municipalities. Conclusions: It is essential to advance theoretical and analytical studies to improve the management capacity of Family Farming in municipalities. Based on Political Administration Theory, this work aims to raise awareness among managers and researchers about the use of a new validated methodological instrument for evaluating the implementation capacity of the municipal Family Farming policy.