title: Integrative practice policy in Recife, northeastern Brazil: an analysis of stakeholder involvement.
abstract: OBJECTIVE
  To examine the involvement of stakeholders in the implementation of a local policy of integrative practices.
  
  
  METHODS
  Qualitative study conducted in the city of Recife, Northeastern Brazil. Data was collected from local health board records between 2004 and 2009, interviews with managers and key informants and focus groups with providers and users. The analysis was performed using the condensation of meaning model. The results were grouped into four categories of stakeholders according to their influence and interest, namely: subjects; population; leaders; and players.
  
  
  RESULTS
  Five years after the policy was implemented in Recife, only a single service offered integrative practices. The population, or users, did not have any effective involvement and did not make any contributions to the policy, and health providers, despite their willingness to participate in the process, were not involved. The leaders included the local health board, managers and medical organizations; the latter two were also players as they were effectively involved in the formulation of the policy.
  
  
  CONCLUSIONS
  The involvement of few stakeholders in the formulation of an integrative practice policy makes it difficult its implementation and widens the gap between formulation and implementation, hindering the achievement of expected results.
authors: Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil. francisco.a.santos@hotmail.com
authors: Francisco Assis da Silva
authors: FA
authors: Santos
authors: Islândia Maria Carvalho de
authors: IM
authors: Sousa
authors: Idê Gomes Dantas
authors: IG
authors: Gurgel
authors: Adriana Falangola Benjamin
authors: AF
authors: Bezerra
authors: Nelson Filice de
authors: NF
authors: Barros
mesh_terms: D001291:Attitude of Health Personnel; D001938:Brazil; D018672:Community Health Planning / Q000458:organization & administration*; D003256:Community Participation; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006286:Health Planning Councils / Q000458:organization & administration; D006288:Health Planning Organizations / Q000458:organization & administration; D006291:Health Policy; D006801:Humans; D009111:Local Government; D011050:Policy Making; D036301:Qualitative Research