Actor-networks and their influences on the informatization of Primary Healthcare in Brazil

Drawing on the Actor–Network theory, this study investigated networks of actors and their influence on the informatization of Primary Healthcare. The cartography of controversies method was used, involving the observation and interviewing of actors from the municipal, regional, state, and federal spheres, together with the collection of published documents. The data was analyzed using the software Gephi and the selection of extracts from the interviews based on the actor–network approach. The mapped network is woven between humans and nonhumans in the different spheres of government. Policies and obligations were shaped into the guiding principles of informatization, pressuring professionals and managers to adapt processes and weave agreements to enable informatization, yet with little success. It is concluded that circumstantial translations in the different spheres of government influence the informatization of primary care in the pursuit of success, but have not yet proved effective for such purpose.本研究借鉴行动者网络理论（Actor-Network Theory），探究了行动者网络及其对初级医疗卫生保健（Primary Healthcare）信息化的影响。研究采用争议制图法，对市级、区级、省级及联邦层级的行动者开展观察与访谈，并收集公开文献资料。本研究使用Gephi软件开展数据分析，并基于行动者网络理论分析框架选取访谈摘录内容。所绘制的行动者网络交织于不同政府层级的人类与非人类行动者之间。政策与规制义务被确立为信息化建设的指导原则，迫使从业人员与管理者调整工作流程、缔结协作协定以推进信息化建设，但收效甚微。研究结论表明，不同政府层级的情境化转译虽在推进初级医疗信息化的过程中尝试达成目标，但目前尚未被证明能有效实现该领域的预期成效。