Análise do cotidiano da unidade de atenção primária à saúde no contexto da estratégia saúde da família em Ubá/MG

• Autor(a) principal: Antonucci, Luiz Augusto de Oliveira
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: LOCUS Repositório Institucional da UFV
• Texto Completo: http://locus.ufv.br/handle/123456789/3394
• topic: Serviços de saúde - Administração; Família - Saúde; Políicas públicas; Saúde da família - Avaliação; Ubá (MG); Health Services - Administration; Family - Health; Políicas public; Family Health - Evaluation; Uba (MG); CNPQ::CIENCIAS SOCIAIS APLICADAS::ECONOMIA DOMESTICA

In practical terms, limited health care direction in Brazil can be translated by concentrated application of resources in high-cost curative services, thus neglecting primary prevention potential and health promotion that, in addition to being of smaller economic value, could avoid a great deal of the unfortunates caused by such diseases. This way, management and political mistakes can be observed, perpetrating this assistancial model based in the flexnerian sanitation paradigm, which emphasizes medical and hospital attention as the main and almost absolute sanitary practice. Because of that, Family Health Program (Programa Saúde da Família, in Portuguese), was created. Nowadays it is called Family Health Strategy (Estratégia Saúde da Família), seeking to change this context through propositions aimed towards the families and the environment where they live via decentralized and participative measures and actions. However, despite the evolution in public health management process, their applicability in real, concrete and local reality is questioned. Thus, the objective in the present research was evaluating the management process in a Primary Health Attention Unit (Portuguese acronym UAPS) within ESF context and from everyday activities and governance practice, as well as their repercussion concerning life quality of its users. Thus, this descriptive research, with a quantity-quality essence, took place in Ubá, a town in the Brazilian state of Minas Gerais. The population for this research was made up of team members from the technical staff and users of the health unit. In order to fulfill the proposed objectives, a documental analysis methodologically took place for tracing back the historic background of the UAPS, as well as for identifying its guiding principles. This analysis was complemented with direct and non-participant observations in order to accompany the everyday activities at work at the UAPS and at home visits to users, as well as interviews with the technical staff in order to identify its perceptions concerning work conditions and organization, as well as the contrast between standards and what is actually done at work by means of self confrontation. Governing structures were also observed by qualifying the relational space and identifying social networks mobilized by the technical staff and users. Lastly, seeking to ponder about users perception concerning their life quality and the impact of UAPS management on it, a free word association test and a questionnaire made up from joining the model from Metzem et al. (1980) and the one recognized by the WHO (1998). Concerning the exam of the basic structure in the activities developed by the staff, considering its arenas and scenarios, it was possible to infer that the existing dynamics in action strategies adopted by professionals was efficient and aimed to reaching its objectives, generating satisfying assistance to users when compared to ESF demands. Concerning governance practices, it was possible to consider repair and negotiation processes as important group practices despite the contradictory interests present, setting a decentralized-centralized management process. Concerning characterization of ESF standards and principles, by checking their applicability in the researched reality, it is evident that professionals work can be seen as a permanent regulation activity among the determiners of the situation and requirements for tasks in order to obtain the final quality at work. In addendum, analysis of social networks involved in health care has revealed two faces of the same coin: the strength of informal relations and fragility in the relations between State and citizens. Implications in the UAPS management process on life quality for its users have revealed consequences in questions concerning both economic and social aspects. Also, life quality was seen by participants as something not measurable and conceptually multidimensional. We conclude that, under the essence of ESF, assistance offered to the local community has been granting subsides for obtaining resources pertaining to different areas of life that contribute for improving life conditions for this population.