O trabalho das equipes de saúde da família na perspectiva da integralidade na atenção à saúde

Abstract

On the Family Health Strategy, teams must organize their work process, guiding themselves by the principles of the Health System, especially the integrality, which enables the enhancement of a more unwavering health care, focused on the users and in their multiple health needs. Such assumption supported the accomplishment of this study, which has the purpose of analyzing the work process of the Family Health teams under the perspective of health care integrality, as well as identifying the improvements and challenges related to the implementation of an unabridged care by these teams. It is a qualitative research, performed with 33 professionals of Family Health and Oral Health teams from three Family Health unities of a town in the forest zone of Minas Gerais. As instrument of data collection, a press conference with the professionals of each worked team was made in two points: the first one with the purpose of learning the understandings about integrality; the second one aroused the professionals’ reflection regarding their practices, from the results of a self-assessment performed in 2013 on the second year of the National Program of Quality and Access Improvements in the town. It was given emphasis on the dimensions of Permanent Education, Work Process and Integral Health Care on the Access and Quality Improvement Self-Assessment. For the analysis, the acquired information on the second point was confronted with the information on the first point, in order to check the consistency between the team professionals’ knowing and practice. Complementary, documents from the town’s Health Department were also analyzed. The analysis was performed in light of the content analyses proposed by Bardin, and allowed the creation of analysis categories, which composed both studied points. The results unveiled some difficulties of the team professionals to articulate the concept of Integrality with professional practices, which brings them to obstacles that interfere on the work process organization towards integrality itself, such as: poor work contracts, lack of permanent education program, lack of integrated action planning, problems regarding reference and counter reference, intersectorial communication bureaucracy; issues regarding Access and Quality Improvement Self-Assessment application for the teams and lack of feedback from the results of this self-assessment are amongst these obstacles as well. It has been verified that the work process in the town is not orientated by integrality. Instead, it is structured in biomedical curative molds. It is hoped that this research may provide the actions to rearrange the work process on the teams under the perspective of integrality, aiming to improve the health care quality in the town.