Comprehensive care and the Family Health Program: a case study in a city in the interior of Bahia. / A Integralidade da atenção e o Programa de Saúde da Família: estudo de caso em um município do interior da Bahia.

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

29/04/2011

RESUMO

The interpretation of comprehensive care, while a constitutional guideline and a principle of Brazilian Unified Health System, has been problematized by several authors when analyzing concrete practices in health services, although there are few empirical studies that seeked to, systematically, evaluate interventions aimed at its operation. This study had, as main objectives, estimating the deployment degree of comprehensive care in different family health teams in a city located in the state of Bahia, considered as one at advanced stage in the decentralization process and as an example concerning to the implementation of the family health program, trying to analyze possible obstacles and facilities to the implementation of that guideline related to the characteristics of the health workers who deal with the program. A single case study was conducted based on family health teams as a unit of analysis. The data collection counted on document analysis of management reports, plans and programs; semi-structured interviews with key informant collaborators (team of health professionals and technicians/coordinators responsible for the family health program) and users of the services, starting with a previous set of interviews covering the analyzed dimensions, followed by the systematic observation of the teams work process. To estimate the degree of comprehensive medical care in the units of family health five dimensions were under consideration: user embracement, longitudinality attention, care coordination, actions offered and continuity of care. The results showed teams with intermediary level of deployment and advanced level of comprehensive medical care. It has been observed that the Municipal Health Management created conditions for the development of the comprehensive medical care in the family health teams scope, however, the differences found in the degree of implementation among them had been related to specific characteristics of those who collaborate with the program, such as specialized graduation in public health and previous professional experience in management. Implications of the insufficiency of the operacionalization of comprehensive cares guideline were discussed, especially in relation to the organization of the services and the practices developed by the health workers, identifying some obstacles and possibilities to the development of integral health practices related to the position occupied by the health workers in the space for family health strategy. The best delimitation and elaboration of the concept, as well as the expansion of a consensus about it will possibly facilitate its expression in practices that consolidate the implementation of health services and/or systems closer to a more integral attention.

ASSUNTO(S)

integralidade da atenção práticas de saúde programa de saúde da família family health program saude publica health care practices comprehensive care attention

ACESSO AO ARTIGO

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