The harm reduction unit of the municipality of Santo André: an evaluation / A unidade de redução de danos do município de Santo André: uma avaliação

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

The subject of this study was the Harm Reduction Unit (HRU) of the Municipal Health Department of Santo André, taking it to be a working tool for healthcare that has the purpose of transforming the health situation of individuals forming part of socially marginalized groups. These are individuals who spend their lives or work on the streets: drug users, prostitutes, female sex workers, men who have sex with men, sexually exploited adolescents, transsexuals, transvestites, lesbians and women working in brothels. The general objective was to evaluate the HRU from the viewpoint of individuals that the program reaches. This study started from the understanding that the "social question" has now taken on new features coming from production restructuring processes that, to a greater or lesser degree, impinge on these individualslives, and from the presupposition that the HRU goes beyond distributing supplies and guidance for preventing transmissible diseases, through seeking to ensure individualsrights to health and support their access to other social rights. It sought to understand the usersfamily, work and life situations, find out how they rated the program and analyze the repercussions of the HRUs work on their lives. This was a strategic study of evaluative nature using a qualitative method to grasp this subject. Nineteen semi-structured interviews were held with users in the different segments attended by the program. The interviewees showed that: they were in a wide variety of family setups; working on the streets was consequential to their marginalized path through life and their impossibility of accessing other types of work; and they craved a better life. The HRUs potential benefits were indicated to be: improved healthcare and condom use; decreased drug use; improved seeking and access to healthcare services; and decreased material sharing for drug use; improved decision-making capacity. The HRU was deemed to be a humanized space performing regular and continuous work that gave users a sense of security and protection. The HRUs actions went beyond prevention of damage to health, through promoting broader transformations such as awareness of social rights in general and health rights in particular, along with actions towards making these rights apply. The users felt strengthened for life and for seeking education, work and housing. Among the weak points of the HRU were: non-constant presence and delay in program response in some of the fields; lack of psychology professionals to follow up users. The municipal health services were greatly criticized, and various episodes of prejudice and even negligence in healthcare attendance were reported. The following suggestions are made: expansion and dissemination of the work developed, adding the HRUs actions to primary healthcare units; support for the implementation of associations to bring together the demands of those who work on the streets or in brothels; and provision of a more suitable place for attendance, among others

ASSUNTO(S)

redução do dano drogas de abuso health service evaluation problemas sociais social problems avaliação de serviços de saúde harm reduction street drugs

ACESSO AO ARTIGO

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