Desafios no acesso e serviços prestados à imigrantes na Atenção Primária em Saúde (APS) de Lajeado/RS.

Abstract

The present master's dissertation has as its theme the relationship between international immigration and public health. The challenges faced by health professionals and immigrants in terms of access and care offered by the services of the Primary Health Care (PHC) network in the city of Lajeado/RS, located in Vale do Taquari, are highlighted. The study also analyzed the health equity promotion strategies developed in these services, contextualizing the reality of these subjects. Issues regarding the social and health conditions of immigrants in relation to the Covid-19 pandemic are still addressed. Therefore, this work has the general objective of verifying how immigrants, SUS users, access the services of the PHC network in the city of Lajeado/RS. Thus, in order to achieve the general objective, the following specific objectives were listed: Identify the challenges of immigrants and health professionals in the care offered by PHC services in the city of Lajeado/RS; understand the health demands of immigrants from Lajeado/RS, in the current context of the pandemic caused by the new Coronavirus; to analyze the strategies for the Promotion of Equity in Health developed by the PHC network in the city of Lajeado/RS. Therefore, to meet these objectives, semi-structured interviews were carried out with a total of thirteen interviewees, who were Haitian immigrants and health professionals in two health establishments of the PHC network in the investigated municipality, the São José Praia Family Health Strategy ( ESF) and the Basic Health Unit Moinhos (UBS). In addition to these, the 16th Regional Health Coordination (CRS) also participated in the research. Therefore, in order to analyze the reports of the interviews, content analysis was used to correctly interpret the collected data. This study was characterized by using a qualitative approach, based on the method of dialectical historical materialism, and its three central categories of analysis: the category of historicity, totality and contradiction. Therefore, in order to analyze the access of immigrants to PHC services, the doctrinal principles of the SUS were observed, namely: universality, integrality and equity in the conduct of care offered to immigrants at the UBS and ESF in Lajeado/ LOL. After analyzing the interviews, some weaknesses were found in the conduct of these principles. The universality of access to all health services at all levels of complexity for immigrants was met. However, in the integrality of attention to the health demands of this population, some challenges persist. In the narratives of the interviews, it seemed that the health actions for these people are based a lot on the biomedical model, and in a situation of intercultural contact, it would be interesting to carry out activities with a health care model that deals with culture in a different way. much more dialectical, interactive, considering interest, desire, culture, the subject and its context. As for the principle of equity, it was found that there were equitable actions for immigrants, such as hiring a translator and producing informative materials in the language of Haitians. Some advances achieved in the processes of inclusion of these groups were also identified, for example, their inclusion in the State Policy for the Promotion of Equity in Health. Therefore, it is believed that this master's thesis will contribute to expanding the qualification of health professionals in this area, as well as strengthening the capacity to formulate more effective policies, programs and strategies to respond to the health needs of the immigrant population, strengthening and improving SUS.