Ação solidária em saúde : estudo de caso em ESF em Santa Cruz do Sul/RS (2010-2012), com foco na HAS.

Abstract

The research is based on a case study including two Estratégia Saúde da Família (ESF) units in Santa Cruz do Sul/RS in the period between 2010-2012. The overall objective was to analyse two teams ESF in the municipality of SCS, your actions with respect to prevalence of hypertension, as well as depictions of professional teams studied. The reasons that led to the choice of the study subject relate to the researcher interest in the institutionalized forms of attention for health, specially in the promoting measures for healthy levels related to Systemic Arterial Hypertension (HAS). The choice for the two ESF units in SCS correspond to the interest of the researcher in two levels: one with the role played by the ESF units in the routine for case detection and approach and its support strategies for diagnosed patients; and the other with the propagated meaning by the Health Ministry (Ministério da Saúde) regarding the differential from the ESF that is advocated as an ordering strategy from a group of activities in the health system. The fundamental concept of organization of the ESF has as basis the territorial action for health. The data was obtained through interviews with the coordinators from ESF in SCS and with the health professionals that act in the ESF from both selected regions in the original condition as risk areas. The interviews created a set of individualized speeches, transcribed and combined into a unique text, having as a cutting axis not individualities or the groups vision, but a set that represents the frame of the selected inquiries from the researcher for this collective, designed by the central theoretical questions proposed in the research goals. The empiric data revealed that the work dynamic developed by the ESF health groups, for the Systemic Arterial Hypertension patients, occur through home visits carried by the Communitary Health Agents (ACS), previously scheduled visits by the nurse or nursing technician and by the educational activities designed for hypertense, diabetics and pregnant groups. Following an in loco analysis and the testimony given by the designed teams, we do realize that the caring was not always done in a satisfactory way. This is a fact justified by the lack of infrastructure and scarcity of professionals. The questioning about daily work and its alignment with the principles and rules that define the role and goals of the ESF gives revealing answers about aspects still present in the unities, which retake or update the traditional practices of the medical-curative model. As for the action teams – especially with reference to HAS- the activities not been following a permanent protocol for the action of the field along the families. Note that in the community in what refers the respect of the administrative rules and technical/operational norms as orderer for the social intervention from the team, it was observed that the participant through Method, during the developed activities by the ACS in its microárea of competence, the absence of a work agenda that defines a default procedure for the field tasks to be realized with the general public and hypertense families. We have noticed that the expected change for the ESF and for the team, in the health assistance, is still seen with some kind of reluctance by the municipal administration, professionals and even for the patients – signalizing deviation in the conduction route for the renewal strategy of the health system. The results of the ESF already achieved in many municipalities across the country, and even in Santa Cruz do Sul, do not create a conviction about the benefits that the ESF produces. The reality observed in the studied units implicates in a shy political position in relation to the importance of the meaning from what the Strategy represents.