A ORGANIZA??O DA ESTRAT?GIA SA?DE DA FAM?LIA EM FORTALEZA-CE: DO PROCESSO DE IMPLANTA??O AO CONTEXTO ATUAL

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

The consolidation of the Family Health Strategy (FHS) in major cities is now a great challenge. The aim of this research was to analyze the organization of the implementation of FHS in Fortaleza City, located in the state of Cear?, since its implementation to the current context. This is a critical and analytical study of qualitative approach. We selected 12 subjects for the study, and 06 health workers from the FHS and 06 coordinators of the Family Health Centers (FHC). We use two main tools for the research process: interview and documentary analysis. Data analysis was performed by an approximating of the Analysis of Content, in a critical and reflexive view, as proposed by Minayo(2007). The results revealed the coexistence of the traditional model and the FHS, existing in the same physical space. As a result, we identified some major conflicts that hindered the process of working teams. We noticed that there wasn?t an effective preparation for the network to raise awareness among older workers. We have also discuss that the practices and model of care are not substituting the older model, although there is an effort in that direction. The actions are still based on traditional practices of medicine and curative care in the spontaneous demand. The principle of territorial and adscri??o of clients are not effectively practiced because of the great demand in the area of units and a disproportionate number of teams. Many of this teams are also incomplete. The infrastructure of some units was considered poor, committing the actions that need to be developed by the teams. We also have noticed some difficulties of health workers to conduct health promotion and prevention, because the work culture in the units is still very dedicated to emergency care. Despite the obstacles, the majority of respondents showed feelings of hope, optimism and confidence, expressed by positive expectations of an effective operation in practice of the program. The study also showed that while the FHS model of care was better understood by health workers who work in the strategy, while the coordinators were still working based on the traditional model and eminently assistance care. From these results, we expect this study to support new forms of management and intervention in health in order to maximize the effectiveness of FHS in the city of Fortaleza-CE. We also believe that this search brings an important contribution about the challenges and opportunities regarding the implementation and consolidation of FHS in large brazilian cities. Finally, we wish that these reflections lead to new paths, new practice and, especially, new subjects, able to transform themselves and the reality in which they are inserted.

ASSUNTO(S)

practices and models of health care. programa sa?de da fam?lia (psf) primary care pr?ticas e modelos de aten??o ? sa?de. family health program health in cities saude publica aten??o prim?ria sa?de nas grandes cidades

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