O agente comunitário de saúde : caracterização da sua formação sócio-histórica como educador em saúde

AUTOR(ES)
DATA DE PUBLICAÇÃO

2007

RESUMO

This thesis focuses the analysis of the Community Health Agents CHA formation as health educator; its object is the educational practice developed by them. The objective was to design a profile of that educational practice based on the theoretical framework of Antonio Gramsci in his reflection on the organic intellectual. The key issue that guided this study was to which extent the CHA internalize the organic intellectual function in relation to the community in which he/she works and shares experiences. Methods: We utilized a historical materialistic approach linking the dialectical hermeneutics to the technique of the Collective Subjective Discourse Analysis. The emergence, consolidation and institutionalization of CHAs work was viewed as a result of the socialhistoric process of the medical work and, consequently, of its construction as a social practice within the capitalist world. We conducted focus group interviews with CHA and community members who were utilizing the public health services at eleven municipalities that were pioneers in the implementation of the national official Programs of CHA and of Family Health (PACS / PSF) in Brazil. Results: The work of CHA overemphasizes preventive actions and functionalistic health promotion practices aiming the development of healthy behavior. A strong affective component was noticeable in the discourse of CHA when they describe their relationship with the community indicating the internalization of a paternalistic role of the State. There is a displacement of the community realm to the States milieau in which CHA is seen as someone of the community who succeeded. The intervention in the community life lacks the ethical-political instruments e o know-how of the what-to-do (in Gramscian terms), which guarantees the dialectical unity of the social profile with the professional profile. In the formal discourse of the CHA reification, there is a lack or neutralization of social and political actions resulting in omissions regarding the political pedagogical project. Actions of information transference emphasizing behavior are distant of the promotion of informed choices on health risk situations. They do not promote the egalitarian access to information that should guide the path to know how to be, to know how to know and to know how to do. Community members know the CHA, identify their actions of information on health care and about medical consultation appointments. The educational practice intentionality shows different levels of image-objective that depend on precarious support to CHAs work (the place of PACS/PSF programs within the national health policy, the work-relation status, the ethical and political direction of the actions, the relationships with the health professionals). Conclusion: The lack of political orientation of the health care practices has led to the condition of traditional intellectual, which maintains the normative nature of work and hampers the development of a health conscience and reality transformation.

ASSUNTO(S)

ciencias da saude saúde pública agentes comunitários de saúde

ACESSO AO ARTIGO

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