Produção do cuidado das Equipes de Saúde da Família em busca da resolubilidade da atenção à saúde

Abstract

Study on the Program of Health of the Family in Alagoinhas, the conception of resolubilidade and the process of worked of the teams with sights the production of the care in health. We trace as objective, to analyze the conception of Resolubilidade pra diligent and using of the PSF of Alagoinhas- BA; to argue the organization of the work of the ESF with sights the Production of the Care in Health; to argue the joint of the PSF with the assistenciais nets for guarantee of the resolubilidade of the necessities of health of the users (individual collective) of the PSF of Alagoinhas- BA as well as the strategies used for the team for this end. One is about a qualitative research, in a structural historical boarding that means a critical and auto-critical balance between objective and subjective conditions, having as inquiry field the Unit of Health of the Family of Alagoinhas-BA. The techniques of production of the data had been the half-structuralized interview, systematic comment and document analysis. The citizens participant had been the diligent users and of the PSF. The method of analysis of the data was an approach the hermeneutics-dialectic, from which if it elaborated 3 categories of analysis: Category 1 - Resolubilidade versus production of the care: of the thought to the práxis in the daily one of the PSF; Category 2 - The organization of the work in the Program of Health of the Family in Alagoinhas: how to construct to practical others with sights to the production of the care in health in favor of the resolubilidade of the actions and services of the PSF? ; Category 3 - Joint of the PSF with the assistenciais nets of health in the guarantee of the resolubilidade of the necessities of health of the users/family: old quandaries and new challenges. The results reached had allowed in them to infer that the Program Health of the Family still meets fragmented and as a “narrow door” of entrance for the users of the system, beyond existing great fragility in the system of reference and against-reference that limits the actions initiated in the PSF and disables a Resolubilidade of the actions of health in the Program. The workers and users recognize that the Resolubilidade is related with a set of characteristics as the shelter, work in team, intersetorialidade, capacity technique, commitment, responsabilização and bond, while characteristic necessary and that must permear the attention carried through in the excellent PSF and to promote the care, however they point that the capacity to decide problems is not summarized to the Program, but extremely it is imbricado with the available resources in the too much nets of assistance of the city. In the production of the data, we find a Program that directs its main actions in the Programáticas Actions and with few actions of Monitoring of the Health of the ESF in the territory. To this spite, we observe that a privileged attention for the groups of risk exists, and low offers of attendance, over all doctor and odontológico for the excessively using ones of the service, characterizing itself as a program-centered service. We also perceive that the ESF organize the work of, from the process and of the technologies of work in health privileging the hard leavenings and, with few traces of the light ones, as territory making of them with approach in acts prescribed in aiding of the doctor-centered model. Ahead of such reality, and understanding that the PSF in Alagoinhas still meets in construction process and, therefore he is unfinished, where if they present some challenges that perpassa over all from the reorganization of the work and the services focado in the necessities of health of the users from the construction of one practical user 10 centered with aiding of the use of the technologies relationariest to promote in fact the production of the care in health.