Práticas de vigilância em saúde no âmbito da estratégia de saúde da família em um distrito sanitário de Salvador

Abstract

Health Surveillance proposes that health services and practices be organized based on the health needs of the territories and populations and articulated intersectorally with other services and policies, in order to produce changes in the Brazilian sanitary reality. This study aimed to analyze the discourses about the practices of health surveillance related to the territory, health problems and intersectoriality within the scope of the Family Health Strategy (ESF) in the Cabula-Beirú Sanitary District in Salvador. This is a qualitative research and an exploratory study, which was based on the administrative headquarters of the Sanitary District and a Family Health Unit. The selected participants were: the Health District managers and the workers and users of the health unit. Data were collected through a semi-structured interview and documentary analysis. To analyze the findings, we used idea association maps and a document analysis matrix. The results were presented in two articles, entitled: Senses attributed by professionals, managers and users on territory, health problems and intersectoriality and Surveillance practices in health in the perspective of the territory, health problems and intersectoriality in Sanitary District of Salvador. In the first article the results indicated that the sense of territory-process, defined by its dynamicity and social aspects, predominated among the interviewees. About health problems, two meanings were identified: problems of health status, attributed by professionals and managers, and problems of systems and services, attributed by users. While professionals and managers associated intersectoriality with multiprofessional team work and the intrasectoral perspective, the users showed little knowledge about the intersectoral activities developed in the unit. In the second article, the results pointed out that only among professionals of the Family Health team were the identification of instruments used in their practices for knowledge of the territory and recognition of the community as informers in this process. The communication among professionals was identified by the interviewees as the main tool for understanding health problems, with a low incorporation of the analysis of the information systems and documents to subsidize the practices. The meetings were pointed out by the interviewees as an instrument for coping with the problems, but without any association with the planning. Intersectoral practices have been limited to partnerships with education, being identified among the difficulties for their development: communication problems, lack of materials and low involvement of professionals. The research showed that there is a need for greater incorporation of the sense of territory-process in the understanding of health problems and in the development of intersectoral practices. The participation and interest of the community in the actions developed by the health units presented as a potential for the strengthening of health practices. We understand that technical support is necessary for Family Health teams to incorporate the analysis of information systems and documents into their practice, as well as it is fundamental strengthening the collective spaces of discussion and construction of strategies and partnerships for coping with problems in the territory.