Educação permanente em saúde na estratégia saúde da família em busca da resolubilidade da produção do cuidado

Abstract

The development of educational activities to the health workers of EstratégiaSaúde da Família – ESF(Family Health Strategy program) is important to the achievement of an integral work. However it is necessary that such workers have their educational practices guided by the observance of Educação Permanente emSaúde – EPS (Permanent Education in Health) to a major resolubility of the actions demanded by the population. This study aimed to analyze the practice of EPS developed in the Equipe de Saúde da Família – EqSF (Family THealth team) of the municipality of Camaçari in the State of Bahia by seeking the resolubility of the production of the health care to the users of the ESF and to discuss the construction of knowledge and practices of the EPS to the EqSF by searching the resolubility of the production of health care. So as to this work could be possible we started a study with the discussion about the historicity of the formation of the health workers in Brazil and the main pedagogical conceptions which are present in the health field: EducaçãoemServiço (Education at Job), EducaçãoContinuada (Continuing Education) and EPS practices. In the aftermath we discussed the resolubility and the wellness production. It is a matter of a qualitative study, of critical-analytical approach, in a perspective approximated to the dialectical method, having as background two Unidades de Saúde da Família – USF (Basic Health Care Unit), the Departamento de AtençãoBásica – DAB (Departament of Primary Health Care) and the Coordenação de Educação Permanente emSaúde – CEPS (Coordination of Permanent Education in Health) of the town of Camaçari. The participants of the study constituted two groups: health workers of ESF (group I), DAB’s and CEPS’s managers (group II) summating 26 participants. We used as data collection techniques the semi-structured interview, the systematic observation and the document analysis, and as method of data analysis of content. From the confrontation of data emerged two categories: 1 – The process of work of the ESF and the (dis)articulation of the EPS in the production of wellness; 2 – Resolubility of the production of care in the ESF and the construction of knowledge and practices: the protagonism of the EPS. Concerning to the process of work of the EqSF the results foregrounded, there is the development of the group work of the ESF which were studied, notwithstanding the reference and counter-reference system of the municipality does not work out adequately. The comprehension about the EPS, in the vast majority of health workers is associated to knowledge qualification and updating; to the managers it is understood as a process of reflection of the practices to their transformation which is supposed to happen in a continuous and permanent way. We observed some aspects which damage the development of actions of the EPS such as: Professional turnover; lack of professionals with a suitable profile to work in the Primary Health Care; the need of more workers in the CEPS and with the necessary formation to perform such activities, lack of materials for holding such activities; and the fact related to the EPS not being considered as a priority by the management staff. We evinced also that the EPS influences both in the technical capability and EqSF team work and in the intersectoriality with other health services before the contributions of the educational activities to the empowerment of the work in the ESF what makes possible that the health workers develop actions of production of care with major resolubility. We consider that a comprehensive discussion about the EPS as a State policy is Paramount, giving to the health workers and the health managers a major comprehension. In the sense of giving resolubility to the needs of health of the population amidst a production of care to real health.