Perspectivas de integralidade em saúde na percepção de profissionais do Núcleo Ampliado de Saúde da Família e Atenção Básica e usuários da equipe de estratégia Saúde da Família no município de Belém

Abstract

Since its inception, SUS has been showing significant progress, including the creation of the Family Health Strategy (ESF), adopted as a prioritary model for the reorganization of primary health care in Brazil. In January 2008, the Family Health Support Center (Nasf) was created to expand, increase the resolutiveness and comprehensiveness of health care, and was later called the Expanded Family Health Center (Nasf-AB). Nasf-AB acts in a number of eSF, being made up of professionals from different areas of knowledge to act in support and in partnership with the eSF. This research aimed to evaluate the Nasf-AB regarding the challenges for comprehensiveness, from the perspective of professionals of two Nasf-AB teams and users of two ESF in Belém, Pará. This was a qualitative, case-study approach with participant observation. Semi-structured interviews were conducted from August to December 2017, and subsequently, the content analysis of this material. Nine professionals of two Nasf-AB teams and nine users of two ESF teams took part in this research. The results show that five professionals have postgraduate degrees, but only one has specialization in the area of Collective Health, indicating insufficient specific theoretical training of the team. Regarding the time that the users participate in the activities in Nasf-AB teams groups, the half of the sample has been doing activities for three years. Among the changes brought by the implementation of ESF reported by the users, the dynamics of scheduling appointments, improvement in access to health services and home visits by the professionals stand out. The professionals demonstrated to understand the essence of comprehensiveness in a critical way, as a fight flag for modifying health practices and consolidating the care model. It was also identified that the interviewees associated the groups of physical activities with improvements in the quality of life of the users, besides being considered the main tool to reach the comprehensiveness in the practices. Finally, it was noticed that the Nasf-AB teams studied need to move forward to offer better working conditions to professionals and stimulate practices of permanent education in health, making possible the transformation of professional practices.