Assentamentos rurais e reservas extrativistas: acesso e barreiras ao sistema de saúde no nordeste paraense

Abstract

The study aims to evaluate the phenomena that affect the access to health services in population groups living in Rural Settlements and Extractive Reserves, in the Northeast Paraense, with the perspective of verifying the existence of social exclusion configured by barriers of access to public health services. In the Brazilian Amazon region, the difficulties in providing care in cities in the region are noticeable because of the structural and political challenges for the implementation of public health policies that would require more appropriate planning for the region. With this, we have several implications for the organization of the local health system. Given this scenario, we will research the sites established in this study, which were delimited: the Cupiúba Federal Settlement in Castanhal; the Taperuçu Federal Settlement in São Domingos do Capim; the 5 de Outubro Informal Rural Settlement in Castanhal; the Vera Cruz Informal Settlement in Curuçá; the São João da Ponta Extractive Reserve; and the Mãe Grande Extractive Reserve in Curuçá. In addition to verifying the availability of professionals, supplies, equipment, and technologies available, thus representing a condition of barriers to access or not to basic health care services. Meanwhile, it is urgent to contextualize the lack of access to health services as a form of being excluded from basic rights, which the population expects to be available when they need them. We will also observe, in this study, the difficulty of access of the population to medical professionals during all the working hours of the Basic Health Units, a fact that has been evidenced in studies, more markedly in the North and Northeast regions of Brazil. In order to identify and evaluate the existence of barriers to access to public health services, through its main programs, in Rural Settlements and Extractive Reserves in the Microregion of Guamá in Northeastern Paraense, to verify the existence and level of social exclusion from the evidence of barriers to access to public health services by citizens residing in these territories; to characterize the barriers to access to existing health services in each location, observing the differences in the promotion of public health services in the territories delimited in the project; to evaluate the reality of local health structures, in the generation of public health services, by verifying the existence and levels of imposition of barriers to access to these services; to obtain the health indicators at the level of basic health care coverage in the Settlements and Extractive Reserves inserted in the research. Based on these objectives, we will investigate to what extent public health services of primary care in Rural Settlements and Extractive Reserves are not inclusive and how the barriers of access to health services are constituted for the residents of these areas included in the research project.