Acesso e efetividade dos serviços do sistema único de saúde (sus) nas comunidades quilombolas Murumuru e Saracura, município de Santarém, Pará

Abstract

Health is a universal right in Brazil at all levels of care, and it is the duty of the State to provide the indispensable conditions for its full exercise, without prejudice or privilege of any kind. Quilombola communities are affected by multiple inequalities, despite constant transformations and attempts to promote equity and universal access to health. In this sense, this dissertation seeks to answer how is access to health services offered by SUS in the remaining quilombo communities Murumuru and Saracura? Seeking to understand if there are conditions of access, if it is effective, if the services offered are able to meet the needs of quilombos and how health care is planned for these communities. For this purpose, the study had as its methodological principle the qualitative approach, using for the interpretation and analysis of the data the Collective Subject Discourse (CSD) technique, by Lefrève and Lefrève (2003). Access to the health services offered by the SUS for the two quilombola communities is hampered by distance; precarious means of transportation and financial resources to travel to the Basic Health Units (UBSs); and the difficulty of obtaining care at the UBSs in the urban area of Santarém.Issues of transportation, infrastructure, lack of financial incentives, and seasonality are obstacles for Family Health Teams (EqSF) to promote health actions more frequently and offer services in the communities.In the quilombos, families resort to the manipulation of medicinal plants in the preparation of teas, syrups, juices, bottles, and also seek benzedeiras, healers, midwives and puxadores for the prevention or treatment of diseases. In both communities, it is common for CHWs to schedule medical appointments when requested, community members have a strong bond with these professionals, who, because they live in quilombos, are the first ones sought by users. In addition, managers' lack of knowledge about public health equality policies that include the black and quilombola population is an obstacle to promoting health equity.