Atenção primária à saúde: práticas profissionais diferenciadas (Arapixuna, Santarém-Pa)

Abstract

Through the study, we approached the conditions of implementation of Primary Health Care (PHC) services, and from this point of view, three associated themes emerged as axes of the issues concerning: (i) interdependence or procedural relationship between health and disease; (ii) resources of local medicine, generally qualified as folk medicine; (iii) adverse working conditions. Thus, it emerges as a general objective: Understand and reflect on the relational construction of the health and disease process from the perspective of professionals of Primary Health Care (PHC), in the Family Health Strategy, in the context of rural life, in the Rivers Region in Western Pará. For the theoretical contribution of this study, we value the theoretical and methodological contributions of Barbara Starfield, Eugênio Mendes Villaça, Milton Santos. This is a descriptive, cross-sectional study based on a qualitative approach. Qualitative data were treated through content analysis. We found that the therapeutic attention practiced in Arapixuna corresponds to a community syncretism, reflexive processes that take into account local needs and realities, such as they are collectively apprehended. There is a shared way of reflecting on life and popular knowledge among community members. We assume that it is demonstrable that at each discourse regarding the interdependence of health and disease, professionals question the link between empirical and scientific knowledge, from the institution they represent, and link this procedural relationship to the general welfare, assessed in correspondence with what supposes real and desired in the objective or daily conditions of life. We verified, as prescribed in the conception of the health program under consideration, that own, built in reference to Western medicine. There is a medicinal valuation of the plant added to the divine proposition and religious aspect, as well as the efficacy approved by the experience of use. We perceive the reflexive integration by the consideration of the great territorial and fluvial extension, circumstances highlighted by the interviewees, as much for what is known appropriate, as also by the ways of life conditioned to the nature cycle, which conditions the necessity of adequate transport, almost always imposing of relative high financial costs for the population's access to health services. The construction of the therapeutic itinerary conceived by the community does not follow hierarchies, but situational needs and opening or closing of alternatives. The following reflections were imposed: - determining factors, devices to meet the demand and the protagonism of the subjects in question. Finally, the limitations stand out, not without first considering how PHC can practice its own competencies. For this reason, PHC in the northern region, being designed by ordinances and regulations of the Ministry of Health, based on formal-legal specificities, including financial resources, which are always limited, should be based on an ideal and practical conception that considers valuation of professionals with the task of attending to so many peculiarities inherent to the population of the Amazon region. the professionals contemplated or participants of this study are provided with knowledge and resources of popular medicine, largely reflections.