Work of community health agents in the Family Health Strategy: meta-synthesis

Abstract

OBJECTIVE To systematize and analyze the evidence from qualitative studies that address the perception of Brazilian Community Health Agents about their work.METHODS This is a systematic review of the meta-synthesis type on the work of community health agents, carried out from the Virtual Health Library using the descriptors “Agente Comunitário de Saúde” and “Trabalho”, in Portuguese. The strategy was constructed by crossing descriptors, using the Boolean operator “AND”, and filtering Brazilian articles, published from 2004 to 2014, which resulted in 129 identified articles. We removed quantitative or quanti-qualitative research articles, essays, debates, literature reviews, reports of experiences, and research that did not include Brazilian Community Health Agents as subjects. Using these criteria, we selected and analyzed 33 studies that allowed us to identify common subjects and differences between them, to group the main conclusions, to classify subjects, and to interpret the content.RESULTS The analysis resulted in three thematic units: characteristics of the work of community health agents, problems related to the work of community health agents, and positive aspects of the work of community health agents. On the characteristics, we could see that the work of the community health agents is permeated by the political and social dimensions of the health work with predominant use of light technologies. The main input is the knowledge that this professional obtains with the contact with families, which is developed with home visits. On the problems in the work of community health agents, we could identify the lack of limits in their attributions, poor conditions, obstacles in the relationship with the community and teams, weak professional training, and bureaucracy. The positive aspects we identified were the recognition of the work by families, resolution, bonding, work with peers, and work close to home.CONCLUSIONS This review provided an overview of the difficulties and positive aspects that are present in the daily work of community health agents. Given this, we have raised two challenges. The first one refers to how public policy makers need to appropriation the research results and the second one refers to the need to invest in studies that are designed to generate solutions for the difficulties faced by community health agents in their work.

Child mental health care in the context of the Family Health Strategy: an evaluative study

“…Child mental health care detected at home through Home Visits (HVs) can be a strategic resource in the scope of substitutive mental health services, such as the FHS. The HV becomes a strategy to humanize care and to unleash bonds among users, staff and family; this tool is permeated by light technologies such as communication, welcoming and bonding, dialog and listening (12) .…”

“…The HV is a working tool mainly for CHAs in the evaluated context that helps to identify risk situations and allows guidance to families and communities, as well as to identify cases and situations that will be shared with other health team members (12) . The HV, as a mental health care measure, enables interaction, promotes bonding and facilitates comprehensive care for children and families, making the residence a therapeutic space in childcare.…”

Capacitação de agentes comunitários de saúde: integração entre universidade e atenção básica

“…Nas atribuições do ACS constam a identificação de situações de risco, orientação para famílias e comunidade e encaminhamento de casos e situações de risco identificados para outros membros das equipes de saúde. A atuação do ACS possui papel complementar no planejamento e implementação de ações de saúde localmente, encaminhando informações do território para a equipe de Saúde da Família (Maciazeki-Gomes et al, 2016;Alonso et al, 2018). No Brasil há mais de 200 mil ACS e suas práticas são alvo de diversas discussões pela posição que ocupam, simultaneamente profissional de saúde e morador da comunidade (Saffer & Barone, 2017).…”

Educação permanente com agentes comunitários de saúde para instrumentalização da visita domiciliar: relato de experiência

“…O agente comunitário de saúde (ACS) atua na EqSF, representando o segmento atenção. Na equipe, é o ACS que mantém contato direto com as pessoas da comunidade mediante visitas periódicas às famílias, tendo assim, papel fundamental ao estar intimamente ligado à população tornando-se o articulador dos processos de trabalho da equipe, por conhecer bem a comunidade e ter maior facilidade de acesso ao território10 .Seu principal instrumento de trabalho, a Visita Domiciliar (VD), pode ser compreendida a partir da realização de etapas: planejamento, execução, registro das informações e avaliação do processo, tendo…”