Políticas do cotidiano: a gestão na atenção básica

Abstract

IT IS WITH GREAT PLEASURE AND JOY THAT WE PRESENT this special issue of the journal 'Saúde em Debate' of the Brazilian Center for Health Studies (Cebes), where it is possible to make available formulations and reflections, products of several years of experimentation in meetings between the people who are involved in the daily lives of health networks. Those meetings were provided by the course directed to the Primary Care Management of the Fluminense Federal University (UFF), which focused on daily policies as well as work micro--politics. We have always spoken of the idea that the 'shop floor' of health services, that is, the meeting place for users and workers, is a place where innovations germinate, through the creative power and force of health work itself. Supported by this conviction, we seek to bring to the debates the scenarios of practices, the multiple relationships at work, the daily exercise of care, all brought to the first production plan of the course. Thus, the courses became life laboratories in their daily activity of production of care.The course has traveled throughout the Brazilian territory, it was invaded by various accents, experiences, of different realities, and the many faces of the huge Unified Health System (SUS) were present. It was the production of a multitude, which, in its multiplicity, brought to the scene what is common to all of us: the work of welcoming, caring, protecting the bodies that come to be cared for in health care networks. Care has the function of giving way to its powers.With all the diversity present, we see that what we all have in common is caring. From this idea, we find the same grammar in the production of life, which directs the actions of work, whether linked to daily health care, or the processes of administration and management of health services for the same purpose, which is the defense of life whatever it may be. All work activities always converge to the same plan, which is the production of care 1 .The meetings we experience in health management blend with the care proposals drawn by the teams. In the daily routine of services, the intense production of ways of relieving pain, of building life-enhancing tools and therapeutic projects with the user is mixed with proposals for better service performance, health planning, and health indicators, that is, different regimes of producing truth 2 are presented in a same scenario that calls for manager and worker to share the user's life, carrying out, through this weaving, arrangements that highlight or not the multiplicities of existence.Management and care conform important dimensions to be faced, mainly for subsuming ways of sustaining and expanding the life power in its production process. It is not a matter of applying concepts, but rather that they are experienced as tools capable of deepening and formulating questions that operate in the daily routine of services.

Continuing Health Education: an interprofessional and affective policy

“…A transmitting education, from those who know to those who do not know, whose strength teaches to learn without having to think, makes interprofessionality extremely challenging due to the devaluation of the other's knowledge, considering it as lesser knowledge. Contrary to this perspective, we can say that, for EPS, learning is not a process of acquiring knowledge but producing life, encounters, intensities, and subjectivities at work 13 .…”

Educação Permanente em Saúde: uma política interprofissional e afetiva

“…Um ensino transmissor, de quem sabe para quem não sabe, cuja força ensina a aprender sem que seja necessário pensar, dificultando sobremaneira a interprofissionalidade pela desvalorização do saber do outro, considerando-o como saber menor. Na contramão dessa perspectiva, podemos afirmar que, para a EPS, o aprender não é um processo de aquisição de um dado saber, mas um processo de produção de vida, de produção de encontros, de produção de intensidades e subjetividades no trabalho 13 . Retomando a cena 2, foi notório que houve EPS, independentemente de espaços físicos e de atividades nomeadas como educacionais.…”