Núcleos de Apoio à Saúde da Família: desafios e potencialidades na visão dos profissionais da Atenção Primária do Município de São Paulo, Brasil

Abstract

Family Health Support Centers (NASF) were created in Brazil to increase the case-resolution capacity of primary healthcare. Prior to their implementation in the West Side of the city of São Paulo, Brazil, a series of workshops were held for primary healthcare professionals to prepare a proposal for such centers. Hermeneutic analysis was used to study the transcribed material. The thematic categories were: role, constitution, and functioning of the NASF, relationship with family health teams, and interdisciplinarity. The participants' expected the NASF to be an empowering device for comprehensiveness of care, intervening in an existing culture of unnecessary referrals while fostering linkage with other levels of care. The participants also expected the NASF to contribute to the discussion on health professionals' training and stimulating reflection with policymakers on health indicators based exclusively on the number of consultations. These indicators fail to reflect the impact on the services' activities and the quality of care offered to the population in the coverage area.

Núcleos de Apoio à Saúde da Família: impactos nas internações por causas sensíveis à atenção básica

“…We verified that, from September 1998 to April 2016, the number of FHS increased, as well as the population coverage: from 2,668, in 967 municipalities (5.9% coverage), to 40,490 in 5,031 municipalities (64.2% coverage) 16 . In December 2005 (three years before the FHSC creation) there were 1,244 State Foundations in the Northeast, 18 in Southeast, 98 in the South and 40 in the Midwest 6 .…”

Pleasure at Work in a Family Health Support Team: A Dejourian Analysis

“…19 Interdisciplinarity exists not only in the interaction among workers through sharing knowledge and possibilities of intervention, but also through sharing responsibility to improve quality of care delivery and patient safety. 20 Even though the work at Nasf was reported to be the most favorable to interdisciplinary work through matrix support in team meetings and shared actions, its implementation is still a source of doubt and concern on the part of the Nasf workers themselves, 21 as the interdisciplinary practice needs to be increased. 22 Even though the work at Nasf drives workers to perform their practice based on interdisciplinarity, the reports show a lack of clarity and reiterates a dilemma between what is specific to each profession and what is generally from the field of health and, therefore, can be shared, such as concerns regarding boundaries of practice and potential loss of professional identity.…”

“…23 Other studies addressing Nasf workers have also identified the search for a collective construction of knowledge that overcomes interdisciplinarity and becomes effective in transdisciplinarity. 10,21 Interdisciplinarity made possible through teamwork contributes to the development of new types of knowledge, adding value and pleasure to professional action, collaborating to overcome practical limitations and disciplinary views rooted in the experiences of each profession.…”

Agentes comunitários de saúde: mapeamento de conhecimento antes e após oficinas de instrumentalização

“…However, it is necessary to check the detailed analysis of each question to understand the dimension and more relevant aspects. An important fact was that the instrument used to collect the data made it possible to raise fundamental issues in the discussion on the communicative development in the different life cycles 12 and the role of the speech therapist in the care network [13][14][15][16][17][18] .…”