Medicina complementar e alternativa na rede básica de serviços de saúde: uma aproximação qualitativa

Abstract

O artigo focaliza as representações sociais de profissionais da área da saúde sobre a introdução de práticas médicas complementares e alternativas na rede básica do município de Campinas (SP). A partir de uma perspectiva metodológica essencialmente qualitativa, o artigo analisa as condições, os problemas e os obstáculos na implementação dessas práticas nos serviços de saúde. O sucesso desta inclusão foi encontrado em quatro razões fundamentais: a disposição da clientela, que apoia e solicita este tipo de serviço; a visão de saúde dos médicos sanitaristas, que mostram uma abertura para este tipo de projeto; o amplo apoio proveniente de profissionais de saúde não médicos, que pretendem valorizar e ampliar a sua prática; e, finalmente, a própria perspectiva das medicinas alternativas e complementares, que se encontra em plena sintonia com a ênfase na saúde proposta pelo Sistema Único de Saúde (SUS). Apesar do sucesso na implantação dessas práticas na rede básica, dois aspectos negativos foram detectados: o planejamento insuficiente e uma visão simplificadora que converte as racionalidades alternativas em meras técnicas que seguem os mesmos princípios mecanicistas da medicina alopática e o mesmo entendimento reificado de doença.

Práticas integrativas e complementares e relação com promoção da saúde: experiência de um serviço municipal de saúde

“…Our findings contribute to the discussion about the increase in the supply of PIC in the national scenario as a structural aspect of the phenomenon of expansion of such practices in society and corroborate other studies that have shown the use of these practices in public healthcare services as an element of advance in the field 14,16,23 . However, this advance, in the case of specialized services, has been very limited, given its little coverage, the distance from the disease and from people's socio-familial, existential situation, the long queues and their relatively large isolation, aspects that make these services specialized in PIC (or medical offices of some PIC inside specialized outpatient clinics) be limited to few techniques offered to few peopleremarkably, people with chronic diseases that see the PIC as the last resource.…”

“…Therefore, the findings allow to state that there is a mismatch in the relation between the supply of the practices and the demand of the population, with restricted access determined by the professionals' availability. Other authors have also shown that the assistance offered by the PIC professionals is still insufficient in light of the high demand, which would require, for its expansion, some operational planning 23 .…”

Phytotherapy in primary health care

“…The studies on phytotherapy programs (Table 1) and actions (Table 2) reported that the intregration of phytotherapeutics and medicinal plants in primary health care improved access to other therapeutic options besides combined medicines, 16,17,24,27,29,37,41 they consolidated the implementation of public policies, 25,35 local development 10,33 and promoted the revival of the population´s traditional knowledge. 4,10,16,24,29,37,41 Additionally, this integration prompted health professionals to organize educational health 10,17,24,27,33,37,40,43 and environmental 16,37 actions, as well as cross-sectoral actions 10,12,16,17,20,24,33,35,38,41 (in partnership with agriculture, education, environment) and extension and research actions with universities.…”

“…4,10,16,24,29,37,41 Additionally, this integration prompted health professionals to organize educational health 10,17,24,27,33,37,40,43 and environmental 16,37 actions, as well as cross-sectoral actions 10,12,16,17,20,24,33,35,38,41 (in partnership with agriculture, education, environment) and extension and research actions with universities. 16,20,41 and programs in health services, including the lack of strategy for registration and accompaniment in clinical use (to produce clinical evidence), 17,33 low investment in the study of Brazilian medicinal plants, 15,16,29,33,37,41 training and qualification deficits among human reso urces, 2,3,7,10,[13][14][15][16][20]…”

“…16,20,41 and programs in health services, including the lack of strategy for registration and accompaniment in clinical use (to produce clinical evidence), 17,33 low investment in the study of Brazilian medicinal plants, 15,16,29,33,37,41 training and qualification deficits among human reso urces, 2,3,7,10,[13][14][15][16][20][21][22]29,33,36,38,40,43 and lack of human resources. 27,35 They also cited the lack of financial resources and management support 10,12,14,16,17,22,29,30,33,35,37 for organizing work spaces and purchasing the equipment and plant supplies required to offer quality phytotherapeutics and medicinal plants in sufficient quantities to meet the demand of the population. 10,23,28,34,35 Figure.…”