Scientific and popular health knowledge in the education work of community health agents in Rio de Janeiro shantytowns

Abstract

Health education for socially marginalized populations challenges the efficacy of existing strategies and methods, and the pertinence of the educational and philosophical principles that underpin them. The Brazilian Community Health Agents Initiative (CHAI) hires residents of deprived marginalized communities to undertake health promotion and education in their communities. The ultimate goal of the CHAI is to connect populations with the public healthcare system by promoting social re-affiliation, protecting civil rights and enhancing equity of access to health services. In this article, we present the education work of community health agents through interplay between popular and scientific health knowledge in nine Rio de Janeiro shantytowns. A critical ethnographic research design, using thematic analysis, allowed us to explore agents' education work to enhance family health literacy in shantytowns. Local culture and social practices inspire Agents to create original strategies to reconcile forms of health knowledge in their work.

Who is a community health worker? – a systematic review of definitions

“…In relation to health promotion and disease prevention, CHWs are involved in activities both within the community and linked to the health facilities they are connected to. In the community, CHWs provide services to promote a healthy lifestyle and prevent disease [ 17 , 19 , 26 , 28 , 33 , 38 , 40 , 43 , 45 , 56 , 57 , 66 , 67 , 70 , 71 , 73 , 79 , 89 , 90 , 93 – 104 ], mobilise and encourage community members to utilise available health services [ 15 , 18 , 95 , 103 , 104 ], and facilitate access to facility-based healthcare by helping community members understand where to access care when needed [ 6 , 15 , 17 , 25 , 26 , 36 , 40 , 43 , 47 , 52 , 56 , 59 , 61 , 63 – 65 , 70 , 72 , 82 , 91 , 104 – 108 ]. Acting as ‘Patient Navigators’ [ 23 , 24 , 40 , 77 , 80 , 109 – 119 ], CHWs interpret health information and provide logistical support to patients accessing healthcare within a complex healthcare system.…”

Education, child rearing and social justice

“…While it is true that they need to have their rights protected from violation and need just conditions to flourish as human beings, it is also necessary to recognize them as worthy and capable people. In addition to developing relations based on cognitive justice, taking an ethical stance in this sense is key to promoting an education based on dialogue within the framework of a problematizing dynamic that can strengthen critical thinking (35). In that way, both, participants and health professionals, can arrive at a better understanding of the social, cultural and political conditions that constitute injustice.…”

Factors Associated with Providers’ Perceptions of Mental Health Care in Santa Luzia’s Family Health Strategy, Brazil

“…In the Unified Health System, multi-professional teams work under the principle of “comprehensive care” [ 26 , 27 ]. The CHWs on ESF teams provide home visits to residents in impoverished neighborhoods, often the same communities in which they reside, with high prevalence of chronic diseases (e.g., diabetes, hypertension) and help to connect individuals to a variety of services to meet their needs [ 28 ], including health counseling and education, identifying individuals in need of ongoing care and/or monitoring for chronic health conditions [ 29 ], and social support services, such as access to food vouchers and child welfare services [ 30 , 31 , 32 ]. Consultations with specialists, such as pharmacists, psychiatrists, and dentists, are also built into the system, though the availability of specialists varies widely across municipalities [ 31 ].…”