0240/2023 - Gestão do trabalho e o cuidado na Atenção Primária à Saúde durante pandemia de Covid-19 no município de São Paulo (SP) Work management and care in Primary Health Care during the Covid-19 pandemic in the city of São Paulo (SP)
O município de São Paulo historicamente foi marcado pela heterogeneidade da implementação pela coexistência de modelos conflitivos de gestão do SUS e de atenção na Atenção Primária à Saúde (APS). Consolidou-se a administração via contratos de gestão dos serviços de saúde, associada a uma lógica produtivista. Durante a pandemia de Covid-19, as fragilidades de uma APS seletiva tendem a ser pronunciadas. Assim, o presente artigo tem como objetivo analisar a gestão do trabalho e o cuidado na APS durante a pandemia de Covid-19 no município de São Paulo, em pesquisa qualitativa multicêntrica, ancorada no referencial teórico Paideia. Foram realizadas 31 entrevistas em profundidade com usuários e trabalhadores da APS e observação participante. Observou-se postura autoritária e gerencialista da gestão municipal na condução das respostas, com pouco espaço para escuta e diálogo. Notou-se enfraquecimento dos espaços coletivos e do vínculo entre serviço e comunidade; burocratização e precarização dos processos de trabalho e desmantelamento do NASF. Neste cenário, o cuidado caracterizou-se pela redução expressiva da clínica ampliada, compartilhada e pelo distanciamento das diretrizes da APS de base territorial e comunitária.
Palavras-chave:
Atenção Primária à Saúde; Gestão em Saúde; Sistema Único de Saúde.
Abstract:
The municipality of São Paulo has historically been marked by the heterogeneity of implementation and the coexistence of conflicting models of SUS management and Primary Health Care (PHC). The administration by health services management contracts was consolidated, associated with a productivist logic. During the Covid-19 pandemic, the weaknesses of ive PHC tend to be pronounced. Thus, the present article aims to analyze work management and care in PHC during the Covid-19 pandemic in the municipality of São Paulo, in a multicenter qualitative research, anchored in the Paideia theoretical framework. We conducted 31 in-depth interviews with users and PHC workers and participant observation. We observed an authoritarian and managerialist posturethe municipal management when conducting the responses, with little room for listening and dialogue. There was a weakening of collective spaces and the bond between service and community; bureaucratization and precariousness of work processes and dismantling of NASF. In this scenario, care was characterized by a significant reduction of the expanded and shared clinical practice and by the distancingthe territorial and community-based PHC guidelines.
Keywords:
Primary Health Care; Health Management; Unified Health System.
Work management and care in Primary Health Care during the Covid-19 pandemic in the city of São Paulo (SP)
Resumo (abstract):
The municipality of São Paulo has historically been marked by the heterogeneity of implementation and the coexistence of conflicting models of SUS management and Primary Health Care (PHC). The administration by health services management contracts was consolidated, associated with a productivist logic. During the Covid-19 pandemic, the weaknesses of ive PHC tend to be pronounced. Thus, the present article aims to analyze work management and care in PHC during the Covid-19 pandemic in the municipality of São Paulo, in a multicenter qualitative research, anchored in the Paideia theoretical framework. We conducted 31 in-depth interviews with users and PHC workers and participant observation. We observed an authoritarian and managerialist posturethe municipal management when conducting the responses, with little room for listening and dialogue. There was a weakening of collective spaces and the bond between service and community; bureaucratization and precariousness of work processes and dismantling of NASF. In this scenario, care was characterized by a significant reduction of the expanded and shared clinical practice and by the distancingthe territorial and community-based PHC guidelines.
Palavras-chave (keywords):
Primary Health Care; Health Management; Unified Health System.
Anéas, T.V, Lima, M.N, Braga, F.J.L, Oliveira, T.L, Menezes, N.T.A, Viana, M.M.O, Santos, D.N. Gestão do trabalho e o cuidado na Atenção Primária à Saúde durante pandemia de Covid-19 no município de São Paulo (SP). Cien Saude Colet [periódico na internet] (2023/Ago). [Citado em 21/05/2024].
Está disponível em: http://cienciaesaudecoletiva.com.br/artigos/gestao-do-trabalho-e-o-cuidado-na-atencao-primaria-a-saude-durante-pandemia-de-covid19-no-municipio-de-sao-paulo-sp/18866?id=18866
