0364/2025 - Participação comunitária na Estratégia Saúde da Família: aspectos históricos, teóricos e metodológicos de sua implementação Community participation in the Family Health Strategy: historical, theoretical and methodological aspects of its implementation
Esse artigo objetiva revisar os enfoques da participação comunitária no contexto histórico social da Atenção Primária à Saúde (APS) para refletir sobre a reconstrução crítica do modelo assistencial da Estratégia Saúde da Família (ESF) e do Sistema Único de Saúde (SUS). Apresenta-se os resultados de alguns estudos avaliativos junto a usuários e profissionais de saúde, apontando-se desafios para a participação comunitária na APS, destacando-se: conhecimento da população sobre o SUS e sobre a saúde como um direito humano; imposição das determinações sociais do processo saúde-doença na fragilização da participação da população; escassez de recursos financeiros e materiais para realização das atividades; fragilidade de tempo e foco por parte dos trabalhadores no desenvolvimento dessas atividades; carência de apoio da gestão a essas iniciativas; desinteresse de parte dos profissionais com a dimensão da participação comunitária, preferindo centrar-se exclusivamente no cuidado clínico individual. Conclui-se acerca da importância da participação comunitária na ESF para construção de uma agenda compartilhada entre serviço, gestão e população para mobilizar estratégias que afirmem a vida, o bem viver e os territórios saudáveis e sustentáveis.
Palavras-chave:
Participação comunitária. Atenção Primária à Saúde. Saúde da Família. Democracia. Territorialização.
Abstract:
This article aims to review approaches to community participation in the historical and social context of Primary Health Care (PHC) to reflect on the critical reconstruction of the care model of the Family Health Strategy (FHS) and the Unified Health System (SUS). The results of several evaluative studies with users and health professionals are presented, highlighting challenges to community participation in PHC, highlighting: the population's knowledge of the SUS and health as a human right; the imposition of social determinants of the health-disease process that weakens population participation; a shortage of financial and material resources to carry out activities; limited time and focus on the part of workers in developing these activities; a lack of management support for these initiatives; and a lack of interest on the part of some professionals in the dimension of community participation, preferring to focus exclusively on individual clinical care. The conclusion is drawn regarding the importance of community participation in the ESF for building a shared agenda between service providers, management, and the population to mobilize strategies that affirm life, well-being, and healthy and sustainable territories.
Keywords:
Community participation. Primary health care. Family health. Democracy. Territorialization.
Community participation in the Family Health Strategy: historical, theoretical and methodological aspects of its implementation
Resumo (abstract):
This article aims to review approaches to community participation in the historical and social context of Primary Health Care (PHC) to reflect on the critical reconstruction of the care model of the Family Health Strategy (FHS) and the Unified Health System (SUS). The results of several evaluative studies with users and health professionals are presented, highlighting challenges to community participation in PHC, highlighting: the population's knowledge of the SUS and health as a human right; the imposition of social determinants of the health-disease process that weakens population participation; a shortage of financial and material resources to carry out activities; limited time and focus on the part of workers in developing these activities; a lack of management support for these initiatives; and a lack of interest on the part of some professionals in the dimension of community participation, preferring to focus exclusively on individual clinical care. The conclusion is drawn regarding the importance of community participation in the ESF for building a shared agenda between service providers, management, and the population to mobilize strategies that affirm life, well-being, and healthy and sustainable territories.
Palavras-chave (keywords):
Community participation. Primary health care. Family health. Democracy. Territorialization.
