Apoio Matricial na atenção básica: sentidos produzidos por psicólogas em um município no interior da Bahia

Abstract

Matrix Support is a model for the reorganization of management and care in the field of Health, based on the democratic and humanized articulation between multidisciplinary teams, which work by providing care and pedagogical support to reference teams. Its objective is to produce care based on the principle of comprehensiveness by involving health professionals, the community, the family and people in the planning of health promotion, prevention and recovery actions, overcoming structural barriers of the Unified Health System. Matrix Support was incorporated into the Brazilian public health policies of national reach through the creation of the Family Health Support Centers (NASF), instituted with the objective of strengthening Primary Care by offering specialized support to the Family Health teams. Adopting the perspective of discursive practices and production of meanings in the field of social psychology inspired by the constructionist movement, this research aimed to understand the meanings produced by psychologists working in the context of a multidisciplinary team of Primary Care, in the interior of Bahia , on Matrix Support in light of the official technical guidance documents that guide its practice. Initially, discursive practices present in booklets of the Ministry of Health and the Federal Council of Psychology were analyzed, documents in the public domain that served to disseminate technical guidelines on Matrix Support to psychologists throughout the country. The discussion about documents in the public domain evidenced the relationship between certain political agendas and the greater or lesser investment in democratic and humanized care for the qualification of Primary Care. Interviews were also carried out with two psychologists from a NASF team from a small town in the state of Bahia, highlighting their professional trajectories, and the challenges and potential inherent in teamwork, intersectoral practices, working in territories crossed by vulnerabilities and the context of dismantling the SUS, especially in Primary Care. Thus, the analysis of public domain documents and interviews allowed us to understand that the political investment reflected in the structural changes that occurred in the organization of teams with the institution of the NASF, added to the concern to reorient their practices based on the circulation of booklets with technical content /scientific, were important factors for the design of professional trajectories that were fruitful to the NASF proposals. However, the current political moment is producing significant discontinuities with initiatives that discourage assistance according to the rationale of Matrix Support. In addition, we emphasize that one of the unique contributions in this study was the finding that the existence of a fertile soil structured to operate according to the principles of the SUS, contributed to psychologists offering practices that were closer to the demands of the population and the guidelines relevant to this assignment.