Mapeando riscos e selecionando interações: a construção de defesas contra a violência por agentes comunitários de saúde de Salvador-BA

Abstract

The present study aimed to analyze the defenses of Community Health Agents (CHA) against possible victimization (direct and indirect) present in their daily work. Studies have addressed threats and/or victimization suffered by occupational categories. Occurrences are related to how their routine activities are organized. In the context of health care, the violence undermines the equity and 1quality in provision of services. Facing the threat of violence, subjects perform changes of their routine activities to built defenses. These are based on individual and inter-individual action, recognition and selective use of urban space and/or the use of social ties with legal and illegal actors. Qualitative methodology was used, resorting to methodological triangulation. The techniques were analysis of documents relating to the activity of CHA, participant observation of the routines in the Health Care Units, of transit in the community and visits to the homes and semi-structured interviews with 22 CHAS. Contexts of the research were one representative entity of the category (Context A) and two Health Districts (HDB and HDC) in the city of Salvador, Bahia. For data analysis we resorted to the body techniques of content analysis. Actions regarding ethics included presentation of consent forms and preservation of names, dates, locations and any other information that could compromise the privacy of the subjects. The results indicate that the suffered victimization and defenses undertaken by CHAs are structured into three spaces: private, state-public and public. In the private and the state-public space, main threats are represented by the users of the program. In public space, CHAs are victimized by the exposure to criminal activities and possible armed conflicts in the micro-area. Among the defenses, we highlight the careful assessment of the resident before entering homes or intervening in domestic violence situations, the area mapping and selective traffic on the streets. Was also noted the use of defenses based on interactions and negotiations with legal (network of surveillance) or illegal actors (protection credits