Mudanças ou manutenção do modelo biomédico de atenção à saúde? Analisando projetos de intervenção em trabalhos de conclusão de um curso do Programa Mais Médicos.

Abstract

The Permanent Health Education (PHE) of the More Doctors Program (MDP) is operationalized from the academic supervision of professional practices and the specialization course in Basic Care (BC). The specialization course is offered in the modality of Distance Education (DE), in a partnership between the Federal Institution of Higher Education (IFES) and the Open University of SUS (UNA-SUS). At the end of the course, the doctors presents the Course Completion Work (CBT) in the form of Intervention Project (IP), based on some problem or health need of the population identified from their practices. The main objective of this study was to analyze the IP of doctors inserted in the MDP, participants of the Specialization Course in Collective Health: concentration in Basic Care-Family Health, in the State of Bahia, checking the possible contributions in the changes of the hegemonic model of health care. For this, the models of health care were taken as theoretical reference and a case study was realized with the first class of Specialization in Collective Health with emphasis on Primary Care/Family Health, conducted by the Net-school of ISC/UFBA from April 2018 to April 2019. Data were collected from the documental analysis, using as sources of evidence: CBT, the list of those approved and the final report of the course. A number of 331 CBT were approved, whose themes were organized into 11 categories in one of a spreadsheet in Excel, which were: child and adolescent health; elderly’s health; women's health, men's health, mental health, humanization of care and reception and Chronic Noncommunicable Diseases (NCDs), infectious diseases; diseases caused by vectors; smoking, alcohol and other drugs; and others, which were later subcategorized. The CBTs read and analyzed in full were the ones that had the highest repetition in the number of choices by the cursists, and the theme of Systemic Arterial Hypertension (SAH) was the most frequent in the subcategorization of NCDs. For data analysis, the content analysis technique was used. The results indicated four empirical categories for analysis: health education technologies, Patient-Centered Clinical Method (MCCP), interdisciplinary action and changes in the work process.social determinants of health and popular participation were absent from the interventions, intersectoriality appeared embryonically. The findings of this study showed that in the IP coexisted health practices of both the hegemonic models and the alternative models of care, with a significant strengthening in the technologies that indicate the alternative models. Thus, it is necessary that other studies be conducted in order to know the potentialities and weaknesses of the IP of specialization courses in AB for the improvement of PHE in the strengthening of alternative models of health care.