O pensar e o agir sobre a gestão do cuidado da obesidade em um curso de educação permanente para gestoras de saúde da Atenção Básica

Abstract

Obesity is a multifaceted phenomenon that requires specific and expanded care within the context of Primary Health Care. In this way, care management that incorporates this perspective into the planning of actions, considering the needs of its territory, is essential to qualify the care for people living with overweight and obesity. In this context, the present study was conducted as part of the project "Qualification of Care for People with Overweight and Obesity in the Basic Health Care of the Unified Health System in the State of Bahia: integrating research, extension, and training," funded by the National Council for Scientific and Technological Development. The course, an integral part of this larger project, was developed by the Center for Studies in Food and Culture at the Federal University of Bahia and targeted health managers in primary care. This retrospective, qualitative study analyzed the perceptions of primary health care managers regarding the care management of people with overweight and obesity within the context of a continuing health education course. The objective was to describe and analyze the planned actions for the care of these individuals, as presented by the participating managers, as well as to evaluate their perceptions of the training process and its implications for the qualification of care. The research included 19 managers, mostly Black women, aged between 28 and 55 years old, occupying roles such as primary health care coordinators, health surveillance, and programs like Health at School. The empirical material was composed of the participants' interactions in the Virtual Learning Environment, as well as individual activities carried out. Content analysis resulted in three thematic categories: a) The place of obesity in primary care – Thinking and acting; b) Challenges and potentialities in care management; and c) Training process and care management qualification. The results show that, for many managers, obesity is often treated as a subtheme of Healthy Eating, without a specific approach in action planning. Furthermore, some reported the lack of a dedicated care pathway for obesity in their municipalities. It was observed that actions aimed at obesity primarily take place in collective settings and within programs with specific funding. Another key point is the impact of the course in mobilizing managers to take action, reinforcing the importance of integrated and contextualized training approaches that consider the complex interactions between social, economic, political, and cultural factors. The managers also recognized their own limitations and potential in dealing with this phenomenon. It is concluded that intersectoral collaboration, interprofessionalism, and the continuous qualification of professionals and public policies are essential for improving the care and management of obesity in primary health care. Additionally, there was alignment between the professionals' reflections and the course's proposals, making it a strategic space for developing comprehensive care, as well as fostering reflections on health actions and the organization of networked care.