ESTRATÉGIA SAÚDE DA FAMÍLIA NA PREVENÇÃO, CONTROLE E ASSISTÊNCIA ÀS ARBOVIROSES

Abstract

The present dissertation aimed to analyze the work developed by the Family Health Strategy for the prevention and control of arbovirus diseases, as well as for the development of care actions for individuals affected by Dengue, Zika, and Chikungunya. It is a qualitative research conducted in Vitória da Conquista, based on 22 semi-structured interviews, participant observation in the territories, and document analysis. The theoretical-methodological framework was based on analytical matrices developed from the constructs of the Unified Health System (SUS), Health Surveillance, and actions and policies for the care and prevention of arbovirus diseases in Primary Health Care (APS). The results and discussion were presented through two scientific articles. The first article aimed to analyze the performance of the Family Health Strategy (ESF) in the care and prevention of arbovirus diseases in high-risk infection areas. The results showed limitations to care actions under the influence of activity overload and the adopted care model. Content-oriented and verticalized educational practices predominated, with community mobilization strategies being campaign-oriented and hygienist. The studied teams did not routinely assume surveillance and control actions. The second article aimed to analyze the performance and coordination of the work of Community Health Agents (ACS) and Endemic Disease Control Agents (ACE) in the prevention and control of arbovirus diseases. The results showed that ACS and ACE have fragmented and uncoordinated performance. There was a clear distinction of roles between the agents. The chemical control of vectors characterizes ACE performance. ACS does not feel responsible for active surveillance of arbovirus diseases. A weak coordination for collaborative work was evident. There are no regular mechanisms for coordinated action or sharing of information and tasks. Contexts of distrust and limited community mobilization mark the agents' relationships with the community. Weaknesses in the training process and the absence of a continuing education policy were identified. The study identified consistent limitations of the Family Health Strategy in preventing, controlling, and caring for arbovirus diseases. The APS must play a greater role in the surveillance of territories and take effective responsibility for the situation of dengue, zika, and chikungunya. There is a need to improve governance mechanisms and strengthen community mobilization strategies.