Resumo:
Currently, humanity is experiencing a new digital transformation known as technological revolution 4.0, characterized by the interrelationship of physical, biological and cybernetic domains with implications for all areas of society, including health work. Digital health is an example of this new technological reality in health actions and practices, with its tools being intensively used since the Covid-19 pandemic, especially in primary health care and in the work of Community Health Workers (CHWs) in Brazil . However, there are few studies that address the health work of CHWs in this context of digital revolution that can support policymakers and managers in decision-making for technological absorption. Thus, this dissertation aimed to analyze the reconfigurations of the CHA work process in the face of the intensification of the use of revolution 4.0 technologies from the perspective of managers, the category itself and other health professionals. This is a qualitative research, with triangulation of methods, produced through different strategies, such as: literature review, non-participant observation, interviews and focus groups, aiming at an in-depth analysis of the object studied. After data collection, the material was organized based on Bardin's content analysis and the interpretation was based on the theory of the health work process according to Mendes-Gonçalves and working conditions, according to Maciel, Santos and Rodrigues . The results are presented in the form of three articles, the first being a review of international literature that mapped the
experiences of community health workers who use digital technologies in their work process, pointing out benefits for the work management of these professionals and for the healthcare system. health; in addition to challenges surrounding the context of work in a digital reality. The second article discusses general characteristics of the work of the ACS with the use of digital technologies, as well as presenting unique experiences of their territorial action, pointing out convergences and divergences in the national scenario in relation to the international one. Finally, the third article addresses the working conditions of CHWs in digital health, highlighting the challenges imposed on the implementation of their practices and to what extent there is a contribution or not to their precariousness. The conclusion is that digital technological absorption is irreversible in CHA practices, influencing their work process with advances in ensuring access to health, but it could also be a new element of health inequity depending on the territorial population served. Nevertheless, the technological revolution 4.0 covers the ACS profession with a new morphology of precariousness that needs to be faced by the political decision to guarantee financial, logistical and permanent education of these health workers around not only digital equipment with quality and efficiency, but of a new critical, emancipatory and culturally sensitive technological competence.