Territórios periféricos na margem da formação de profissionais no e para o SUS?
Carregando...
Data
2023-10-30
Autores
Paes, Mariana Fonseca [UNIFESP]
Orientadores
Andreazza, Rosemarie [UNIFESP]
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: A formação de profissionais de saúde no contexto da atenção básica tem como padrão-ouro as residências médica e multiprofissional em saúde da família e comunidade, já que em tais perspectivas temos a possibilidade de estabelecimento de práticas crítico-reflexivas pela educação no trabalho considerando as implicações das diversidades e características territoriais no cuidado em saúde. Objetivo: Buscou-se na tese, aprofundar análises sobre as vivências e as percepções dos estudantes de pós-graduação (modalidade residências em saúde) em relação às estratégias educacionais vivenciadas em territórios periféricos da cidade de São Paulo. Já que em tais territórios, temos a composição de situações de vida repletas de diversidades sociais, com situações de vulnerabilidades e potenciais que constituem elementos fundamentais a serem considerados no contexto da formação NO e PARA o Sistema Único de Saúde, ao visar a garantia da universalidade, integralidade e equidade no cuidado em saúde. Método: Utilizou-se o método qualitativo para produção e análise dos dados, a partir da realização de entrevistas cartográficas com residentes do primeiro e segundo ano de dois programas de residência em saúde da família e comunidade na zona leste de São Paulo. As entrevistas foram realizadas de forma aberta, sem estruturação de um roteiro prévio de perguntas, durante o ano de 2021. Após a transcrição e análise das respostas, estruturou-se os núcleos de sentido e principais achados relativos à compreensão da relação dos(as) residentes com os territórios periféricos. Resultados e Discussão: Como principais achados, identificou-se que houve lacunas formativas importantes com relação a vivências mais próximas aos contextos territoriais das periferias, com ausência de aprofundamento sobre os conceitos de território e comunidade, bem como de vivências de territorialização. A pandemia de Covid19, foi um dos fatores determinantes para o distanciamento das vivências dos(as) residentes com os territórios, influenciando atividades de cuidado em saúde, individuais e coletivas intra e extra “muros” das unidades básicas de saúde. Essas lacunas refletiram em poucas possibilidades de ações dos residentes frente às vulnerabilidades identificadas nesses territórios, bem como, para vinculação dos(as) residentes com as realidades e culturas locais, e para lidarem com suas percepções das desigualdades sociais. A ausência de espaços de diálogo e aprofundamento sobre as questões étnico-raciais, representaram mais uma camada das lacunas evidenciadas na investigação, confirmando o distanciamento entre o processo formativo e as realidades periféricas. Por fim, propõem-se reflexões acerca da qualificação do componente comunidade no currículo formativo, tendo como prisma a necessidade de ampliar a abordagem da equidade nos processos educacionais, e utilização do conceito de interseccionalidade como ferramenta teórico-metodológica para abordagem das questões étnico-raciais, sociais e de gênero para práticas formativas implicadas na qualificação da formação e do cuidado em saúde.
Introduction: The gold standard for training health professionals in the context of primary care is medical and multiprofessional residencies in family and community health, since these perspectives offer the possibility of establishing critical-reflective practices through work-based education, taking into account the implications of territorial diversities and characteristics for health care. Objective: The thesis sought to deepen the analysis of the experiences and perceptions of postgraduate students (health residency modality) in relation to the educational strategies experienced in peripheral territories of the city of São Paulo. This is because such territories are full of socially diverse life situations, with situations of vulnerability and potential that are fundamental elements to be considered in the context of training IN and FOR the Unified Health System, in order to guarantee universality, integrality and equity in health care. Method: The qualitative method was used to produce and analyze the data, based on cartographic interviews with first and second year residents of two family and community health residency programs in the east of São Paulo. The interviews were conducted in an open-ended manner, without structuring a previous script of questions, during 2021. After transcribing and analyzing the answers, we structured the nuclei of meaning and main findings regarding the understanding of the residents' relationship with the peripheral territories. Results and Discussion: The main findings were that there were important training gaps in relation to experiences closer to the territorial contexts of the peripheries, with a lack of in-depth study of the concepts of territory and community, as well as experiences of territorialization. The Covid-19 pandemic was one of the determining factors in the distancing of residents' experiences from the territories, influencing individual and collective health care activities inside and outside the "walls" of primary health care units. These gaps meant that residents had few opportunities to take action to deal with the vulnerabilities identified in these territories, as well as to connect residents with local realities and cultures, and to deal with their perceptions of social inequalities. The lack of spaces for dialog and in-depth study of ethnic-racial issues represented another layer of the gaps revealed in the research, confirming the distance between the training process and the peripheral realities. Finally, we propose reflections on the qualification of the community component in the training curriculum, taking as a prism the need to broaden the approach to equity in educational processes, and the use of the concept of intersectionality as a theoretical-methodological tool to address ethnic-racial, social and gender issues for training practices involved in the qualification of training and health care.
Introduction: The gold standard for training health professionals in the context of primary care is medical and multiprofessional residencies in family and community health, since these perspectives offer the possibility of establishing critical-reflective practices through work-based education, taking into account the implications of territorial diversities and characteristics for health care. Objective: The thesis sought to deepen the analysis of the experiences and perceptions of postgraduate students (health residency modality) in relation to the educational strategies experienced in peripheral territories of the city of São Paulo. This is because such territories are full of socially diverse life situations, with situations of vulnerability and potential that are fundamental elements to be considered in the context of training IN and FOR the Unified Health System, in order to guarantee universality, integrality and equity in health care. Method: The qualitative method was used to produce and analyze the data, based on cartographic interviews with first and second year residents of two family and community health residency programs in the east of São Paulo. The interviews were conducted in an open-ended manner, without structuring a previous script of questions, during 2021. After transcribing and analyzing the answers, we structured the nuclei of meaning and main findings regarding the understanding of the residents' relationship with the peripheral territories. Results and Discussion: The main findings were that there were important training gaps in relation to experiences closer to the territorial contexts of the peripheries, with a lack of in-depth study of the concepts of territory and community, as well as experiences of territorialization. The Covid-19 pandemic was one of the determining factors in the distancing of residents' experiences from the territories, influencing individual and collective health care activities inside and outside the "walls" of primary health care units. These gaps meant that residents had few opportunities to take action to deal with the vulnerabilities identified in these territories, as well as to connect residents with local realities and cultures, and to deal with their perceptions of social inequalities. The lack of spaces for dialog and in-depth study of ethnic-racial issues represented another layer of the gaps revealed in the research, confirming the distance between the training process and the peripheral realities. Finally, we propose reflections on the qualification of the community component in the training curriculum, taking as a prism the need to broaden the approach to equity in educational processes, and the use of the concept of intersectionality as a theoretical-methodological tool to address ethnic-racial, social and gender issues for training practices involved in the qualification of training and health care.
Descrição
Citação
PAES, Mariana Fonseca. Territórios periféricos na margem da formação de profissionais no e para o SUS? 2023. 166 f. Tese (Doutorado em Saúde Coletiva) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP). São Paulo, 2023.