<p>Objetivo: conhecer os discursos de homens sobre o acesso à saúde na Atenção Básica. Método: estudo descritivo, realizado em dezembro de 2016 com 20 usuários da Atenção Básica do município de Cajazeiras, Paraíba, Brasil. Adotou-se como recurso metodológico a Análise de Discurso. Resultados: dos discursos emergiram as categorias: dificuldade em discernir as funções da Atenção Básica; exaltação do modelo biomédico; prática da medicalização; fatores de afastamentos do serviço; ausência de ações e programas destinados aos homens; e divergência entre masculinidade e feminilidade. Conclusão: os discursos masculinos ratificaram a necessidade de reorientação de saberes e práticas dos serviços de saúde para ampliar o acesso da população masculina na Atenção Básica.<br />Descritores: Atenção Primária à Saúde. Masculinidade. Gênero. Saúde do Homem.</p>

Objetivo: Analisar as dificuldades experienciadas pelos Agente Comunitário de Saúde no seu cotidiano na realização da educação em saúde na Atenção Básica. Metodologia: Pesquisa descritiva, de cunho qualitativo, sustentada nos marcos conceituais da análise de discurso de Michel Pêcheux. Resultados: Identificou-se fatores que gerava dificuldades no cotidiano das práticas de educação em saúde e por consequência restrição nas ações realizadas pelos agentes. Discursões: Os principais obstáculos foram: resistência do público em participar das ações; falta de apoio da gestão e necessidade de utilização da barganha como método de incentivo para que a população participe das atividades de educação em saúde. Conclusão: Torna-se importante ressaltar a construção do cuidado em busca de superar os empecilhos da rotina de trabalho em relação à educação em saúde, visto ser a mesma uma possibilidade de empoderamento social.DIFFICULTIES EXPERIENCED BY COMMUNITY HEALTH AGENTS IN THE CONDUCT OF HEALTH EDUCATIONObjective: To analyze the difficulties experienced by the Community Health Agents in their daily life in the realization of health education in Primary Care. Methodology: Descriptive research, of a qualitative nature, based on the conceptual frameworks of Michel Pêcheux's discourse analysis. Results: We identified factors that generated difficulties in the daily life of health education practices and, consequently, a restriction on the actions performed by the agents. Discussion: The main difficulties were: public resistance to participate in actions; influences of the biomedical model; lack of management support and the need to use bargaining as a method of encouraging the population to participate in health education activities. Conclusion: It is important to emphasize the construction of care in order to overcome the obstacles of the work routine in relation to health education, since it is a possibility of social empowerment.Descriptors: Family Health Strategy; Community Health Worker; Health Education. DIFICULTADES EXPERIENCIAS POR LOS AGENTES COMUNITARIOS DE SALUD EN LA REALIZACIÓN DE LA EDUCACIÓN EN SALUDObjetivo: Analizar las dificultades experimentadas por los Agentes Comunitarios de Salud en su cotidiano en la realización de la educación en salud en la Atención Básica. Metodología: Investigación descriptiva, de cuño cualitativo, sostenida en los marcos conceptuales del análisis de discurso de Michel Pêcheux. Resultados: Se identificaron factores que generaban dificultades en el cotidiano de las prácticas de educación en salud y por consecuencia restricción en las acciones realizadas por los agentes. Discusiones: Las principales dificultades fueron: resistencia del público en participar de las acciones; influencias del modelo biomédico; falta de apoyo de la gestión y necesidad de utilización de la negociación como método de incentivo para que la población participe en las actividades de educación en salud. Conclusión: Es importante resaltar la construcción del cuidado en busca de superar los escollos de la rutina de trabajo en relación a la educación en salud, ya que es la misma una posibilidad de empoderamiento social.Descriptores: Estrategia de Salud Familiar; Agentes Comunitarios de Salud; Educación en Salud.

Background: Our team has been fighting nosocomial infections since 1991. During our journey, we often ask why people do not wash their hands! Semmelweiss discovered in the 1840s that handwashing prevented deaths from puerperal sepsis, but we still need to convince healthcare workers about hand hygiene. One answer is that washing hands is an unsophisticated gesture, without any technology, so people just do not do it. How can we improve compliance with hand hygiene? We imagined a robot in our team to remind people to wash their hands. Then, in 2016 we met Meccanoid, a US$200 toy robot: a 4-foot-tall programmable humanoid robot with voice recognition capabilities. We made adaptions in the robot (mini-projector + audio amplifier + alcohol dispenser + spy camera), and we gave him a name (Ozires) and a purpose: He became a professor who teaches healthcare workers how, when, and why wash their hands! Here, we describe the multimodal strategy centered around Ozires. Methods: The multimodal strategy consists of 7 key elements: (1) the robot, accompanied by a infection control practitioner, performs audio and video lectures about hand hygiene techniques, motivational videos, data feedback; (2) the robot’s wood copies with sound alert with motion detector for hand hygiene are spread out in the whole hospital; (3) fridge magnet with robot prints (gifts for patients and healthcare professionals); (4) app for hand hygiene monitoring (Hands Clean); (5) adherence rates by professional category and individual feedback; (6) patient empowerment for hand hygiene; and (7) sound alert for hand hygiene in the patient room’s door. Results: After the insertion of Ozires in 3 ICUs of hospital A (pilot study), the hand hygiene (HH) rate increased from ~36%, between January and July 2016, to ~68% between August 2016 and October 2019. At hospital B, Ozires started his lectures in May 2018, throughout the hospital. Hand hygiene adherence increased from 23% between July and December 2017 to 60% between June 2018 and October 2019. In the 3 months before this multimodal strategy was implemented in hospital C (June–August 2019), and the mean rate of hand hygiene was 65%. With the robot, the hand hygiene rate increased to 94% (September–October 2019). Conclusions: The multimodal strategy centered around the robot Ozires works! Hand hygiene compliance increased significantly after the interventions. People listen the robot much more attentively than to their human colleagues, and healthcare worker behavior changed! We need to go further improve the program, but it is sustainable. Finally, we succeeded in convincing people to improve their hand hygiene practices.Funding: NoneDisclosures: None