Agentes comunitários de saúde: a reconstrução do conceito de risco no nível local

Abstract

Discute-se o conceito de risco e seus limites como constructo técnico-científico de representação da realidade e dispositivo de apoio à intervenção social. A evolução histórica da epidemiologia e do conceito de risco é relacionada à ideia de arbitragem social junto aos grupos populacionais, examinando-se a possibilidade de apropriação desse conceito para a ampliação da percepção e o fortalecimento das respostas sociais às situações de saúde e vida, à luz de uma experiência pedagógica baseada na perspectiva da educação popular e saúde, com agentes comunitários de saúde de uma localidade urbana periférica. Defende-se que os processos educativos participativos ampliam o compartilhamento de saberes e a capacidade de analisar criticamente as múltiplas relações entre os problemas de saúde e os contextos de vida local e global, recolocando a questão da arbitragem social nas respostas às situações-limite.

O papel do agente comunitário de saúde no fortalecimento da educação popular em saúde The role of the community health worker to strengthen popular education in health

“…[10][11]15 On these ways of coping by the population, the field of People's Health and Education has developed reflections on the limits of technical and scientific perspective to identify, in the laterality and seemingly scattered and unfocused practices, resistance dimensions of the popular groups while facing adversities. [4][5] This perception is diffuse and ambiguous -the CHA expresses a malaise for failing to give answers to the questions, through health services, and at the same time, you realize that the field of social determinants is broad and that many cases relate to one social order marked by inequality.…”

“…It is a special way of conducting the educational process taking into account the subjectivity of individuals, their ways of thinking, acting and feeling that will provide greater political engagement and critical reflection of reality, aimed at their transformation. 4,15 This open stance can counter to the objectives of the work of the teams of the FHS, based on epidemiological information and the concept of risk. The normative point of view, the CHA must identify the factors relevant to the construction of indicators based on risk factors to guide and prioritize their activities.…”

“…13 One way that can be attributed to this mediation is the access to social rights, to the extent that the educational action is crafted as a social practice of stimulating reflection and strengthening of subjects, and not as a mere persuasion tool. 2,4,14 In the context of primary care, it is argued that the CHA is a professional with a critical educational potential that is underrated, and that can contribute to the realization of understanding processes and performance of teams within an expanded concept of health, as your life and the people in the community in which it operates are in historical and direct relationship 15 . However, given that the CHA is both a member of the health team, the explanatory power of the biomedical model, combined with the normative force of health education within the bank design mark their educational practices in order to reproduce the same models of education, in case no questions are raised in the teams, or if already exists accumulations in terms of critical reflection on the role of health education.…”

“…15 On overcoming the idea that understands the educational practice as the process of providing individuals with knowledge for the improvement of their health, admits that the prospect of the PEH is able to go beyond recognizing the transformative potential of CHA educational action, highlighting the collective response capability under the limit situations.…”

Agentes comunitários de saúde: aspectos bioéticos e legais do trabalho vivo

“…Em muitos casos, os municípios abrem um processo de seleção pública, por meio de um edital, como uma alternativa provisória. Nesse ínterim, o ingresso dos ACS ao serviço público é marcado pelo debate ideológico e muita das vezes, político-partidário de lideranças locais Araújo, 2010).…”