Management in Primary Health Care: Discourses About the Search for Respiratory Symptomatics of Tuberculosis

Abstract

The study aimed to analyze the discourse of Primary Health Care managers about the search for respiratory symptomatics as an epidemiological surveillance action of tuberculosis. A qualitative study was undertaken, guided by the theoretical and analytical framework of French Discourse Analysis. Data were produced in May 2012 through semi-structured interviews with 14 subjects. Two discursive blocks were produced: marks of power in the execution of the search for respiratory symptomatics; resistance strategies in the search for respiratory symptomatics. Discursive positions were grounded in the traditional management model, making it difficult to incorporate the search for respiratory symptomatics as a participatory action that integrates health staff, managers and the community. Insufficient human resources, workload and rigor in achieving goals favor postures of immobility among the professionals. It is concluded that the managerial work outlined in the health surveillance model encourages the mobilization of practices that contribute to qualify the search for respiratory symptomatics in Primary Health Care.

Detecção da tuberculose: a estrutura da atenção primária à saúde

“…This generates work overloads, and consequently, in detriment of the assistance, weakening the link between user, team and fragmenting care (16)(17) . Even though the active search of cases is an activity inherent to all PHC professionals, the units with ESF are more capable of executing it, because their teams are required to have an ACS professionals, who have to carry out domiciliary visits in their daily routines, increasing the odds of early discovery of the disease (18) .…”

Avaliação dos serviços de atenção primária à saúde na tuberculose

“…7 A broader view of the health-disease process and of the relationships between team members and between the health services themselves needs to be redeployed, requiring the incorporation of HCN components management mechanisms so that all care locations explore their potential of TB diagnosis according to the available technological density and the complexity of the cases. [29][30] The results confirm the need for improvements in the actions developed in the scope of PHC for the detection and control of TB, mainly in relation to the work process in the development of the actions of PHC health teams, in the sensitivity to the detection of and community-based actions. It CONCLUSION J Nurs UFPE on line.…”

Capacidade Gerencial Da Atenção Primária À Saúde Para O Controle Da Tuberculose Em Diferentes Regiões Do Brasil

“…3,7 In Brazil, despite the availability of a greater supply of TB control actions in PHC, the healthcare network is mostly disarticulated, poorly distributed and poorly equipped. [8][9][10] The local health systems present complex and heterogeneous realities concerning this level of care, such as the coverage percentage of primary health care services (PHCS), access to the computer system for TB care at the PHCS and the care process (offering medical/ nursing, management and monitoring actions of TB cases in PHCS).…”