Construção participativa de um manual de orientação do processo de trabalho para agentes comunitários de saúde

Abstract

The community health agent (CHA) is recognized as responsible for carrying out activities for disease prevention and health promotion, through home or community actions, either individually or collectively. Their main activity is home visits. However, due to the lack of clear boundaries in the responsibilities of these professionals, they are susceptible to high levels of stress, including being held accountable for actions that fall outside their scope of duties. This study is justified because this situation was observed in the municipality where the research took place and because there is no manual guiding the responsibilities of these professionals, which sometimes leads to their work being questioned or carried out inadequately. The general objective is to develop, in a participatory manner, a guidance manual for the work process intended for community health agents. This is a descriptive study with a qualitative approach, developed through participatory action research. Data was collected through discussion circles, guided by a form with leading questions. The statements were analyzed based on the method presented by Bardin, using thematic Content Analysis. The analysis of the material resulted in three non-aprioristic categories: the ACS work process, active search as an ACS responsibility, and manuals and protocols: their contributions to the quality of the work process. The research led to the development of a technical product entitled Guideline Manual for the Work Process of the Community Health Agent, which aims to support and qualify the practices carried out by ACS during home visits. It is organized in a standardized way throughout all sections, containing action flowcharts, ACS responsibilities, frequency of home visits, and important observations for the particularities of each life cycle or health condition. The content of the aforementioned document is composed of 10 (ten) chapters addressing home visits to a new resident, to pregnant and postpartum women, to children, adolescents, women, men, patients with hypertension and/or diabetes, patients with tuberculosis or leprosy, and elderly patients. It also includes a flowchart regarding communication with patients about scheduled tests and appointments. The study made it possible to understand the daily work routine of Community Health Agents (ACS), beyond what is outlined in ministerial documents and the Professional Practice Law of the category, based on the perspectives of the research participants. The technical product developed aims, in addition to systematizing the work of the Community Health Worker (ACS), to clarify all services within the municipality's Health

Care Network regarding their responsibilities, as an attempt to reduce demands for tasks that are outside their scope of action and to minimize the workload experienced by these workers. The choice of participatory action research for the development of the manual was seen as a strength in the implementation of this work, as it provided an opportunity to value the worker through participatory management, in which the main people involved in home visit actions were heard.