Home visits by Community Health Agents: professionals’ and users’ conceptions

Abstract The objective of this study was to analyse the conceptions of workers’ and users’ of the Family Health Strategy (FHS) program regarding home visits by Community Health Agents (CHAs). In this qualitative research, individual semi-structured interviews were performed with seven professionals and eighteen users from two Health and Family Units in a mid-sized city in the countryside of São Paulo and participant observation of the CHAs’ activities were carried out. Thematic content analysis revealed that, despite the social support provided by the CHAs, participants see home visits as mechanical activities with bureaucratic purposes, aimed at the individual and the disease, thus deviating from the original purpose of healthcare transformation and exposing a contradictory aspect of such work. This study broadened the view regarding home visits by CHAs and highlighted the importance of reviewing this activity, to achieve a FHS in better alignment with the premises of the Health Reform.

摘要 本研究旨在剖析家庭健康战略（Family Health Strategy, FHS）项目中，从业者与使用者对社区健康专员（Community Health Agents, CHAs）家庭访视工作的认知。本研究为质性研究，对圣保罗州内陆地区一座中型城市的两家卫生与家庭服务站的7名从业者及18名服务使用者开展了半结构化个人访谈，并对社区健康专员的工作开展了参与式观察。主题内容分析法结果显示：尽管社区健康专员能够提供社会支持，但受访对象均将家庭访视视为带有官僚主义倾向的机械性活动，其服务聚焦于个体与疾病，因此偏离了医疗保健转型的初衷，也暴露出此类工作的矛盾性特质。本研究拓宽了学界关于社区健康专员家庭访视工作的认知视野，并强调了重新审视该工作的必要性，以使家庭健康战略更契合卫生改革的核心前提。