O uso da ginástica laboral na promoção à saúde do agente comunitário de saúde

O Agente Comunitário de Saúde (ACS) é o principal elo entre a comunidade e a Unidade de Saúde, no território onde está inserido. Sua dinâmica laboral pode gerar sobrecarga emocional e física que podem impactar negativamente na sua saúde, tornando-se necessária a realização de ações direcionadas à saúde desse trabalhador. Diante disso, o objetivo do presente trabalho é relatar a experiência de sessões de Ginástica Laboral (GL) com ACS de uma Unidade de Saúde da Família no município de Itabuna-BA. As sessões de Ginástica Laboral promoveram bem-estar, valorização da saúde do trabalhador e interação grupal. Ações continuadas de promoção à saúde são imprescindíveis para esses profissionais, que muitas vezes têm sua saúde negligenciada pelo serviço de saúde. Palavras-chave: ginástica laboral; promoção à saúde; agente comunitário de saúde; saúde do trabalhador; unidade de saúde da família. Abstract The Community Health Agent (CHA) is the main link between the community and the Health Unit, in the territory where it is inserted. Their work dynamics can generate emotional and physical overload, which can negatively impact their health, making it necessary to carry out actions directed to the health of this worker. Therefore, the objective of the present work is to report the experience of Labor Gymnastics (GL) sessions with CHW from a Family Health Strategy, in the municipality of Itabuna- BA. The Labor Gymnastics sessions promoted well-being, valuing the health of the worker and group interaction. Continued actions to promote health are essential for these professionals, who often have their health neglected by the health service. Keywords: labor gymnastics; health promotion; community health agent; worker's health; family health strategy.

Implementation Research for the Evaluation of the Child Health Education and Surveillance Tool Application

Community health agent programs and modern information and communication technology can greatly improve knowledge of healthy childrearing practices by caregivers in low resource settings, if implemented effectively. Improved knowledge by caregivers can lead to better sanitation, diet, and child development practices. A digital health tool (CHEST App) was developed and deployed in a community health agent program in the Amazon of Peru to improve community health agent performance and ultimately improve early childhood development in the communities. This study presents the results of and evaluation of the implementation and clinical outcomes of the program. METHODS The CHEST App intervention was evaluated using a Hybrid Type II evaluation study design. The effectiveness of the intervention was determined by conducted a paired t-test analysis to compare the mean differences in knowledge scores, hemoglobin levels, early childhood development (ECD) scores, and incidence of diarrhea. The evaluation of the implementation outcomes was conducted with a mixed method approach to identify the extent to which the intervention was successfully installed into the local CHA program. The results of the study are presented within the framework of the Implementation Research Logic Model. RESULTS The CHEST App intervention is associated with improvements in knowledge scores, hemoglobin levels, ECD scores, and decreased diarrhea. However, the evaluation could not isolate the effect of the intervention due to reduction in sample size from COVID-19 closures. The implementation of the CHEST App intervention was effective with high degrees of acceptability, adoption, and fidelity. Adoption and fidelity of the surveillance function of the CHEST App by program coordinators was not achieved. CONCLUSION The CHEST App intervention is a promising tool to improve the performance of CHAs during their home visits, to accomplish their objective of teaching caregivers healthy childrearing practices and improving child health and development in their communities. Trial Registration Trial registered on 11/29/2018 at ISRCTN43591826.

Breast cancer screening in Primary Health Care in Brazil: a systematic review

ABSTRACT Objectives: to analyze care strategies for breast cancer screening in Primary Health Care in Brazil. Methods: this is a systematic review following the Cochrane Collaboration recommendations. Results: among 355 manuscripts, five were eligible. The patient navigation program by Community Health Agent stood out with the best result, among the strategies: flexibility of goals considering viability; community engagement; team training; active search of the target population by Community Health Agent; request for mammography by physicians; actions integrated to women’s health; monitoring of mammography results, absent users, and population coverage by physician and nurse; and assessment of criteria for requesting screening mammography by means of an information system. The population coverage rate in the program ranged from 23% to 88%. Conclusions: Primary Health Care in Brazil presents devices with potential to induce the production of care for breast cancer screening.

Community Health Agent: a professional world in search of consolidation

The contribution of community health agents (CHAs) is strategic for overcoming the biomedical health model. However, weaknesses in defining the specific roles of this profession impose contradictions and impediments to this work, making it difficult to construct the professional world of CHAs. Thus, this study aimed to analyze the tasks performed by the CHAs to reveal the objects, values, and tools, used by these workers to help consolidate their professional world. This study is a qualitative research study guided by the principles of activity ergonomics that include documentary analysis, systematic observations, and interviews. The results showed that due to the myriad of activities performed by the CHAs, the professional world of these workers is not fully delineated. However, it is believed that the results, analysis, and discussion of the data verified in this research, can support the consolidation of the professional world of the CHAs.

Social determinants of health and community health agent work

Objective: To understand the social determinants of health from the perspective of the work of community health agents. Method: A qualitative study conducted in a Health District Management in the city of Porto Alegre/Rio Grande do Sul, Brazil, through focus groups and semi-structured interviews with community health agents. The analysis took place through thematic categorization, and the social determinants of health were adopted as the analytical category. Results: Twenty-five (25) community health agent workers participated. Overlapping individual and collective themes emerged, from violence and drug trafficking to lack of sanitation, improperly disposed garbage, illiteracy and the health problems themselves. Conclusion: The study revealed a complex relationship between the work of community health agents and the social determinants of health, reinforcing the need for a cohesive health team with intersectoral initiatives to address the different demands of the territories which are worked and lived in.

Conhecimento dos agentes comunitários de saúde da fronteira franco-brasileira sobre atenção básica

Resumo: O Agente Comunitário de Saúde (ACS) realiza um trabalho fundamental no envolvimento da população para o enfrentamento dos problemas de saúde, sobretudo para a modificação das condições de vida, buscando melhores conjunturas de saúde em seu território de abrangência profissional. O Ministério da Saúde salienta que a qualificação do ACS deve ser contínua e permanente, sendo fundamental para aprimorar as capacidades individuais e coletivas na prática profissional. O objetivo deste estudo foi relatar a percepção dos ACS a respeito de seu papel dentro da Atenção Básica em um município fronteiriço. O estudo teve caráter descritivo com análise qualitativa realizada através da análise de Bardin. Os dados foram coletados em 2018. Resultados demonstraram que os ACS estão desinformados quanto a situações de agravos a saúde, o programa da atenção básica não está sendo executado da forma como é preconizado, apesar de alguns discursos relatarem de forma concreta a importância desses profissionais.Palavras-chave: Saúde Pública; Agentes Comunitários de Saúde; Promoção á Saúde. Knowledge of community health agents of the french brazilian border on basic careAbstract: The Community Health Agent (CHA) performs a fundamental work in the involvement of the population to face health problems, especially for the modification of living conditions, seeking better health conditions in their professional territory. The Ministry of Health emphasizes that the qualification of the CHA must be continuous and permanent, being essential to improve individual and collective capacities in professional practice. The aim of this study was to report the perception of CHAs about their role within Primary Care in a border municipality. The study was descriptive with qualitative analysis performed through Bardin analysis. The data were collected in 2018. Results showed that the CHA are uninformed about health problems, the primary care program is not being implemented as recommended, although some speeches specifically report the importance of these professionals.Keywords: Public Health; Community Health Agents. Health Promotion.

Riscos ocupacionais no processo de trabalho do agente comunitário de saúde: revisão integrativa/ Occupational risks in the work process of the community health agent: integrated review

Objetivo: Identificar, na literatura científica, publicações sobre os principais riscos ocupacionais no trabalho do Agente Comunitário de Saúde (ACS). Método: Pesquisa qualitativa do tipo revisão integrativa de literatura, tendo como questão norteadora: Quais os riscos que os ACS estão expostos na sua atividade laboral? A coleta de dados ocorreu em maio de 2019, nas bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Electronic Library Online (SciELO), por meio do portal da Biblioteca Virtual em Saúde (BVS), a coleção principal da Web of Science, através do Portal de Periódicos da Capes. Resultados: Foram identificadas 43 publicações que, após a filtragem segundo critérios de inclusão e exclusão, culminou em uma amostra de 12 artigos. Foram identificados quatro tipos de riscos, apresentados no formato de categorias de análise, a saber: Riscos físicos; Riscos químicos; Riscos biológicos; Riscos psicossociais. Conclusões: Diante da tamanha relevância do ACS para a Estratégia Saúde da Família e a saúde pública, cabe a reflexão sobre as condições laborais nas quais estes profissionais se encontram e espera-se que gestores, os próprios ACS e demais profissionais se mobilizem para estruturar mecanismos de apoio e defesa desta categoria, minimizando e sanando os riscos ocupacionais.

Condições de trabalho e saúde de agentes comunitários de saúde

RESUMOObjetivo: identificar as produções científicas que demonstram como as condições de trabalho influenciam a saúde dos agentes comunitários de saúde do Brasil. Método: trata-se de um estudo bibliográfico, tipo revisão integrativa, de artigos publicados no período de 2002 a 2016, nos idiomas inglês, espanhol e português, inseridos na base de dados da Biblioteca Virtual em Saúde. Realizou-se a leitura dos títulos, resumos e artigos completos que atendessem ao objetivo proposto. Apresentaram-se os resultados em forma de figura. Resultados: selecionaram-se 20 artigos que se evidenciaram, a partir da análise dos artigos, diversas formas de adoecimento, tanto de ordem física, como psíquica. Relacionaram-se intimamente as condições de trabalho ao comprometimento da qualidade de vida desses trabalhadores e à exposição aos agravos e doenças. Conclusão: aponta-se a necessidade de intervenções imediatas nas condições de trabalho do agente comunitário de saúde, por parte dos gestores, visando à redução da morbimortalidade desses profissionais de saúde. Descritores: Saúde do Trabalhador; Trabalhadores da Saúde; Agente Comunitário de Saúde; Condições de Trabalho; Condições de Saúde; Multimorbidade. ABSTRACT Objective: to identify scientific productions that demonstrate how working conditions influence the health of community health agents in Brazil. Method: it is a bibliographical study, integrative type review of articles published from 2002 to 2016, in English, Spanish and Portuguese languages, entered in the Virtual Health Library database was performed reading the titles, abstracts and complete articles that met the proposed objective. The results were presented in figure form. Results: we selected 20 articles that were evidenced, from the analysis of the articles, various forms of illness, both physical and psychic. Work conditions were intimately related to the impairment of the quality of life of these workers and to exposure to illnesses and diseases. Conclusion: it is pointed out the need for immediate interventions in the working conditions of the community health agent, by the managers, aiming at reducing the morbidity and mortality of these health professionals. Descritores: Occupational Health; Health Personnel; Community Health Workers; Working Conditions; Health Status; Multimorbidity.RESUMEN Objetivo: identificar las producciones científicas que demuestran cómo las condiciones de trabajo influencian la salud de los agentes comunitarios de salud de Brasil. Método: se trata de un estudio bibliográfico, tipo revisión integrativa, de artículos publicados en el período de 2002 a 2016, en inglés, español y portugués, insertados en la base de datos de la Biblioteca Virtual de Salud. Se realizó la lectura de los títulos, resúmenes y artículos completos que atendieran al objetivo propuesto. Se presentaron los resultados en forma de figura. Resultados: se seleccionaron 20 artículos que se evidenciaron, a partir del análisis de los artículos, diversas formas de enfermedad, tanto de orden físico, como psíquico. Se relacionaron íntimamente las condiciones de trabajo al comprometimiento de la calidad de vida de esos trabajadores y a la exposición a los agravios y enfermedades. Conclusión: se señala la necesidad de intervenciones inmediatas en las condiciones de trabajo del agente comunitario de salud, por parte de los gestores, objetivando a la reducción de la morbimortalidad de esos profesionales de salud. Descriptores: Salud Laboral; Personal de Salud; Agentes Comunitarios de salud; Condiciones de Trabajo; Estado de Salud; Multimorbilidad.