Agentes comunitários de saúde no Maranhão: resgate de uma experiência

Abstract

This study aims to rescue the history of Community Health Agents in Maranhão, before the official implantation of PACS in the 1980s by the Brazilian Ministry of Health. It is a socio-historical research, with a qualitative, descriptive and exploratory approach, using oral history. The study site was Maranhão. The interviewees were the managers, professionals, coordinators and teachers of the institutions, who participated in the history of the health policy of the state involved in the management of the work of the ACS, the municipalities of São Luís, São José de Ribamar and the Community Health Agents involved with experience. Atotal of 27 professionals were interviewed, and 49 community health agents were interviewed. Thematic and documentary analysis were used, using the triangulation of the data. The study pointed out that Maranhão lived a work experience with Community Health Agents that had the participation of governmental, nongovernmental, local, national and international institutions that used people from the community voluntarily, to develop actions for the mother and child binomial. Son, in view of the high infant mortality rates of the State at the time. This work had the participation of 10 institutions, with Pastoral, UNICEF, State and Municipal Health Secretary and UFMA being the most important, since they were directly involved in the actions, from technical and financial cooperation to planning and execution, directly in the community. The work proposal for the community health agent at that time included actions to promote health. Coming with a state-of-the-art public health proposal for the state, the experience became commensurate with the yearnings of a population that had hitherto lived at the mercy of a failed health system. At this juncture, the community health agent was the nuclear agent that enabled the support, implementation and development of community-oriented basic actions in order to expand and strengthen them at the local level. The experience had positive impacts on the reduction of infant mortality and malnutrition in the State, and regardless of whether these initiatives were official or not, contributed to the construction of a critical mass that testified to its effectiveness in emergency situations and pointed to the possibility of reorganization of basic care through more structured actions, pointing out a new path to follow.