Trajetórias assistenciais de mulheres trabalhadoras rurais nas redes de atenção à saúde

Abstract

Introduction: Advances in society lead to reconfiguration in social dynamic unfolding deep and constant transformations for people in their work and lives, imposing a challenging context to strengthen and enhance universal access to actions and services according to the Unified Health System (SUS in Portuguese). Its organization is structured in different health arrangements called Health Care Networks (RAS in Portuguese), which establish Primary Health Care (APS in Portuguese) as an entry point in the health care system. APS is deemed as a gateway to solve, allow the access and meet health needs of individuals and communities. However, the ways to search the access for health care do not follow the rules determined by the SUS, mainly among rural women workers that have to face the inequality in the distribution of health services, imposing obstacles in their trajectories to access these services. Thus, a question emerges: what are the itinerary trajectories of rural women workers in RAS in a municipal district in the state of Minas Gerais? Objective: To analyze the care trajectories of rural women workers in Health Care Networks in a municipal district in the state of Minas Gerais. Methodology: This study follows a qualitative research approach, using Thematic Oral History in order to obtain the main sources. The research participants were 15 rural workers and 3 community health workers. Data were collected through semi-structured interviews guided by a script and observation field notes, from May 2021 to August 2021. Thematic content analysis was used, proposed by Bardin, with ATLAS.ti, version 9.1.4. This study was approved by the Research Ethics Committee of UFMG, opinion number 4.864.980. Results:As a result, 3 thematic categories emerged: “On the way to Family Health Strategy: therapeutic itinerary of rural women workers during the COVID-19 pandemic” which allowed an understanding of living, working and health conditions of these women. Besides, it was possible to describe therapeutic itinerary of rural women during the pandemic, choosing the ESF as their preferred network which demonstrate the organization of health services in the territory and the experience of pandemic in this context. The second category, called “Barriers to accessibility to health services: oral history of rural women”, revealed that these women build their paths in seeking care, however they find socio-organizational and geographic obstacles that move these women away from the effectiveness of accessibility to services and their health care. In the third category, “Building bridges in the health territory: social support network of rural women”, the study showed that the formal and informal social support network of rural women significantly promotes the experience in seeking care in APS. The link between women and community agents was highlighted as well as the importance of this connection between the community and the ESF bringing support for managers and health professionals to invest in social arrangements aiming to promote access and health care in rural areas. Final Considerations:The COVID-19 pandemic was crucial to worsen health inequalities experienced by female rural workers, research subjects in this study. The relevance of building proposals and actions directed to the reorganization of health services for the rural territory of rural workers is highlighted. Socio-organizational and geographic barriers are present in their trajectories in order to access services in their region. In addition, social support networks built to facilitate the access to health services emerge, making evident the support of community health agents given through the bond and empowerment for these women.