Atenção integral à saúde do adolescente em cumprimento de medida socioeducativa de semiliberdade na atenção primária à saúde: pontencialidades, impasses e desafios

Abstract

Considering that the rights to health guarantee for adolescents during their time in juvenile detention may be the first opportunity for these young people to access the Brazilian Unified Health System (SUS), this paper describes a qualitative study of documentary analysis that investigates the challenges and advances in health care for adolescents who serve a semi-detention program in a Belo Horizonte regional office. The documents used were written sources called "minutes", where topics discussed in intersectoral meetings held to organize the planning, implementation, and monitoring of the policy for comprehensive health care to adolescents in semi-liberty were recorded. After collecting and organizing the data, the content analysis was applied. The seven structuring axes of the National Policy for comprehensive health care for adolescents in conflict with the law, provided for in Ordinance 1082 of May 23, 2014, were categorized: Attention to the monitoring of physical and psychosocial growth and development; Sexual and reproductive health; Oral health; Mental health and prevention of alcohol and other drug use; Prevention and control of diseases; Health education and human rights, Promotion of the culture of peace, Prevention of violence and victim assistance. The first impasse detected was the poor application of the adolescent’s evaluation of the integral health protocol by some professionals in Primary Health Care. The incidence of the culture of fear, as well as the prejudices and stigmas associated with these adolescents, affects their access to health care. The prohibition of condoms in the juvenile detention unit, problems of dialogue between the Semi-liberty and the mental health network were some of the impasses encountered. Stimulating health professionals to promote the protagonism of young people and their families in relation to their own health stands out among the challenges to be faced. Advances and potentialities were detected, as in the case of oral health, immunization, and health education, which have reached the goals proposed by the Action Plan. We have concluded that health care for adolescents must go beyond health care protocols, and consider social reinsertion, risk prevention, and vulnerabilities in health promotion.