Limites e possibilidades da atenção ao portador de hanseníase no âmbito da Estratégia Saúde da Família

Abstract

The magnitude and transcendence indicators of leprosy in Brazil made this issue to be included in the group of the strategic areas of Primary Health Care, developed by the municipalities from the recent guidelines on decentralization and regionalization of healthcare in the country. Although there is this indicator in the policy guidelines, in practice it is observed that the actions for the elimination of leprosy are still centralized and less widespread within the work of Family Health Teams (ESF's). This study aimed to analyze the limits and possibilities of implementation of the National Leprosy Control (PCNH) teams in the Family Health Program (PSF). The methodology used was an integrative review. Despite there are few reports of studies in Brazil assessing the relationship between the operational strategies and epidemiological indicators about the disease, it is clear that decentralization is an instrument capable of expanding access to health services, enabling the integration of activities early detection of new cases, chemotherapy treatment, disability prevention and surveillance of contacts. However, it was observed that the ESFs professionals still have difficulty in prioritizing prevention, control, diagnosis, treatment and rehabilitation of disability of this condition compared to the other programs of primary health care. The turnover of medical professionals, the precariousness of the labor rights for professionals working in the ESFs, the deficiency in continuing education, lack of material resources and lack of political will of local management are factors that influence the preparation of ESFs not performing actions in leprosy control. We conclude that early diagnosis of leprosy may help to break the cycle of disease transmission, and avoiding or reducing disability in patients. Some experiences in literature showed that one can deploy PNCH in the units of PSF, but for that, it is needed to overcome the limits reported in this work, as well as ensuring an effective system of reference and counter reference.