COVID-19 na atenção primária: repercussões e desafios sob a perspectiva dos Coordenadores de Unidades Básicas de Saúde de uma cidade de grande porte - MG

Abstract

COVID-19 has emerged as a serious public health problem, configuring itself as the greatest health challenge of the century, mainly as a result of its potential for rapid dissemination around the world. The pandemic required quick responses from health systems, showing that they needed to go beyond hospital services, requiring a reorganization of Primary Health Care (PHC), of territorialized, community and home actions, both in terms of care directly linked to the impacts of the virus, as well as maintaining the activities peculiar to this level of attention. With the aim of discussing the repercussions and challenges encountered in coping with COVID-19 in Primary Care, a qualitative study was carried out to understand the phenomenon from the perspective of coordinators of basic health units who have a strategic vision of the various processes and actors involved in the organization and local management in health. For this, semi-structured interviews were carried out with managers of a health sector in a municipality in Minas Gerais, during the months of July and August 2022, which totaled 17 approaches, since the Sector has 14 Basic Family Health Units and three Basic Health Units, each with a nurse responsible for its management. Of this total, 10 interviews were carried out in person, with those who did not meet the inclusion criteria and those who were unable or unwilling to participate being excluded. All interviews were transcribed in full and printed for organization and floating reading of the material, which allowed the categorization of the results found, submitted to Bardin's method of content analysis. The results found were divided into six categories based on the similarity of the speeches: Services in Primary Care; Team Related Challenges; Population Related Challenges; Challenges in Unit Management in the Pandemic; Challenges Related to Biosafety and Challenges Related to Health Management and Social Organization. Based on these findings, it is possible to observe that there were many consequences of the pandemic in PHC and in the various actors involved in its operation, in addition, several of the impacts of this period on the health indicators of the population are already visible, mainly because many of the services were interrupted or reduced to the extent that the focus of health actions was on the hospital context and care for acute situations. The pandemic hit the Brazilian population at a time of many social, economic, political and structural vulnerabilities, as a result of which it highlighted several bottlenecks in the organization of health services and in facing the crisis scenario, also a consequence of the government's mistaken actions and negligence in conducting of the period. Thus, it became evident how necessary and urgent it is to resume and strengthen the specific actions of Primary Care through investments, coordination of care and, above all, the change in the care paradigm so that the guidelines of the Unified Health System are implemented, as constitutionally prescribed. Only through this level of attention, its possibilities of scope and action, is it possible to envision an improvement in the Brazilian health scenario and in coping with crisis situations, such as the pandemic context.