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Intervention strategies for morbidity due to external causes: how do community health workers manage them?

External causes of morbidity/mortality have been a serious public health concern in Brazil. The present study sought to explore Community Health Workers (CHWs) strategies and to understand how they manage this morbidity at the primary care level. There were studied 36 CHWs working in 7 different primary care services such as the Family Health Program in an area of the city of Porto Alegre, southern Brazil. The most prevalent external causes were accidents, including common accidents such as falls among the elderly and accidents among children. These events are not always recognized as preventable health problems and they are usually regarded as "unforeseeable events". According to CHWs, these events can be easily approached in the family since they are positively influenced by education strategies. We found that violence in its different forms is the most difficult event to be approached in the families as they involve risk situations. CHWs regard themselves unprepared to manage these situations, and emphasize referral problems by support networks in the area studied and in the city in general.

External Causes; Community Health Agents


Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. Av. dr. Arnaldo, 715, Prédio da Biblioteca, 2º andar sala 2, 01246-904 São Paulo - SP - Brasil, Tel./Fax: +55 11 3061-7880 - São Paulo - SP - Brazil
E-mail: saudesoc@usp.br