PROGRAMMATIC VULNERABILITY AS A CATEGORY TO EXPLAIN ETHICAL PROBLEMS WITHIN PRIMARY HEALTH CARE

Abstract

Ethical problems in public health – especially those concerning primary health care – require a specific and adequate approach. The factor analysis of quantitative data about ethical problems in primary health care pointed to management, longitudinality, team experience, professional profile, secrecy and privacy as specific topics. In the subsequent qualitative stage, we searched for examples and solutions through a focal discussion with primary health care teams in the cities of Porto Alegre and Sapucaia do Sul, in the state of Rio Grande do Sul, Brazil. The adopted methodological approach was the Grounded Theory. The analysis of the results had as reference points the causal and intervening conditions and the strategies for action when facing these problems. The fragmentation of care and the lack of prominence, caused by insufficient planning and permanent education, weaken the users and the professionals. The refinement of these results through selective codification reached the nuclear category of programmatic vulnerability as an explanatory category for the occurrence of ethical problems in primary health care.

ethics; public health; primary health care; social vulnerability; grounded theory