Analysis of work organization in the Extended Family and Primary Health Care Centers in Rio de Janeiro

Saporito, Bruna Esteves; Barros, Denise Cavalcante de; Alonso, Carolina Maria do Carmo; Lago, Regina Ferro do

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FREE THEME • Physis 32 (2) • 2022 • https://doi.org/10.1590/S0103-73312022320211 copy

Analysis of work organization in the Extended Family and Primary Health Care Centers in Rio de Janeiro

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The implementation of Extended Family and Primary Health Care Centers (EFPHCC) has fostered more dialogic care strategies and the monitoring of population groups that, historically, had little access to Primary Health Care (PHC). However, in the municipality of Rio de Janeiro, oscillations in federal and municipal management implied the reduction or elimination of these teams. To understand the impacts of this scenario on the daily routine of EFPHCC teams, this research analyzed regulatory documents and the professionals' perception of the work organization. Accordingly, a qualitative study was conducted using data collection, document analysis, and semi-structured interviews with eight EFPHCC professionals from a region of Rio de Janeiro between August 2019 and February 2020. Data treatment was based on content analysis. The results expose the impacts of the changes in the organization and financing guidelines of EFPHCC and address the workers' perception of the work process. Thus, it was evident that EFPHCC has the potential to qualify actions and interventions in the context of PHC; however, the growing job insecurity overloads the workers and hinders the achievement of its original goals.

Keywords:
Health care workers; Family Health Strategy; Qualitative research; Precarious work; EFPHCC.

Document	Year published	Presentation
Primary Care Notebooks n. 27	2010	Presents the EFPHCC Guidelines
Primary Care Notebooks n. 39	2014	Extended Family and Primary Health Care Center : Tools for management and daily work.
RIO DE JANEIRO MUNICIPAL HEALTH SECRETARIAT (SMSRJ). Circular S/SUBPAV/SAP/CPNASF Nº1/2016	2016	Presents guidelines for the operation of EFPHCC in the city of Rio de Janeiro.
RIO DE JANEIRO MUNICIPAL HEALTH SECRETARIAT (SMSRJ). Circular letter SMS No. 05/2016.	2016	Presents the Guidelines for EFPHCC 's actions and the Standard Agenda. Defines the hiring of professionals that must be done through the OS with the support of the General Coordinator of Primary Care
RIO DE JANEIRO MUNICIPAL HEALTH SECRETARIAT (SMSRJ). SMS Circular Letter No. 004/2017. Indicators for the Extended Family and Primary Health Care Center (EFPHCC )	2017	Informs the new parameters to be considered in the EFPHCC Standard Agenda and revokes the parameters established in the EFPHCC Standard Agenda by Circular Letter No. 05/2016.
National Primary Care Policy.	2017	Establishes the guidelines and norms for the organization of Primary Care, reviewing the previous policies (2006 and 2011)
RIO DE JANEIRO MUNICIPAL HEALTH SECRETARIAT (SMSRJ). Attributions of the EFPHCC supporter.	2018	Presents the assignments that aim to help the professionals who work as EFPHCC Supporter General Coordinator of Primary Care (PCC).

EFPHCC Team (all type 1)	Number of EFPHCC professionals	Number of supported teams	Number of supported HUs
1	6	14	2
2	3	13	1
3	5	10	2
4	4	8	2
5	6	12	2
6	4	8	2
7	7	11	1
8	4	9	2

PHYSIS - Revista de Saúde Coletiva Instituto de Medicina Social Hesio Cordeiro - UERJ, Rua São Francisco Xavier, 524 - sala 6013-E- Maracanã. 20550-013 - Rio de Janeiro - RJ - Brasil, Tel.: (21) 2334-0504 - ramal 268, Web: https://www.ims.uerj.br/publicacoes/physis/ - Rio de Janeiro - RJ - Brazil
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[TFN4] Source: Prepared by the author.

EFPHCC Teams	Previous Composition	Current Composition	Status
EFPHCC 1	Social worker, physical educator, physiotherapist, nutritionist, 2 psychologists, and an occupational therapist	Social worker, physical educator, physiotherapist, nutritionist, 2 psychologists, and an occupational therapist	Active
EFPHCC 2	Social worker, physical educator, physiotherapist, nutritionist, 2 psychologists, and an occupational therapist	Social worker, 2 psychologists and an occupational therapist	Active
EFPHCC 3	Social worker, a physical educator, 2 physiotherapists, a nutritionist, and 2 psychologists.	Social worker, physical educator, nutritionist, and 2 psychologists.	Active
EFPHCC 4	Social worker, physical educator, physiotherapist, nutritionist, and 2 psychologists.	Social worker, physical educator, physical therapist, and 1 psychologist.	Active
EFPHCC 5	Social worker, physical educator, physiotherapist, nutritionist, and 2 psychologists.	Social worker, 2 physical educators, a physiotherapist, a nutritionist, and 1 psychologist.	Active
EFPHCC 6	Social worker, physical educator, physiotherapist, nutritionist, 2 psychologists, and an occupational therapist.	Social worker, physical educator, psychologist, and occupational therapist.	Active
EFPHCC 7	Social worker, physical educator, physiotherapist, speech therapist, nutritionist, and 2 psychologists.	Physical educator, physiotherapist, speech therapist, nutritionist, and 2 psychologists.	Active
EFPHCC 8	Social worker, physical educator, physiotherapist, nutritionist, and 2 psychologists.	Social worker, physical educator, physiotherapist, and 1 psychologist,	Active
EFPHCC 9	Social worker, physical educator, physiotherapist, gynecologist, pulmonologist, cardiologist, nutritionist, pediatrician, psychologist, psychiatrist	Physical educator, physiotherapist, gynecologist, pulmonologist, pediatrician, psychologist, psychiatrist	Active
EFPHCC 10	Social worker, physiotherapist, nutritionist, 2 psychologists	Not applicable	Terminated
EFPHCC 11	Social worker, physical educator, physiotherapist, nutritionist, 3 psychologists, and occupational therapist	Not applicable	Terminated