Nasf: fragmentation or integration of health work in PHC?

ABSTRACT

This study aimed to analyze the technical and social relations of work among Primary Health Care (PHC) professionals, especially investigating whether the insertion of the Family Health Support Center (Nasf) contributes for the integration or the fragmentation of health work. This is a case study carried out in a municipality of Bahia, considered successful regarding the implementation of PHC. The study was based on the health work process theory and used as evidence documents related to the municipal management, produced by the Nasf, semistructured interviews with managers, Nasf professionals and three teams of family health as well as the information of the researcher's field journal. Although the units have expanded their offer of services with the Nasf, the results obtained from this study point to the existence of a tenuous link between the PHC teams. The actions were carried out by the grouping of agents, with fragmentation of work and juxtaposition of activities with a timid construction of a common care project. Asymmetric relationships of power and subordination of other professionals to doctors, conflicting relationships and different rules of management of team work were observed, contributing to disjointed practices.

KEYWORDS
Primary Health Care; Family Health Strategy; Health care; Public health practice