Mapeamento da sobrecarga de atribuições em equipe da Atenção Primária

Abstract

This is a descriptive, qualitative study conducted with the Family Health Strategies (FHS's) located in the northern region of the state of Minas Gerais, Brazil; the participants were professionals of these service units who comprise minimum teams, according to the definition of the Ministry of Health. The assumptions of cartography were adopted as theoretical and methodological reference. This work is justified by the fact that a Family Health Strategy team is comprised by a group of professionals responsible for various tasks, what often brings heavy workloads to their schedules. This study sought to analyze the roles of the teams; map the micro-regional reference municipalities which have minimal teams; verify assignments of each FHS; and investigate the enhancers and challenging factors in carrying out the tasks of the teams in the perception of health professionals. The proposed methodology was divided into two phases: observation exploration and focus groups. In the first phase, data on the FHS's allocated in the host cities of the health micro-region were collected by means of contact with local and state managers, as well as telephone contact and visits with professional teams; these data were duly recorded in a field diary. In the second phase, seven focus groups were conducted in selected cities among those which have more than fifty thousand inhabitants. The participants of the groups were physicians, nurses, practical nurses and community health workers – professionals who make up the minimum team of an FHS, as determined by the Ministry of Health. Free speech of the participants was stimulated, guided by the question: "What is your perception about the FHS team assignments?" Speeches were transcribed and analyzed through careful listening, combined with the information in the field diary, using cartography as theoretical steps of analysis, what revealed a considerable overload of tasks submitted to FHS teams in northern Minas Gerais, originated from diverse sources, such as population's request, demand of municipal managers, and an increase of duties determined by the Ministry of Health. Considering Deleuze and Guattari's cartographic thought, these different overloads were identified as lines of force which act upon each FHS, allowing them to acquire singularities, a process of characteristicsubjectivation of each unit'smicropolitics. The overload of assignments submitted to the professionals limits the development of live work, compromising the quality of services provided. The interventionist nature of cartography was observed, through focus groups, what stimulated the speech of the professionals in a reflection upon the practices conducted. The study highlighted the overload of assignments of FHS teams on the perception of their members, an important challenging factor for a better performance in activities of health prevention and promotion. Attention is also drawn to the importance of considering the varied micropolitics in determining the tasks, allowing time for reflection within the team to improve their functioning