Listen To Community Health Workers To Strengthen Health Systems

I would like to share a couple of articles produced by our research group regarding CHW roles.

1. Trapé CA, Soares CB. Educative practice of community health agents analyzed through the category of praxis. Rev Latino-am Enfermagem 2007 janeiro-fevereiro; 15(1):142-9. http://www.scielo.br/pdf/rlae/v15n1/v15n1a21.pdf

This study aimed to: analyze the conceptions of health education that guide educational practices of community health agents in the Family Health Program of the Butantã Health Coordination, São Paulo, Brazil, and analyze the character of these educational activities. Data were collected through focus groups and indepth semi-structured interviews with 39 agents. The analysis procedures followed the recommendations of thematic content analysis, and praxis was the analytical category. Regarding theoretical activity as a component of praxis, we found that most health education conceptions were based on the transmission of normative information learned from health technicians. This theoretical activity ended up guiding a practical activity typical of repetitive praxis, in which the agents do not participate in the health work planning process and do not dominate the “ideal object”, reproducing tasks planned by others.

2. Work Process in Primary Health Care: action research with Community Health Workers. http://www.scielosp.org/pdf/csc/v20n11/en_1413-8123-csc-20-11-3581.pdf

The aim of this article was to describe and analyze the work of community health workers (CHW). The main objective of study was to analyze the development process of primary health care practices related to drug consumption. The study is based on the Marxist theoretical orientation and the action research methodology, which resulted in the performance of 15 emancipatory workshops. The category work process spawned the content analysis. It exposed the social abandonment of the environment in which the CHWs work is performed. The latter had an essential impact on the identification of the causes of drug-related problems. These findings made it possible to criticize the reiterative, stressful actions that are being undertaken there. Such an act resulted in raising of the awareness and creating the means for political action. The CHWs motivated themselves to recognize the object of the work process in primary health care, which they found to be the disease or addiction in the case of drug users. They have criticized this categorization as well as discussed the social division of work and the work itself whilst recognizing themselves as mere instruments in the work process. The latter has inspired the CHW to become subjects, or co-producers of transformations of social needs.

Thank you for your attention,

Cassia Baldini Soares

Associate Professor, Department of Collective Health Nursing

School of Nursing, University of São Paulo

HIFA profile: Cassia B Soares is Director at the Joanna Briggs Institute Collaborating Centre in Brazil. cassiaso AT usp.br

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