Universalização do acesso à saúde: um desafio para a população em situação de rua na Atenção Primária à Saúde

Abstract

Since the Brazilian Constitution of 1988, which recognized the universal right to health, there have been many achievements for the homeless population, such as the creation of the National Policy for the Homeless Population in 2009 and the implementation of the Street Clinic, in 2011. But, despite constitutional advances, historically the homeless population has limited access to services. In the municipality of Contagem, Minas Gerais, the Consultório na Rua was implemented in 2019 as a health care strategy offered to homeless people, thus creating the need for better knowledge of this population to subsidize this service and verify if there are barriers to access. at the service of Primary Health Care. The present study sought to understand the access of the homeless population to the Primary Health Care service, in the perception of professionals from basic health units, the staff of the Street Clinic and people living on the streets, in addition to verifying whether there were difficulties for professionals at this level of care in assisting homeless people in the municipality of Contagem, Minas Gerais. Eighteen homeless adults, five professionals from the Street Clinic and fourteen professionals from Primary Health Care were interviewed. The interviews were analyzed using Laurence Bardin's content analysis technique. It was found that the unhealthy conditions experienced on the street favor illness and result in a poor self-perception of their health, but due to barriers to accessing Primary Health Care, homeless people seek urgent and emergency services to meeting your health needs. The main barriers to access identified were stigmatization and prejudice, requirement of documents and proof of address for care, non-attendance due to poor hygiene conditions and prolonged waiting for care. Entry into Primary Health Care services is best achieved when mediated by assistance equipment for this group, such as the Consultório na Rua and the Shelter. The Street Clinic proved to be the best strategy for assisting this population segment, promoting comprehensive treatment in street spaces and articulating the longitudinality of care with other points in the network. Primary Care professionals considered that the health network is not fully prepared to assist the homeless population and cited as difficulties for care the lack of knowledge of the user's health history, difficulty in locating this individual after care, lack of of professionals to meet an increasing demand, in addition to recognizing the existence of prejudice practiced by health professionals themselves. The research evidenced the need for training of health professionals, expansion of the number of vacancies in the Shelter and the guarantee of a complete team of professionals from the Consultório na Rua team and from the Primary Health Care services.