Resolutividade dos serviços de saúde na Aldeia Indígena Kwatá: percepção do indígena e da equipe de saúde

Abstract

Introduction: The National Policy for Health Care of Indigenous Peoples, as part of the Brazilian National Health, provides a differentiated service by the Brazilian Unified Health System to indigenous peoples, to guarantee respect for the cultural specificities of each indigenous group. The Subsystem of Attention the Indigenous Health is organized into 34 Special Districts Indigenous Health, which are configured as a dynamic ethno-cultural space, geographic, population and administrative framework for the scope of the resolution of the health needs and problems of indigenous peoples. Objective: To analyze the solving of health services in Kwata indigenous community, through the perspective of health professionals and Munduruku Indians. Methodology: This is a qualitative and descriptive study, based on ethnographic assumptions. Data collection was carried out in June and September 2015, totaling twenty days of stay in the village. The techniques for data collection were semi-structured interviews and participant observation with notes in a field diary. Participated in this research: Fifteen health professionals and five users of the polo-base Kwata. The data were organized and processed through content analysis. Results: The study revealed that the pursuit of solving the health problems of the Munduruku Indians is related to continuing education for Indigenous Health Agents, safety in inland waterway transport of patients, investment in physical and human resources, nursing-Indian dialogue on the health process -doença-care. The study showed that there are work processes that are facilitators and resolving capacity in indigenous health, such as nursing actions polo-base Kwata and processes and situations that weaken the practice of solving the problems, such as distance from the village location to House of Support for Indigenous Health and the hospital in the nearest county seat, given the need for referencing the patient for care and treatment in healthcare levels of more complex health. Conclusions: From the point of view of indigenous and health team, prevailed some categories associated with solving health problems, but in practice, some aspects were not found. One of these important aspects treated factors that go beyond the health team actions, as challenges in the use of river transport, lack of material and human resources and barriers in the therapeutic itinerary. On the other hand, there are factors that have proven to be possible to achieve the solving through health team actions, such as the appreciation of indigenous traditional knowledge in the planning of health actions. The establishment of cultural competence, proposed by the anthropology and that inspired the Transcultural Nursing, it is a consistent way to the scope of problem solving in a different context, as is the indigenous health. The link between the Special Indigenous Sanitary District of Manaus, the professionals of the House of Support for Indigenous Health, professional health health polo-base and Munduruku Indians, it is essential to the search for solutions to the problems related to health, and these can be shared and learned with a view to building a dialogue between these stakeholders, with a view to ensuring the resolution of health problems for individuals and the community