Acesso e acessibilidade aos serviços de saúde em três quilombos na Amazônia paraense: um olhar antropológico

Abstract

The quilombola populations are among the most vulnerable groups of Brazil related to health services. This qualitative study aimed to know the access and accessibility to the health services in quilombos in the Paraense Amazonia, in three communities, África/Lanranjituba in Abaetetuba, Santo Antonio/Foz do Cravo in Concórdia do Pará and Mangueiras, in Salvaterra in the Marajó island. The subjects of the research were the residents and the managers and health professionals of the municipal district. Other sources were: the primary data of the socioeconomic conditions of the families and documental analysis of reports and information from the Ministry of Health. The research describes the access to the health services from four dimensions, Geographical, Functional, Cultural and Economical, and presents a transverse analysis of the access while analytical category of the planning and administration of the services in agreement with the re-interpretation of welfare care models in health. It was detected the difficulty and/or impossibility of the quilombolas in having access and accessibility to all the levels of complexity of health attendance, being this a result of a group of processes that involve several aspects as the distance of the urban centers and the lack of services that offer access by land and fluvial; the high financial costs (transport, feeding, medicines, permanence in the city, etc.) of the search for health services; the adaptation lack to the afro-descending habits from the managers and health professionals that assist them; and the functionality of the health services offered. We concluded that the health services are just offered by the municipal managers that adopt the Economic and ―Planificador‖ Models due to the Brazilian system of allocation of budgets for health, so there is not a National Politics of access and accessibility to health services that allows the National Politics of Integral Health of the Black Population to become real. Therefore it is fundamental the planning of health public politics of access and accessibility starting from a participative and promoter of the health equity logic, compatible with the geographical and socio-cultural dynamics of the Brazilian Amazonia.