Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.
Crédito: Rafa Neddermeyer/Agência Brasil

Ways of life and work organization of community health workers of river units in the Amazon, Brazil

  • Mariana Baldoino
  • Fernando Herkrath
  • Bernardo Horta
  • Luiza Garnelo
  • Mariana Baldoino

    Fundação Oswaldo Cruz, Instituto Leônidas & Maria Deane, Laboratório Situação de Saúde e Gestão do Cuidado de Populações Indígenas, Manaus, Brasil

    Fernando Herkrath

    Fundação Oswaldo Cruz, Instituto Leônidas & Maria Deane, Laboratório Situação de Saúde e Gestão do Cuidado de Populações Indígenas, Manaus

    Bernardo Horta

    Universidade Federal de Pelotas, Departamento Medicina Social, Pelotas

    Luiza Garnelo

    Fundação Oswaldo Cruz, Instituto Leônidas & Maria Deane, Laboratório Situação de Saúde e Gestão do Cuidado de Populações Indígenas, Manaus

    https://orcid.org/0000-0003-0263-7286



Abstract

The article analyzes ways of life and organization of work of community health workers working in rural communities served by Basic Fluvial Health Unit, in the city of Manau, Brazil. Daily activities and challenges of these professionals were investigated, interaction with the families served, links with the communities and with the natural environment. Exploratory qualitative research conducted in 17 rural riverside communities distributed on the left bank of Rio Negro, along 190 kilometers. Data collection in 2021 and 2022 covered semi-structured interviews, staggered issues of attachment to the place and participant observation of the performance of community health workers. The results showed that the qualification of these workers meets the main demands of daily work in rural areas. The time of experience was relevant in the position, indicating robust knowledge of nature and attachment to the place/community, established by kinship links, identification and knowledge of the natural environment. They rebuild intersectoral practices, prioritizing interventions associated with social, micropolitical and cultural determinants of the health-disease process and participation in communal life in households accessed exclusively by river displacement and spread across a vast territory. The intramural administrative work was interpreted as deviation of function and removal of daily interactions in households, generating dissatisfaction and demotivation of these workers.

Keywords

rural population health,
primary health care,
basic river health unit,
community health worker

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