ABSTRACT
A Estratégia Saúde da Família (ESF) foi ampliada com os Núcleos de apoio à Saúde da Família (NASF). Devido ao ineditismo dos NASF, sua implantação representa um desafio. Diante disso, objetivou-se relatar a experiência de implantação e implementação do NASF, no município de Arneiroz/CE, a partir da experiência da Residência Multiprofissional em Saúde da Família e Comunidade da Escola de Saúde Pública do Ceará (RMSFC-ESP-CE). Trata-se de relato de experiência oriundo da prática gerencial e assistencial, entre julho/2013 e maio/2016, em Arneiroz/CE. As informações emergentes da prática profissional foram registradas em diário de campo e analisadas na perspectiva hermenêutico dialética com base no referencial teórico e nos dados dos sistemas de informação. A implantação dos NASF exige reformulações no processo de trabalho da ESF capazes de promover a interprofissionalidade e intersetorialidade na perspectiva do apoio matricial. Em Arneiroz/CE, esse desafiador processo aconteceu concomitantemente à implantação da RMSFC-ESP-CE, cujas atividades foram essenciais no suporte técnico-pedagógico aos gestores e profissionais do município, facilitando a incorporação e efetivação do preconizado pelo Ministério da Saúde. Quanto às ações educativas em saúde e aos atendimentos de profissionais de nível superior na ESF, houve um aumento importante depois da implantação do NASF, indicando melhoria no acesso e nos indicadores de saúde. Aponta-se ainda o impacto das Residências Multiprofissional em Saúde enquanto estratégia de Educação Permanente em Saúde e subsídio aos processos de gestão municipal em saúde, especialmente em municípios de pequeno porte, de modo a também subsidiar a implementação das políticas públicas de saúde. (AU)
The Family Health Strategy (ESF) has been expanded with the Family Health Support Centers (NASF). In face of NASF's novelty, its implementation represents a challenge. This study aimed to report NASFs implantation and implementation experience in Arneiroz/CE municipality from Multiprofessional Residency Program in Family and Community Health of the School of Public Health of Ceará (RMSFC-ESP-CE) experience. This is an experience report from management and assistance practice between July/2013 and May/2016 in Arneiroz/CE. The information emerged from professional practice was recorded in a field diary and analyzed in dialectical hermeneutic perspective based on theoretical reference and data of information systems. The NASF's implementation requires reformulations in ESF's work process capable to promote interprofessionality and intersectoriality in matrix support perspective. In Arneiroz/CE, this challenging process happened concurrently with RMSFC-ESP-CE implementation, whose activities were essential in the technical-pedagogical support to managers and professionals of the municipality, facilitating incorporation and effectiveness of the recommended by Health Ministry. Regarding health educational actions and attendances of higher level professionals in ESF, there were a significant increased after NASF implementation, indicating improved access and health indicators. It also pointed out the impact of the Multiprofessional Residency in Health as a strategy of Continuing Education in Health and subsidy to municipal health management processes, especially in small municipalities, in order to also subsidize public health policies implementation. (AU)
The Family Health Strategy (ESF) has been expanded with the Family Health Support Centers (NASF). In face of NASF's novelty, its implementation represents a challenge. This study aimed to report NASFs implantation and implementation experience in Arneiroz/CE municipality from Multiprofessional Residency Program in Family and Community Health of the School of Public Health of Ceará (RMSFC-ESP-CE) experience. This is an experience report from management and assistance practice between July/2013 and May/2016 in Arneiroz/CE. The information emerged from professional practice was recorded in a field diary and analyzed in dialectical hermeneutic perspective based on theoretical reference and data of information systems. The NASF's implementation requires reformulations in ESF's work process capable to promote interprofessionality and intersectoriality in matrix support perspective. In Arneiroz/CE, this challenging process happened concurrently with RMSFC-ESP-CE implementation, whose activities were essential in the technical-pedagogical support to managers and professionals of the municipality, facilitating incorporation and effectiveness of the recommended by Health Ministry. Regarding health educational actions and attendances of higher level professionals in ESF, there were a significant increased after NASF implementation, indicating improved access and health indicators. It also pointed out the impact of the Multiprofessional Residency in Health as a strategy of Continuing Education in Health and subsidy to municipal health management processes, especially in small municipalities, in order to also subsidize public health policies implementation. de trabajo de ESF capaces de promocionar interprofissionalidade y el enfoque intersectorial en perspectiva de soporte de la matriz. En Arneiroz/CE, este proceso desafiante ocurrió al mismo tiempo que ha pasado a la aplicación de la RMSFC-ESP-CE, cuyas actividades eran esenciales en apoyo técnico y pedagógico a los directivos y profesionales municipales, facilitando el desarrollo y realización de la recomendada por el Ministerio de Salud. En cuanto a las acciones de educación en salud y la atención de los profesionales de alto nivel en el ESF, hubo un aumento significativo después de la aplicación de NASF, lo que indica mejoría en los indicadores de acceso y de salud. También destacó el impacto de la Multidisciplinar Residencia en Salud como una estrategia de Educación Continua en Salud y subsidio a los procesos de gestión municipal en materia de salud, especialmente en los municipios pequeños, con el fin de subsidiar la implementación de políticas de salud pública. (AU)