O processo histórico da Confederação Nacional dos Agentes Comunitários de Saúde: trabalho, educação e consciência política coletiva

Abstract

This research investigates the historical process of organization of Community Health Agents (ACS) workers in the National Confederation of Community Health Agents (CONACS). It analyzes indicative aspects of the elaboration of a collective political conscience (GRAMSCI, 2012) of the ACS based on the experience of organizing CONACS, especially through the mediation of the relation between work and education objectified in the collective actions and claims produced in the historical process of the Confederation in relation to the work and professional qualification. Under the neoliberal hegemony, in the 1990s, the ACS Program (PACS) and the Family Health Program (PSF) were instituted in the Unified Health System (SUS). The institutionalization of the work of the ACS, workers who act exclusively within SUS, takes place. The ACS work and reside in territories marked by precarious living conditions resulting from existing social inequalities. The ACS do not have specific vocational training and the requirement of schooling to perform the function is the complete elementary education. In this study, 20 interviews with union and workers associations leaders were carried out, a questionnaire was applied to 105 ACS from different regions of the country and documents produced by CONACS were analyzed. The work of the ACS has historical relations with the guidance of international organizations on community health workers; With experiences of community organization to claim better living conditions and access to health services; And with the experiences of community medicine that took place in the country before the 1990s. The participation of the ACS in the 8th. National Health Conference was decisive for the incorporation of its work to the health system and remuneration. From the institutionalization of the role, the number of Agents was increased and municipal associations were created, as was the National Association of ACS that became CONACS in 1996. The Confederation, which is constituted by unions and associations of ACS, is an important political force in the fight for rights associated with the work of the Agents. Its priority agenda during the 1990s was the regulation of employment bonds. It included the demand for professional training, and the organization of municipal associations was prioritized. After claiming and winning laws that create the profession and regulate the employment bonds, as of the year 2002, the organizational work of the bases and the demand for formation were emptied; Focusing on the dispute over the drafting of federal laws to enforce labor rights and corporate economic gains. Within CONACS there is a certain ideological positivation of the state and alliances with political forces within the legislative power. CONACS has a strong mobilization potential with the ACS throughout the country. The collective political conscience of the ACS is an ongoing process, transiting from the economic-corporate moment to the moment when they demand to have a voice within the State, but only in the grounds of attaining political-juridical equality