Desafios na implementação de políticas públicas em saúde para população em situação de rua

Abstract

Universal access to health being a constitutional right of all Brazilian citizens. Although, for homeless population, barriers to access and health care still persist. The guarantee of services to this population by Primary Care is a challenge for SUS - Unified Health System. Negation of social rights - such as the right to health and even citizenship rights has harmful consequences to homeless people: the loss of recognition of their voice and identity, making them invisible. Understanding the history and context surrounding this population is necessary to analyze public policies related to this group, that has a lot of vulnerabilities. In this way, this research sought to analyze the strategies to guarantee the right to health of homeless population, articulating the social construction of this population, the public policies directed to them and the obstacles to its implementation in the practice of care by health professionals, making a case study at PHS in the city of Rio de Janeiro. In order to achieve the research goals, the methodological path consisted of document analysis in order to describe, investigate, examine, analyze, interpret and synthesize information related to public policies for the homeless population; literature review on the practice of caring for homeless people; and interviews with Primary Health Care workers who deal with the street population. From the analysis of the interviews, the following permanent categories emerged from the research results: 1) The need to re-signify the attributes of Primary Health Care for the homeless population; 2) Territory and Nomadism: whose the patient is? 3) Violence and discrimination. 4) Identity and invisibility. 5) Alterity, emotions and feelings. We sought to highlight the need for health professionals to re-signify attributes of primary health care, allowing expanded health care to reach this population. For this, a less technical bias is needed, more aligned with practices that can achieve socio-cultural transformations that reduce stigmas of people who live on the streets