O Agente Comunitário de Saúde no enfrentamento da pandemia COVID-19 na área programática 3.2 no município do Rio de Janeiro

Abstract

The presence of Community Health Agents (CHAs) in territory monitoring enhances knowledge about families and the territory, contributing to surveillance, monitoring, and health education actions in the face of the COVID-19 pandemic. The objective was to reflect upon and analyze the performance of CHAs in dealing with the COVID-19 pandemic. Initially, a remote survey was conducted, which was answered by 45 CHAs working in healthcare units of the Programmatic Area Coordination 3.2 in the city of Rio de Janeiro. The survey aimed to identify their demographic and social profile, as well as the activities they were involved in within their health units/teams during the COVID-19 pandemic. In the second stage, semi-structured interviews were conducted in person with 17 CHAs, and a thematic analysis was performed based on their responses. The results showed that the survey identified a socio-demographic profile of the agents similar to the literature on the subject, with a predominance of female agents, black or mixed race, and a higher percentage of secondary education. Regarding surveillance actions, they were maintained through home visits and remote monitoring for groups at higher vulnerability and individuals with respiratory symptoms. From the analysis of the interviews, integrated with field diary notes and literature records on the topic, three categories emerged: 1) Family health: people who care for people and the territory, 2) Daily life and CHAs' practices during the pandemic, and 3) Impact of the pandemic on CHAs' health. The interviews revealed significant discussions about the work processes and the necessary skills of these professionals during the pandemic period, as well as their commitment to work with users and teams, even under circumstances of significant personal and professional burden during the pandemic. Another relevant aspect was their adaptation to changes in the work process, which required performing different activities in each phase of the pandemic. Agents mentioned feelings of fear and grief, their work with vulnerable populations, and work overload as factors causing great physical and emotional distress. It was concluded that reflecting on the performance of CHAs in dealing with the COVID-19 pandemic helps to understand and analyze the specificity of these healthcare professionals who exclusively work in the Unified Health System (SUS), while also highlighting the importance of a strengthened, equitable, and inclusive primary healthcare system that addresses local health needs.