Effort, reception and impotence: dilemmas of community health workers in care and humanization

The “Family Health” Strategy (Estratégia de Saúde da Família) extends the doctor-centered modelto the team model. Conversations between health workers and users are valued by the National Policy ofHumanization (Plano Nacional de Humaniza o - PNH). The practices and concepts of 41 agents on personaland collective engagement in humanized care were investigated in six health services in a municipality in theState of Mato Grosso do Sul. The content analysis showed that agents oscillate between effort and impotence,because they cannot provide full care to patients, especially when techniques, procedures, and coordinationof actions by the management are demanded. The implementation of the National Policy of Humanization,cross-sectional to the “Family Health” Strategy, is fundamental to the local quality of the Public Health Service(SUS); it affects the real possibilities of humanization, the sustainability of agents’ engagement in care, andthe health service subjectivity. Managers must care about the perceptions and expressions of helplessness andfrustration from workers, taking them as indicative of structural and process problems that should to be managed.