Conhecimento e subjetividades: a [re]construção da promoção da saúde no Programa Academia da Saúde, no estado de Goiás

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2019-12-06

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Universidade Federal de Goiás

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Introduction: the Organic Law no. 8.080 / 1990, which establishes the Brazilian health system SUS from a positive health perspective, considers that the coexistence of the promotion- protection-recovery tripod is fundamental for the guarantee of health and life itself. Without the coexistence of these three dimensions, it is not possible to provide the integrality and universality, founding principles of that system. Object: the Programa Academia da Saúde, a ministerial proposal created in 2011, seeks to implement support centers for the Rede de Atenção à Saúde, specifically Atenção Primária à Saúde, for the development of health promotion actions. Objective: the research aims to analyze the implementation of the Política Nacional de Promoção à Saúde, made through the Programa Academia de Saúde, and its configuration in the microspace context. The thesis presents two analytical categories: 1) access and participation; and 2) understanding and incorporating beliefs and values about health promotion within the Programa Academia de Saúde. Through a sociological reflection, it seeks to understand the present nuances between the theoretical assumptions that underlie the creation of this policy and the empirical field, anchoring in theorists of the sociology, such as Bourdieu (1983, 1996, 2001, 2004), Foucault (1977, 1984, 1987, 2006), Giddens (1991, 2009), Butler (1997, 2015, 2018) and Agamben (2017). Methodology: the complexity to develop studies related to the health field is combined with the qualitative and quantitative approach, for it recognizes the limitations existing in the mentioned approaches and that associating them makes it possible to minimize specific biases of each approach. As it is an exploratory-descriptive study, with a quantitative and qualitative approach, it associates multiple research and data collection methods and techniques. Therefore, an association is made between documentary, descriptive statistics and field research. The field research involved 04 (four) selected towns, in which 21 interviews were conducted with coordinators, health professionals and users. Results: the preventive and functionalist character enrolled in the institution's decree of the Programa Academia da Saúde, by proposing as a central objective the promotion of body practices, physical activities, leisure and healthy lifestyles, is presented in the realities of the subjects and in the territories of Goiás. Thus, even though it is admittedly a free access program and for the general population, there is the presence of the elderly population and/or people with non-communicable chronic diseases, such as hypertension and/or diabetes. The participation of users is restricted to the presence in the developed activities, not presenting processes that formalize and encourage their actions in the program management. This is also demonstrated in the data extracted from monitoring, by showing the low representativeness of these users and family members in the management support group. Final Considerations: the perceptions and the way the Programa Academia de Saúde and health promotion are known, recognized and (re)produced go through the subjectivities and collectivities that exist in this microspace context. It is considered that the program brings, in its core, the hybridizations between health paradigms that coexist in the Sistema Único de Saúde. There is a complexity that comes from the coexistence between concepts and practices of control, regulation of bodies and principles and values that involve social participation, empowerment and social protagonism, such as autonomy, social justice and health equity.

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PARREIRA, Fernanda Ramos. Conhecimento e subjetividades: a [re]construção da promoção da saúde no Programa Academia da Saúde, no estado de Goiás. 2019. 280 f. Tese (Doutorado em Sociologia) - Universidade Federal de Goiás, Goiânia, 2019.