The role of community health workers and environmental health specialists in health care: The case of Vitoria-ES-Brazil

The Community Health Workers and Environmental Health Specialists make up the Basic Health Units in Brazilian cities and work mainly to promote health.

Both teams and their jobs, form the so called SUS - Sistema Único de Saúde (Unified Health System) and they focus on changing the health care model. They have great importance, passing both scientific and popular knowledge to the communities, as well as strengthening their links with the health service, allowing it to be as close as possible to life as it is at home.

This study analizes the working process of these professionals in the city of Vitória-ES-Brazil, showing how this activity is organized, its object of study, knowledge and tools. It also wants to identify the problems and show the real way that health care is done in the studied Unit. It considers that the work is developed along with micropolitics, where subjectivity and interchange, from everyone involved, are displayed.

This is a qualitative survey of case study. In order to analize the work of all the people involved, analytical dimensions of the organization have been used such as: access, integrity and relationship to the user.

Semi-structured interviews, direct observation and flow diagram made it possible for us to observe the care that was given as well as its technologies.

We could see that the work performed is focused on both soft and hard technologies, that the actions taken were based on knowledge gained during work itself, the importance of the relationship with the community and even its independence and the possibility of giving it to the users themselves.

Among the difficulties, we can highlight excessive demand, noise in the relations between workers of this team and users, and the biomedical-centered knowledge when it comes to the health care itself.