University-health services partnership: Training professionals for the integrality of primary health care (PHC)

Twenty years after its implantation, the Single Health System (SUS) still requires efforts for the full application of its principles: universality, integrality, equity, decentralization, regionalization, hierarchization, participation and social control. Considering health as a social right and the determination of the health-illness process, these goals challenge educational institutions, requiring new commitments to solve practical issues. This context, marked by territorial differences, by decentralization of actions and services and by policies for PHC strengthening guidelines of the Health System (HS), requires workers committed with the SUS principles. This paper reports our experience in the articulation between University and Service/HS in Ribeirão Preto, a large city in the Brazilian Southeast, which has been organizing Health School Districts (HSD) since 2000, with four HSD currently operating at different organization levels. The University of São Paulo (USP), the largest Brazilian public university, has been active in this partnership since 1978 through the Schools of Medicine, Nursing and Dentistry. They are responsible for the West District, performing care, teaching and research at Family Health Units (FHU) and units of higher technological density, in order to strengthen PHC. The FHU installation started in 1999, under the responsibility of USP, in connection with the municipal government. Since then, about 90 family and community Medical Residents have been trained. Every year, 170 Nursing, 200 Medical, 40 Physiotherapy, 30 Speech Therapy and 20 Occupational Therapy undergraduates spend a training period, with presence of Pharmacy and Psychology students in smaller number. The proximity of the University to the services permits learning about the context of community life and adopts their socio-cultural references for the exercise. Despite practicing in the same place, the effective integration of multi-professional and interdisciplinary work in contextualized and co-responsible health practice remains a challenge, as the different health professionals’ training practice is not integrated.