Acompanhamento coletivo do crescimento e desenvolvimento infantil: uma análise da prática e expansão no município de Natal/RN

Abstract

The collective monitoring of the child’s growth and development (GD) stands out as redirection of the biomedical health care model and seeks to encourage the use of soft technologies and improve the quality of life of users. This way of care is an action for construction and expansion to other units, which makes it vulnerable to a random practice, since there is no guarantee of systematization to ensure its legitimization. In addition, the group work itself, within the primary network, in general, runs the risk of of focusing its actions on the disease by reflecting the biomedical model still prevailing. The collective monitoring may be vulnerable to these problems, which requires the need to know its operationalization. This study had the objective of analyzing the practice and expansion of the collective monitoring of the GD of children in Family Health Strategies (FHS) from the municipality of Natal/RN. This is a qualitative research that had the research-action as its method. It encompassed eleven nurses of four FHS from the municipality of Natal in the period between April and October 2014. Data were collected through focus group and participant observation, and they were analyzed in accordance with the direction of the thematic analysis of Paulo Freire. The study was approved by the Research Ethics Committee from the UFRN, Opinion nº 562.315, and met the Resolution nº 466/2012 of the National Health Council. At the stage of situational diagnosis, which investigated the operationalization of the collective monitoring of the GD of children by nurses, we realized that they seek to accomplish it with basis on prior planning and organization, in such a way as to make it as qualitative as possible. They understand the importance and benefits of this activity, especially concerning the empowerment of users. Nevertheless, the lack of systematization of this monitoring has been identified because of the different modes of its operationalization on the part of professionals. Furthermore, the lack of support from the health team was realized, which leaves them unsatisfied. Due to the need to change this reality, we have decided to jointly construct an instrument able to systematize the actions, as well as to conduct training courses to sensitize the support on the part of teams. At the stage of the implementation, the nurses showed great interest in the check-list constructed through conversation circles; however, regarding training courses, the researcher has failed to implement them in a satisfactory way because of the unavailability of teams and of some nurses. We have found that they rated their participation in the survey in a positive manner, which fostered the exchange of experiences and the change of negative points, besides having instigated the partnership between caregivers and professionals. As suggestions for future, the nurses have listed the encouragement of further researches in this field and the constant support on the part of the UFRN, and called for a specialization in child’s health. As main difficulties, one should highlight the high rate of faults among nurses belonging to the focus groups; the little motivation of some participants, as well as of the board of directors of a FHS and the lack of participation of the health team in training actions. Accordingly, one can find that, given the disorganized expansion of this group approach, the researches in this area should be constantly encouraged to achieve a greater improvement.