The creative potential of health work to develop an integrated care model in Brazilian primary health care
In November 2015, at the 3rd World Congress on Integrated Care and 8th National Congress of Integrated Medicine, “Co-producing High Quality People-Centered Integrated Care for ALL”, Debora Santos presented her PhD research on primary health care teams in Alagoas, the most unequal state in Brazil. According to Debora Santos, while Brazil's Unified Health System (SUS) is headed by principles of integrated care, in practice a biomedical conception of health typically prevails instead of one focused on integrated care. Therefore, the objective of her research was to identify potential ways to develop an integrated care model of primary health care focused on the principles of social health rights, integrated access, equity, team work and health promotion. Through focus groups and interviews with primary health care teams she identified several challenges and potentialities for integrated care. For example, the teams faced both objective (clinical) and subjective (emotional) needs but had limited skills to deal with subjective issues. Therefore, teams would benefit from including a wider range of professionals. Moreover, the teams were already using so-called “soft technologies” (these are tools used to develop a relationship with the patient, such as listening and being compassionate, as opposed to “hard technologies”, such as material instruments). However the teams saw these “soft technologies” more as humanitarian acts than as instruments of their work. Santos concluded her presentation by making the case that, despite these multiple challenges, there was potential to shift towards an integrated model of primary health care.