Fitoterapia na Atenção Primária à Saúde: interação de saberes e práticas de cuidado

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Fitoterapia na Atenção Primária à Saúde: interação de saberes e práticas de cuidado

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Title: Fitoterapia na Atenção Primária à Saúde: interação de saberes e práticas de cuidado
Author: Antonio, Gisele Damian
Abstract: The use of medicinal plants as a therapeutic resource is considered one of the earliest forms of health care used by man and is related to the tradition of the people . Given the importance of medicinal plants in health care and simultaneously the scarce literature that analyzes their inclusion in the scope of services of the Primary Health Care, this study aimed to analyze the development of actions/programs with medicinal plants, described Brazilian literature, Brazilian municipalities in PHC services. We prepared an essay on the theoretical and conceptual diversity of knowledge, care settings and usage of medicinal plants that interact with the PHC services. This theoretical essay presents a conceptual approach anchored in the "ecology of knowledge" proposed by Boaventura de Souza Santos and authors of the anthropology of health on the forms and care sectors. The discussion of the state of the art of medicinal plants in the APS involved a documentary analysis of official publications of the Ministry of Health who reported on actions and phytotherapy services deployed in APS, a bibliometric analysis of the scientific production on the subject in the period 1988-2012 and meta-study on actions/programs with Brazilian medicinal plants described in the literature over the same period. We performed an empirical study with a qualitative approach that aimed to understand the risk factors, hindering and contributions of phytotherapy in APS, in four selected municipalities, from the look of health professionals. Information gathering were conducted semi-structured interviews with key informants. Results: discussion of the ecology of knowledge applied to the subject revealed the importance of dialogue between the knowledge and practices of medicinal plants for the NHS and the APS, beyond the scientific discourse, in order to exploit emerging knowledge present and accumulated in Brazilian society, without disparaging the scientific knowledge, important for the consolidation of herbal medicines in Brazil. The analysis of the approaches to forms and contexts of use of plants in Brazil, culturally diverse, produced a proposal for recognition of five contexts of use of the same: family (standalone), folk, traditional, inserted in biomedical rationality and other medical (use heteronomous, in general). A bibliometric analysis showed an increasing publications in the period 1990-2012, although they are few in national and international environment. From the analysis of 24 Brazilian experiences identified in the meta-study, it was found that the insertion of phytotherapy in APS presents different approaches, motivations, practices and services. However, even many years after the publication of the National Policy on Integrative and Complementary Practices and National Policy on Medicinal Plants, in 2006, there are many factors that hinder the expansion and continuity of work with medicinal plants in APS. Among them are: the absence of clinical trials of Brazilian medicinal plants, difficulties in complying with the regulations for public services deficit in the training of health professionals, lack of adequate technical support to the reality of public sector services, lack of support continuing education . The acceptance , qualification and interest (related) professionals , participation and good popular acceptance (especially in smaller city), the presence of joint intersectoral and adequate infrastructure were mentioned as factors facilitating the insertion of different actions with medicinal plants , as well as consider it as a treatment option to be prescribed and a product to be provided in the PHC services . Observed in PHC services investigated the herbal approach contributes to the professional community and strengthens the bond - staff community, is a mediating tool for health education, promotes joint intersectoral and facilitates the interaction of different knowledge circulating in communities. It was concluded that the herbal medicine is a practice that facilitates the interaction of knowledge, values and cultural resources practices and local knowledge. Contributed to bringing together professionals and users through dialogic approaches and empowering. Enriches the therapeutic possibilities autonomous and heteronomous and health promotion in PHC, and consist of a promising source of therapeutic products homemade, handled or processed.
Description: Tese (doutorado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Saúde Coletiva, Florianópolis, 2013
Date: 2013

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