Health promotion in primary care across Brazil: Genealogic-inspired qualitative study

Fernanda Carlise Mattioni, Liara Saldanha Brites, Liciane Da Silva Costa Dresch, Cristianne Maria Famer Rocha
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Abstract

Objective: To describe and analyze Health Promotion practices in Primary Health Care. Method: Genealogic-inspired qualitative, descriptive, and exploratory research conducted in a PHC service in Porto Alegre, Rio Grande do Sul, Brazil. Twenty-three semi-structured interviews were held with the service staff from February to May 2020. The data were qualitatively analyzed using genealogically inspired techniques, which allowed us to identify tensions, disputes, discourses, practices, and power relationships. Results: We established eight sets of Health Promotion practices: 1) Educational activities focused on behavioral/habit changes and development of personal abilities; 2) Intersectoral practices and community social networks involving other community equipment; 3) Practices that encourage community organization and participation; 4) Integrative and Complementary Health practices; 5) Practices that stimulate meeting people, sociability, art, and creativity; 6) Practices that encourage environmental and food sustainability; 7) Practices that stimulate income generation; 8) Community communication practices. Conclusion: We identified a heterogeneous field of practices to promote health established through the circulation of different types of knowledge and powers. The practices are permeated by discourses linked to neoliberal governability and practices that position themselves against such discourse.  
巴西初级保健中的健康促进:家谱启发的定性研究
目的:描述和分析初级卫生保健的健康促进实践。方法:在巴西南大德州阿雷格里港的初级保健服务中进行了家谱启发的定性、描述性和探索性研究。2020年2月至5月,对服务人员进行了23次半结构化访谈。使用家谱启发的技术对数据进行定性分析,这使我们能够识别紧张,争议,话语,实践和权力关系。结果:我们建立了八套健康促进实践:1)以行为习惯改变和个人能力发展为重点的教育活动;2)涉及其他社区设备的跨部门做法和社区社会网络;3)鼓励社区组织和参与的做法;4)综合和补充保健做法;5)促进与人交往、社交、艺术和创造力的实践;6)鼓励环境和粮食可持续性的做法;7)刺激创收的做法;8)社区沟通实践。结论:我们发现了一个通过不同类型的知识和权力的流通来促进健康的异质实践领域。实践中充斥着与新自由主义治理能力相关的话语,以及将自己定位于反对这种话语的实践。
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