Formative Intervention to Change the School Health Center Activity

Abstract

The aim of this paper is to propose an interventionist approach for transforming a School Health Center (CSE) in São Paulo, Brazil. The Center is in a situation of crisis, providing precarious health services due to limited human and material resources. In the article we argue that the solution for the crisis depends on how it is interpreted. We present an ethnographic narrative constructed collectively by researcher and practitioners through data from interviews and a mini-intervention. The aim of this narrative was to provide a better understanding about the development of the activity of health care and education/research conducted at the CSE. As it will be argued this hypothesis is the first step towards a broader on-going intervention using a method called Change Laboratory, which is based on an Activity Theoretical approach. The narrative shows that the School Health Center’s object (primary and secondary health care) and the object of the Faculty of Public Health (research and education) have changed towards different developmental directions. The integration between these two objects is narrower than when the Center was first created, and this can be a key source of conflicts between CSE by the Faculty. The results suggest that a more effective solution to the crisis would involve the reconstruction of the object motivation (product service) produced in the activity.