Avaliação da linha de cuidado à pessoa com sobrepeso e obesidade nos três níveis de atenção à saúde em municípios paraibanos

Abstract

Introduction: obesity is a public health problem and has been growing in its epidemiological magnitude in Brazil and in the world, with risk factors for several other non-communicable chronic diseases, contributing to the increase in deaths every year. The concern with the health of overweight and obese people made it possible to implement guidelines within the Unified Health System, which seeks, through the articulation of different services and levels of care, organized through Lines of Care, to contribute to care for more universal, integral and equitable health. The concern of managers and health professionals has aroused the use of care strategies for overweight and obese people, but the records of the practice show that this care is still very heterogeneous. Objective: to evaluate the line of care for overweight and obese people at the three levels of health care in Paraíba municipalities. Methodology: case study with a qualitative approach, carried out in the cities of João Pessoa, Campina Grande, Patos and Sousa, which had as fields of investigation the basic health units and specialized services of medium and high complexity and the population consisted of 19 participants. The selection of services was done by simple random sampling and the participants, through convenience sampling. Data were collected between December 2020 and February 2021 through an individual form and semi-structured interview. Data analysis was performed using Bardin's content analysis and the IRAMUTEQ software. Results: five thematic categories were elaborated. The first presents the concepts conferred by managers about the Care Line for Overweight and Obesity Persons, attributing to it views that permeate from care and management processes. The second is supported by three subcategories, which allowed us to infer that managers operate from the perspective of institutional support, however, it is noted that there are flaws in relation to the conformation of the aforementioned Care Line, and it was also identified that the flow of care for the overweight and obese person, it must go through the three levels of health care. The third category demonstrates the perception of Primary Care, recognized as the main gateway and gateway for overweight and obese individuals. In the fourth category, difficulties faced in dealing with the issue of obesity are presented, with mention of the inexistence of protocols, as well as the lack of institutional policy. In the last category, the distance from reaching the assumptions to idealize care for the obesity issue is deduced, as well as the inadequacy of services for this audience. Conclusion: it was possible to know health promotion actions with regard to the care provided to overweight and obese people, but specific actions based on the real demands of the population and structured from a line of care were not confirmed by the interviewees, as was also evidenced that the care of overweight and obese people goes beyond the therapeutic process, requiring social and economic support, as well as monitoring by a multidisciplinary and interdisciplinary team, from primary care to more complex levels of care. Given the importance of the subject studied, it is highlighted that organizations and agents should debate and share knowledge, seeking to act in an articulated and synergistic way on these agendas, needing to restructure their efforts to provide adequate care to overweight and obese people through line of care, ensuring a flow of care in a health care network.

Keywords: Obesity. Overweight. Health care. Unified Health System.