Community workers in Primary Health Care in Brazil: an inventory of achievements and challenges

Abstract

The article analyzed the construction of the profile of professionals internationally known as Community Health Workers, supported in the discussion about the disputes surrounding their work. Health policy  documents were examined, with emphasis on the  inflections produced on their attributions and professional training. It was sought to comprehend  the rationality and the arguments that sustain the  changes induced by the policies and their possible  results on the practices. It was identified that this work has assumed conformations increasingly close to  health education in a biomedical aspect, aggravated  by management mechanisms that promote its  fragmentation and simplification. There was no  progress in the implementation of the Technical  Course of Community Health Worker and, in parallel, short qualifications have been introduced and driven  by specific demands. It is understood that the policies  directed to this worker are guided by a short-term  perspective and express, in the current Brazilian  context, the very weakening of the Unified Health  System. It is observed the reduction of the role of the  Community Health Worker in the consolidation of  strategies that could contribute to implement Primary  Health Care as a space for strengthening universality  and integrality.