O acesso aos serviços de saúde: o que dizem as pessoas em situação de rua

Abstract

The population in street situation is more vulnerable to varied situations, among them social and health vulnerability. To live in a street situation expose these people to risks that make this population require a single health care approach. Among these risks we can mention: violence, uncertain food, low hygiene conditions, poor availability of water or poor quality of water, sleep deprivation, deprivation of affection, variations in time, shame, impaired self-care and, mainly coverage and limited access to health services. Therefore, the objective of this study is to analyze what street people have to say about their access to the psychosocial care network. This is a qualitative, exploratory-descriptive study that had as a scenario the locations of six teams of the Maceió’s Street Clinic (Consultório na Rua). The participants of the survey were street people in the city of Maceió. The inclusion criteria were: to be 18 years of age or older and to be in a street situation. Data were collected after approval by the Ethics and Research Committee of the Federal University of Alagoas, and it was done through a semi-structured interview script, being carried out 19 interviews, between the months of April and July of 2017, following the saturation of the data. To analyze the data, the content analysis was used in the thematic analysis modality. The analysis of the results pointed out three categories: 1) It is only possible to think about Equity in health for a person in a street situation from the deconstruction of their social invisibility; 2) Where is the Universality? If “when we can get acess fine, when we don’t we try to solve it ourselves”; 3) To get access to the network the solution is the Street Clinic. The results of this study showed that there are still many barriers for the street population to access health services, although this must be guaranteed through public policies. It has been found that once the principle of universality is fragile, this also has implications for the effectiveness of the other fundamental Unified Health System (UHS-SUS) principles, such as equity. Thus, faced with a context of social inequality, this is reflected in the limits of access to services and, consequently, in the guarantee of integral care. Therefore, one must understand the need to reflect on ways to expand access and expand care actions in order to imply services, managers and public policies for this population.