摘要：Considering that the work performed by the Family Health Program must ultimately take into account the knowledge of the surroundings where it will be effected, which means to go beyond the walls of Primary Health Unit in order to get to know the scope area of the Health Unit as well as identify how those people live, get ill and die, we carried out this study objectifying to understand the process of broadening health units’ scope and analyze the changes in health care at Health Unit in Curitiba city - Brazil from 2000 to August, 2004. A semi-structured interview was the instrument used as well as structured observation for data collection. The interviews were carried out with 11(eleven) subjects who signed a consent form where their rights of secrecy, anonymity and acquittance have been ensured. Analyzing the data, it was evidenced the process of broadening the health unit scope, however not all subjects perceived it as the framework for discussion and model design of health care in that community. The frame of health assistance has still been focused on the spontaneous demand, performing home visits to assist bearers of some kind of disease or diagnosed health risks. It was reported that the changes evidenced along the period are related to the health care and that is a slow process, affected by shortage of professionals and high staff turnover. That has made us think about professionals qualification in order to carry out the Family Health Program, and such professionals would demand a longer stay in the unit so that the new design for health care was on settled and consolidated. We believe that the changes occurred along the initial period of the program were ultimately brought about by the professionals’ performance supported by the local community. We concluded that this study made us realize that we are far from undertaking the health care sistem proposed by the Family Health Program. Thus, we deem necessary to carry out many investigations like this in order to think over the several “realities” in the health realm and actions that health services have been performing.
其他摘要：Considering that the work performed by the Family Health Program must ultimately take into account the knowledge of the surroundings where it will be effected, which means to go beyond the walls of Primary Health Unit in order to get to know the scope area of the Health Unit as well as identify how those people live, get ill and die, we carried out this study objectifying to understand the process of broadening health units’ scope and analyze the changes in health care at Health Unit in Curitiba city - Brazil from 2000 to August, 2004. A semi-structured interview was the instrument used as well as structured observation for data collection. The interviews were carried out with 11(eleven) subjects who signed a consent form where their rights of secrecy, anonymity and acquittance have been ensured. Analyzing the data, it was evidenced the process of broadening the health unit scope, however not all subjects perceived it as the framework for discussion and model design of health care in that community. The frame of health assistance has still been focused on the spontaneous demand, performing home visits to assist bearers of some kind of disease or diagnosed health risks. It was reported that the changes evidenced along the period are related to the health care and that is a slow process, affected by shortage of professionals and high staff turnover. That has made us think about professionals qualification in order to carry out the Family Health Program, and such professionals would demand a longer stay in the unit so that the new design for health care was on settled and consolidated. We believe that the changes occurred along the initial period of the program were ultimately brought about by the professionals’ performance supported by the local community. We concluded that this study made us realize that we are far from undertaking the health care sistem proposed by the Family Health Program. Thus, we deem necessary to carry out many investigations like this in order to think over the several “realities” in the health realm and actions that health services have been performing.
关键词：Saúde da família;Sistema local de Saúde;Planejamento em saúde;Programa saúde da família;Family health strategy;Local health system;Health planning;Family health program;Salud de la familia;Sistemas local de Salud;Planeamiento en salud
