Nasf: fragmentation or integration of health work in PHC?

Abstract

This study aimed to analyze the technical and social relations of work among Primary Health Care (PHC)  professionals, especially investigating whether the  insertion of the Family Health Support Center (Nasf )  contributes for the integration or the fragmentation  of health work. This is a case study carried out in a  municipality of Bahia, considered successful regarding the implementation of PHC. The study was based on  the health work process theory and used as evidence  documents related to the municipal management,  produced by the Nasf, semistructured interviews with  managers, Nasf professionals and three teams of  family health as well as the information of the  researcher’s field journal. Although the units have  expanded their offer of services with the Nasf, the  results obtained from this study point to the existence of a tenuous link between the PHC teams. The actions were carried out by the grouping of agents, with  fragmentation of work and juxtaposition of activities  with a timid construction of a common care project.  Asymmetric relationships of power and subordination 
of other professionals to doctors, conflicting relationships and different rules of management of  team work were observed, contributing to disjointed  practices.