Diagnosis of the problems interfering with the actions of the Family Health Program in the city of Araruama: suggesting empowerment as an organizational theory

Abstract

In the current Brazilian health policy, the Family Health Program (FHP) is playing an important role in the construction and consolidation of the Brazilian Health System.Within this conception it can be observed that the health policies are put in practice in the services, through the actions and daily practices of the social actors in the context of the FHP. The purpose of this study was to identify the main barriers related to infra-structure, behavior and social-demographic factors pointed out by the health professionals working in the FHP in the city of Araruama. According to the results, empowerment was suggested as an organizational theory. The concept of empowerment used refers to changing the traditional mentality of command and control, creating a supportive environment allowing for people to develop a new mentality and give their best for the benefit of the organization. This epidemiological descriptive study used semi-structured interviews to collect information about the major barriers for the performance of the professionals and about possible associations between those factors. Eighty-two health professionals from the eight FHP teams of Araruama participated in this study. The results of socio-economic factors indicated that 50% participate in the program for more than five years and dislike their activity for the following reasons: long permanence at the same work place; repetition of the same experiences; conflicts among team members; lack of motivation; lack of solutions for the problems of the community and low wages. In relation to infrastructure, the results demonstrated that 77% consider their activities distressing due to the poor working conditions. The behavioral factors indicated as the major barrier the relationship of the team members, in special the lack of consensus among the professionals, disagreements, and the power of doctors and nurses reducing their commitment and the dialogue among them and with thecommunity. The empowerment stimulates the mechanisms for listening and promotes interaction among managers, health professionals and the community so that their opinions and suggestions can be taken into consideration in the process of change. The lack of motivation, conflicts and lack of commitment among the team members can be minimized using the individual, organizational and community dimensions of empowerment creating new strategies through continued relationship among the team members.