[Integrality-building in the care of people with diabetes mellitus in a healthcare unit of Feira de Santana, Bahia State]

Abstract

This study analyses the care of people with diabetes mellitus (DM), under the light of integrality, through access, bond-accountability, and team formation in a healthcare unit of Feira de Santana, Bahia State. It is a qualitative study adopting a critical and reflexive approach. The subjects were healthcare workers (Group I) and users registered in the diabetes program (Group 2). Data collection techniques included a structured interview and systematic observations, while the data analysis was based on content analysis and Merhy's analyzer flow chart. The results reveal that basic attention has little structure, an ineffective organization model, and a healthcare process built on the everyday of the service in a fragmented and shallow way, centered on the figure of the doctor. They also reveal that municipalization of health, as it has been done in Feira de Santana, caused the dismantling and discontinuation of healthcare attention to people with DM. Access is restricted, focused on and directed to low-complexity actions. Hosting and bond with the user are still distant from co-responsability, and there is a lack of autonomy and education in the process. In conclusion, it is necessary to widen the debate on whole care and work management, and valuate the everyday praxis of those involved with care.