Work management and care in Primary Health Care during the COVID-19 pandemic in the city of São Paulo , Brazil

• Published in: Ciência & saude coletiva 2023-12, Vol.28 (12), p.3483
• Main Authors: de Vasconcellos Anéas, Tatiana, de Lima, Marcos Nunes, de Jesus Ligeiro Braga, Fernanda, de Oliveira, Thiago Loreto, de Almeida Menezes, Natalia Torres, de Oliveira Viana, Mônica Martins, dos Santos, Dário Nunes
• Format: Article
• Language: English
• ISSN: 1413-8123
• DOI: 10.1590/1413-812320232812.06062023EN

The municipality of São Paulo has historically been marked by a heterogeneous implementation and coexistence of conflicting models of SUS management and Primary Health Care (PHC). The administration of health services management contracts was consolidated and associated with a productivist rationale. The selective PHC weaknesses tend to be pronounced during the COVID-19 pandemic. Thus, the present article aims to analyze work management and care in PHC during the COVID-19 pandemic in the municipality of São Paulo through a multicenter qualitative research anchored in the Paideia theoretical framework. We conducted 31 in-depth interviews with PHC clients and workers, along with participant observation. We noted the municipal management's authoritarian and managerialist stance when conducting the responses, with little room for listening and dialogue. We identified weakened collective spaces and service-community bond, bureaucratization and precariousness of work processes, and NASFs dismantling. In this setting, care was characterized by significantly reducing the expanded and shared clinical practice and the distancing from the territorial and community-based PHC guidelines.