Saúde do trabalhador e da trabalhadora do campo: efetivação de políticas públicas na atenção primária à saúde

Abstract

Introduction: The Ministry of Health's public policies aimed at Rural Workers' Health include the National Workers' Health Policy (PNSTT) and the National Policy for Comprehensive Health of the Rural, Forest and Water Population (PNSIPCFA). It is important to understand its implementation in the processes and practices of Primary Health Care (PHC). The research question emerges: how are public policies related to the health of rural workers in PHC implemented in practice, in the perception of professionals who are technical references in their municipalities? General objective: to understand the implementation of public policies related to rural workers' health in PHC practice, based on the perception of professionals who are technical references in workers' health in their municipalities. Method: Study with a qualitative and descriptive approach. The participants were technical reference professionals in occupational health in the municipalities of the 15th Regional Health Coordination, health region 20 of Rio Grande do Sul, adjacent rural classification, belonging to the CEREST coverage area. Data collection was carried out in 2023, through semi-structured interviews and focus group discussions online, on the Google Meet platform. The data were subjected to the qualitative analysis described by Minayo with the aid of NVivo software. The study was approved by the Research Ethics Committee. Results: Regarding the participants' perception of the PNSTT and the PNSIPCFA, the highlight is the notifications and investigations of deaths. In identifying the potentialities and difficulties in implementing these Public Policies in the daily life of PHC, good communication between professionals stands out; the proximity of technical reference to PHC professionals and, on the other hand, the shortage of professionals in the network and small teams and accumulation of functions and work overload. With regard to actions and strategies for the health of rural workers in PHC, notification of work accidents and death investigations stand out; and few actions to prevent diseases and promote health in partnerships with intersectoral bodies. Strategies include partnerships with RAS, RENAST and intersectoral actors; team meetings; creation of an exclusive team for worker health; training on rural worker health issues; expanding service shifts and offering different opening hours for health campaigns. Final Considerations: The construction of new studies to strengthen the SUS and to implement public policies in the RAS is relevant. The promotion of rural workers' health must be encouraged and expanded in the RAS, seeking to guarantee the principles of comprehensiveness and equity in health care for the rural population. The debate on work as a social determinant of health and its risks in the rural context is important, supporting effective and continuous actions aimed at workers in rural areas, in addition to triggering and sustaining changes in the RAS work processes.