Trad Leny Alves Bomfim, Castellanos Marcelo Eduardo Pfeiffer, Guimarães Maria Clara da Silva
Departamento de Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal da Bahia, 40110-040 Salvador, BA, Brasil.
Rev Saude Publica. 2012 Dec;46(6):1007-13.
To analyse the accessibility of primary health care for black families from a poor neighbourhood.
Ethnographic study with an interpretative anthropological approach, carried out with 18 families selected from a poor neighbourhood of Salvador, Northeastern Brazil, over a period of two years. Criteria for inclusion included being resident in the neighbourhood and classifying themselves as black. The analysis was based on interpretative anthropology and encompassed the following categories: ethnic and racial self-reference; experience of discrimination from public services; perception of accessibility to primary health care and barriers to accessibility.
We identified the following aspects: a) ethnic and racial identity and health: the users' perception that organizational barriers and barriers to access are due to the wider social context which produces "first class" and "second class" citizens, rather than due to institutional racism; b) the accessibility of the Brazilian National Health System (Sistema Único de Saúde, SUS): difficult access, delays in being seen, lack of commitment on the part of health professionals, no management action taken to manage or improve these situations; c) accessibility of primary health care; overall vision of the context of the SUS and support in the interviewees descriptions of access to primary health care.
There are economic, organizational and cultural barriers to access which come between the service provided and effective care for the needs of the population of this study.
分析来自贫困社区的黑人家庭获得初级卫生保健的情况。
采用解释性人类学方法进行人种志研究，在两年时间里对从巴西东北部萨尔瓦多一个贫困社区挑选出的18个家庭开展研究。纳入标准包括居住在该社区且自认为是黑人。分析基于解释性人类学，涵盖以下类别：族裔和种族自我认同；公共服务中的歧视经历；对初级卫生保健可及性的认知以及可及性障碍。
我们确定了以下几个方面：a）族裔和种族身份与健康：使用者认为组织障碍和获取障碍是由于产生“一等”和“二等”公民的更广泛社会背景，而非制度性种族主义；b）巴西国家卫生系统（Sistema Único de Saúde, SUS）的可及性：获取困难、就诊延误、卫生专业人员缺乏责任心、未采取管理行动来管理或改善这些情况；c）初级卫生保健的可及性；对SUS背景的总体认识以及对受访者关于获得初级卫生保健描述的支持。
在本研究人群的需求与所提供的服务及有效护理之间存在经济、组织和文化方面的获取障碍。
