The Brazilian Family Health Strategy and the management of intestinal parasitic infections

Aim: This study analyzed the management of intestinal parasitic infections in the Family Health Strategy covering Brazilian urban slums. Background: The Family Health Strategy is the preferred strategy for providing public, community-based primary health care in the Brazilian Unified Health System (SUS). Through this strategy, Family Health teams are responsible for the health of residents of a defined territory, including health promotion, health education and control of neglected tropical diseases such as intestinal parasitic infections. Methods: Knowledge, attitudes and practices surveys were applied with Family Health team members (n = 58) and patients (n = 571) of an agglomeration of Brazilian urban slums in Rio de Janeiro. Findings: The management of intestinal parasitic infections and health promotion were limited. Health education was not considered an essential aspect of team members' work and did not include environmental or social determinants of health. Community health workers and urban slum residents presented similar knowledge, attitudes and practices regarding intestinal parasitic infections. Conclusions: Multiple, competing demands promote prioritization of the aspects of care where curative, biomedical activities predominate over prevention and an integral approach to health. However, the complex processes involving the cycle of poverty and disease go beyond the biomedical, limiting the potential for health in urban slums. Implications include a need to better prepare health professionals for primary health care services through reflection on local concerns and the social determinants of health, highlighting the importance of territorialized care and permanent education.