Barriers in the management of diarrheal diseases from the norms to the reality of the Sistema Único de Saúde

Abstract

Objective: to know the care barriers related to the proper management of diarrheal disease in public health services. Methodology: qualitative study carried out with nine health professionals working in health care in the Brazilian Unified Health System. Data were collected through semi-structured individual interviews and analyzed by categorical thematic content. The responses were organized into subcategories. Results: the identified subcategories were related to barriers in the dimensions: physical infrastructure; managerial/organizational; and, technical-scientific quality of care. The inappropriate physical infrastructure of the services makes it difficult for patients to reassess. In the dimension of management and organization of the health service, the care pressure emerged due to the high demand and the incipient role of nursing. The low technical-scientific quality of care for the disease led to distrust among professionals about the effectiveness of oral rehydration solution, resulting in excessive medicalization of patients. In the same category, the inadequate clinical evaluation of the patient due to the low technical-scientific quality of care was evidenced, which corroborated the inadequate care management. Final Considerations: these identified barriers negatively interfere with the services, determining the inadequate management of the disease to the detriment of the existing care guidelines, and contributing to the increase in hospital morbidity due to diarrheal diseases.