Saúde e as relações intra e interurbanas em cidades locais híbridas: uma análise socioespacial de Glória de Dourados, Douradina e Rio Brilhante – MS

Abstract

This paper aims to analyze access and accessibility to health services in local hybrid cities. To this end, we approach the production of urban-regional space through analysis of the urban network and the SUS network, in a daily movement of coming and going. In this context, the territorial policies that are implemented by the State as a space transforming agent directly affect the lives of social subjects. Perceiving the access and accessibility to health services from the social-spatial reality of local hybrid cities has led us to understand the structure of Primary Health Care at the intra-urban scale, as well as the articulations and fragmentations of the levels of Care at the interurban scale. As an empirical and analytical cutout, we analyzed three cities in the urban network of Dourados - MS.: Glória de Dourados, Douradina, and Rio Brilhante. The three of them are located in the southern portion of Mato Grosso do Sul state, Brazil. In order to achieve our objectives, we conducted bibliographic research on secondary sources such as IBGE, REGIC, MS State Health Plan, MS State Health Secretary, Municipal Health Managements; mapping of health units in the intraurban spaces of the cities and interviews. The interviews were conducted by working with qualitative research model carried out by Pereira (2006), with profiles and social types, so we interviewed 15 social subjects in each city, among these groups there were five social profiles - elderly, working woman, unemployed, student, and the chronically ill - and for each profile, there were three interviewees. Therefore, for the analyzed cities, it is evident that the access and accessibility problems are particularly related to the articulation in the health care of medium and high complexity. The fragmentation in the health care network becomes a central issue, especially for the population living in local hybrid cities.