Os desafios do atendimento humanizado às pacientes indígenas na visão da equipe multiprofissional de saúde da maternidade do hospital universitário de Dourados/MS

Abstract

Primary healthcare for indigenous peoples is the responsibility of the Indigenous Healthcare Subsystem, while secondary and tertiary care includes outpatient clinics and general hospitals within the Unified Health System (SUS), such as the University Hospital of the Federal University of Grande Dourados (HU-UFGD). The aim of this study was to understand the challenges faced by professionals in the maternity ward of HU-UFGD in providing assistance to indigenous pregnant women, parturients, and puerperal women and their companions. To achieve this, we sought to identify the knowledge of the multidisciplinary team about the indigenous peoples of the Dourados macro-region, identify the main problems faced by professionals in providing care to indigenous patients, and discuss the challenges based on the principles of the National Humanization Policy and the Rede Cegonha. A descriptive qualitative research was conducted through interviews using a semi-structured questionnaire with seven professionals from the multidisciplinary team of the HU-UFGD maternity ward. The interviews were subjected to content analysis, opting to work with thematic analysis of the material. Fourteen specific categories were delimited, grouped into five general categories: (1) characterization of the interviewees; (2) prior familiarity with the indigenous theme; (3) knowledge about indigenous culture; (4) institutional support to serve the indigenous population; (5) perceptions about serving the indigenous population at HU. The results showed that the training process of healthcare professionals, when contributing to work in interethnic and intercultural contexts, is superficial and insufficient. Although they learn from practice, professionals recognize significant gaps in their knowledge about the ways of life of indigenous communities and traditional care during the gestational and puerperal period. The need for differentiated attention to the indigenous population was recognized, guaranteed by the National Policy of Healthcare for Indigenous Peoples, by the principle of equity established in SUS and in the Rede Cegonha. It is important to emphasize the different understandings of the word "differentiated" by professionals. It was found that the main challenges faced by professionals are: communication difficulties, hospital routine/structure, and cultural differences between professionals and patients. It was concluded, considering the results, that the valorization of the biomedical perspective is very present in the institution, often leaving issues related to the humanization of care in the background. The results also indicate that slow but procedural changes are occurring at HU-UFGD, related to the consolidation of collective discussion spaces, which is promising for the promotion of more comprehensive and humanized care to all maternity users.