The Role of Community Health Workers in Primary Care: Professionals’ Perspectives on Their Responsibilities

• DOI: https://doi.org/10.22533/at.ed.0159682617067

• Palavras-chave: Community Health Agents; Primary Health Care; Health Workers; Family Health Strategy.

• Keywords: Community Health Agents; Primary Health Care; Health Workers; Family Health Strategy.

• Abstract:

  Introduction: Community Health Workers (CHWs) are one of the main pillars of Brazil’s Primary Health Care (PHC) system, playing a strategic role in linking health services with the community. Despite their importance to the Family Health Strategy (ESF), changes in care demands and in the organization of their work processes have impacted their professional responsibilities and challenges. Objective: To analyze community health workers’ perceptions of their responsibilities and the challenges related to their work processes in Primary Health Care in the city of Rio de Janeiro. Methods: A descriptive study with a qualitative approach conducted at two Primary Health Care units in the city of Rio de Janeiro. Eighteen community health workers, selected by theoretical saturation, participated. Data were collected between March and May 2024 through semistructured interviews and subjected to thematic content analysis. The study was approved by the Research Ethics Committee of the Rio de Janeiro Municipal Health Secretariat (CAAE No. 50708021.7.0000.5279). Results and Discussion: The participants recognized community health workers (CHWs) as a fundamental link between the community and health services, highlighting their role in monitoring priority groups, conducting home visits, providing care, and facilitating access to care. Although they demonstrated knowledge of most of the duties outlined in the National Primary Care Policy, difficulties were identified regarding the understanding of certain responsibilities, particularly in care coordination processes. The interviewees reported being overburdened due to the multiplicity of functions, structural limitations, insufficient initial training, and reduced time allocated to community-based activities. Despite these challenges, the opportunity to contribute to improving the population’s health, recognition from service users, and the longitudinal follow-up of families were cited as important factors in professional motivation. Final considerations: The results highlight the central role of Community Health Agents (ACS) in the effectiveness of Primary Health Care (PHC) and point to the need to strengthen strategies for continuing education and professional development, in order to provide greater clarity regarding their duties, improve the quality of their work, and enhance their impact within communities.