Vania Bustamante

O cuidado de grávidas e bebês no contexto do Programa de Saúde da Família: um estudo etnográfico

This study contributes to the conceptual discussion of healthcare, seen through an ethnographic approach to the care of pregnant women and newborns offered by health professionals working under the Family Health Program in a low-income neighborhood of Salvador, Brazil. Research involved Interviews and participant observation. In the article we analyze and compare professionals’ and user’s perspectives in two disti nct contexts: The discovery of pregnancy and the decision to take it to completion; and attitudes an d practices with respect to breast-feeding. We argue that, for both, care involves a permanent con struction of “projects of the person”. While professionals focus their interventions on women, s eeking to implement guidelines and planned routines, users of the health centre resort to spon taneous behavior that attends to practical demands in which several relatives participate and where em bodied experience is central. Differences between professionals and users are linked not only with subjective characters but with the social positions that they occupy.Este trabalho pretende contribuir para a discussao conceitual sobre o cuidado a partir de uma abordagem etnografica com gravidas e bebes em um bairro popular de Salvador atendido pelo Programa de Saude da Familia. Realizamos entrevistas e observacao participante. Com base na analise de duas situacoes - a descoberta da gravidez com a decisao de leva-la adiante e o aleitamento - comparamos a perspectiva dos profissionais com a dos usuarios. Argumentamos que, para ambos, o cuidado envolve a construcao permanente de projetos de pessoa. Enquanto os profissionais centram suas intervencoes nas mulheres, buscando dar orientacoes e aplicar rotinas planejadas, os usuarios fazem referencia a comportamentos espontâneos que respondem a demandas praticas e onde a corporalidade da experiencia e central. As diferencas entre profissionais e usuarios sao relacionadas nao apenas com caracteristicas subjetivas, mas com as posicoes sociais que ocupam.

Cuidado infantil na relação entre adultos e crianças na periferia de salvador

We conducted an ethnographic study on the construction of child care in everyday family living in a poor neighborhood of Salvador, seeking to integrate concerns of psychology with the anthropological discussion about person. We used participant observation and interviews. Taking as starting point the reflections of Ayres, we argue that care involves ongoing construction of projects of person in a framework of power relations. The research results identified the centrality of the daily work with the body to achieve the goal of having an educated and nature dominated child, and these concerns are central to the construction of the person. We advocate the importance of thinking in the social construction of the person - including contributions from anthropological research - to build a research agenda in psychology that addresses cultural diversity.

Cuidado e construção social da pessoa: contribuições para uma teoria geral

O presente trabalho tem como objetivo realizar uma reflexao conceitual sobre o cuidado. Apos desenvolver uma revisao da literatura, que se detem especialmente no trabalho de Ayres, defende-se a necessidade de pensar duas grandes maneiras de compreender o cuidado na area da saude: de um lado, o cuidado constitui um horizonte normativo que orienta as praticas de saude; de outro, tal como e mostrado com dados etnograficos, cuidado envolve a construcao cotidiana de projetos de pessoa que se da em um marco de relacoes de poder. O primeiro e um conceito inspirador para a construcao de boas praticas de saude. O conceito aqui proposto nos aproxima do cotidiano, de praticas de cuidado construidas por pessoas nos mais diversos contextos. Ambos os conceitos estao ligados a perspectiva ontologica do Cuidado e sao fundamentais para a construcao de uma teoria geral sobre o cuidado.

Caring for pregnant women and babies in the context of the Family Healthcare Program: an ethnographic study

This study contributes to the conceptual discussion of healthcare, seen through an ethnographic approach to the care of pregnant women and newborns offered by health professionals working under the Family Health Program in a low-income neighborhood of Salvador, Brazil. Research involved Interviews and participant observation. In the article we analyze and compare professionals’ and user’s perspectives in two disti nct contexts: The discovery of pregnancy and the decision to take it to completion; and attitudes an d practices with respect to breast-feeding. We argue that, for both, care involves a permanent con struction of “projects of the person”. While professionals focus their interventions on women, s eeking to implement guidelines and planned routines, users of the health centre resort to spon taneous behavior that attends to practical demands in which several relatives participate and where em bodied experience is central. Differences between professionals and users are linked not only with subjective characters but with the social positions that they occupy.Este trabalho pretende contribuir para a discussao conceitual sobre o cuidado a partir de uma abordagem etnografica com gravidas e bebes em um bairro popular de Salvador atendido pelo Programa de Saude da Familia. Realizamos entrevistas e observacao participante. Com base na analise de duas situacoes - a descoberta da gravidez com a decisao de leva-la adiante e o aleitamento - comparamos a perspectiva dos profissionais com a dos usuarios. Argumentamos que, para ambos, o cuidado envolve a construcao permanente de projetos de pessoa. Enquanto os profissionais centram suas intervencoes nas mulheres, buscando dar orientacoes e aplicar rotinas planejadas, os usuarios fazem referencia a comportamentos espontâneos que respondem a demandas praticas e onde a corporalidade da experiencia e central. As diferencas entre profissionais e usuarios sao relacionadas nao apenas com caracteristicas subjetivas, mas com as posicoes sociais que ocupam.

El cuidado de grávidas y bebés en el contexto del Programa de Salud de la Familia: un estudio etnográfico

This study contributes to the conceptual discussion of healthcare, seen through an ethnographic approach to the care of pregnant women and newborns offered by health professionals working under the Family Health Program in a low-income neighborhood of Salvador, Brazil. Research involved Interviews and participant observation. In the article we analyze and compare professionals’ and user’s perspectives in two disti nct contexts: The discovery of pregnancy and the decision to take it to completion; and attitudes an d practices with respect to breast-feeding. We argue that, for both, care involves a permanent con struction of “projects of the person”. While professionals focus their interventions on women, s eeking to implement guidelines and planned routines, users of the health centre resort to spon taneous behavior that attends to practical demands in which several relatives participate and where em bodied experience is central. Differences between professionals and users are linked not only with subjective characters but with the social positions that they occupy.Este trabalho pretende contribuir para a discussao conceitual sobre o cuidado a partir de uma abordagem etnografica com gravidas e bebes em um bairro popular de Salvador atendido pelo Programa de Saude da Familia. Realizamos entrevistas e observacao participante. Com base na analise de duas situacoes - a descoberta da gravidez com a decisao de leva-la adiante e o aleitamento - comparamos a perspectiva dos profissionais com a dos usuarios. Argumentamos que, para ambos, o cuidado envolve a construcao permanente de projetos de pessoa. Enquanto os profissionais centram suas intervencoes nas mulheres, buscando dar orientacoes e aplicar rotinas planejadas, os usuarios fazem referencia a comportamentos espontâneos que respondem a demandas praticas e onde a corporalidade da experiencia e central. As diferencas entre profissionais e usuarios sao relacionadas nao apenas com caracteristicas subjetivas, mas com as posicoes sociais que ocupam.

Everyday Child Care in Daycare Centers: An Ethnographic Study

This study is part of a wider project about the daily construction of childcare in a working-class neighborhood in Salvador, Bahia, Brazil. It involves three years of field work on family routines and their relationship with health and education institutions. We suggest that care can be thought of as the construction of projects of the person, which is expressed in everyday practices and which occurs in a framework of power relations between agents who occupy different social positions. This chapter seeks to contribute to the conceptual discussion of childcare based on analysis of a daycare center. The research involved participant observation of the daily routine, as well as interviews with the workers at the daycare centers and local residents. We analyze and describe various dimensions of the daily construction of care as it occurs within the relationship between adults and children. Our study identified tensions between academic knowledge, linked to ‘planning,’ and practical knowledge, which informants associated with abilities posited as intrinsic to women. It also revealed that there is a tendency to idealize both caregivers and children, which coexists with the need to respond pragmatically to day-to-day demands. In fact, caregivers experience difficulties in containing disruptive behaviors, leading to indifference and to scolding of children in their care or even expression of anger. We argue that all of these phenomena may be considered different facets of childcare in this setting. Finally, we discuss the relationship between day-to-day practices in daycare centers in Salvador and the history of such centers as institutions for “needy” children, and we offer our assessment of the political and practical challenges ahead. Also addressed is the importance of thinking about care and educational practices in an integrated way and working within the framework of intersector policies.

Cuidado e desenvolvimento em crianças escolares de Salvador

The relationship between family, school and health services was analyzed considering the development and care of children living in a low income neighborhood. We understand care as quality attention provided by adults and also as the day-to-day practical construction of personal projects, a process marked by power relations. We conducted participant observation and interviews with residents in the neighborhood studied and with health professionals and education workers. From among these a representative case was selected. The analysis identified differences in the way professionals talk about children with low school performance. By contrast in family and kinship spaces a different way of thinking about education operates, in that children encounter an expanded view of themselves and of their potential. We stress as a vital necessity that studies include all the different day-to-day contexts that comprise childrens experiences and emphasize that professionals and workers take into consideration and attribute value to the perspective of the family and relatives.