The work process in health care for homeless in city of São Paulo

Abstract

Introduction: With successive economic and social crises in the world, the number of people living on the streets is increasing,
especially in large cities. Implemented public policies aim at social protection and facilitate access by highly vulnerable people to
health systems. In the city of São Paulo, since 2012, teams from the Street Office (CnaR) have been implemented in primary health
care. Objective: To analyze the work process of the CnaR teams, knowing the singularities of the actions and challenges pointed
out by the team workers. Method: Research with a qualitative approach through semi-structured interviews and thematic content
analysis. 28 professionals were interviewed in pairs indicated by the 14 CnaR teams registered in 2017 in the city of São Paulo.
Results and Discussion: CnaR teams use similar tools such to work as territorialization, approach, scheduled meetings, action
planning, in the streets, in Basic Health Units (UBS) and in social institutions. The territory of action influences the planning of the
work process, such as the number and distribution of homeless people and whether the base UBS adheres to the program. Conclusions: The work process of the CnaR teams in a group facilitates access and work on the streets suggests that it is the main
care strategy. The transfer of knowledge between teams, permanent education, and management support for complex challenges
such as intersectoral relations, suggest improving the program's actions, renewing health care for homeless people, who in high
social vulnerability constitute a growing and complex problem of public health.