Professional practices of primary health care for Brazilian health and gender inequality

European Sting IFMSA Gender Inequality

(IFMSA, 2017)

This article was exclusively written for the Sting by Ms Milena Takamiya Sugahara, currently a medical student at the Federal University of the Recôncavo da Bahia (UFRB), Santo Antônio de Jesus, Bahia, Brazil. Ms Sugahara is affiliated to the International Federation of Medical Students Associations (IFMSA). The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

The mere naturalization of biological differences between men and women in the routine of health professionals is still a persistent practice, although there are significant advances in studies that transcend such perspective. In Brazil, some policies emphasize approaches that consider gender and other intersectionalities, but health care neglects the diverse inequities and professional practices in most public primary care services further underline gender inequality.

It is observed that in the work process of the health teams of local units, there is a programmed and oriented logic for the care of women focused on the collection of preventive cervical screening, family planning, prenatal and puerperium. Even if local health facilities meet other demands, such as those related to violence, it noticeably focuses on the roles that most women assume to be historically constructed.

Obviously, the health of women in the current mold is also of paramount importance. It is necessary the assistance during pregnancy, the cytological examination which is one of the diagnostic tools for the reduction of mortality of cervical cancer and others. Furthermore, it is very important the reflection that woman experiences daily imposed violence, in subaltern roles, reproductive and sexual imposed, which are determinants of the health-disease process. When entering the Unified Health System women experience the naturalization of such violence much beyond the speech and the health practice continues to treat them with the same reproductive and sexual roles, previously socially given.

It is noteworthy that with the feminism of the 60s and 70s, studies on the subject have made important advances, such as denouncing the invisibility of women and violence, especially domestic violence. It is possible to see targeted campaigns, and some networks of health care, a few of them structured. However, few municipalities and services have a network of clear attention and knowledge of the public. Moreover, it is possible to incur reductionism considering only the approach against violence, enough to transcend the naturalization of the differences between men and women.

For gender equality, silent and almost imperceptible naturalizations for many, such as those occurring in health care practices in most Brazilian public services, should be dismantled and structured assists that consider the integrality of the subjects. Therefore, health care should provide the possibility of promoting service users to reflect on their condition, which is the fundamental core in determining the health-disease process. Thus, the woman is able to understand the roles imposed and how they determined her health, to make conscious choices and to participate in the construction of her therapeutic project.

About the author

Ms Milena Takamiya Sugahara is currently a medical student at the Federal University of the Recôncavo da Bahia (UFRB), Santo Antônio de Jesus, Bahia, Brazil. She has a background in nursing and specialization in family health at the Medical School of Marília (FAMEMA), master in Community Health from the Department of Social Medicine of the University of São Paulo at Ribeirão Preto Medical School (USP). She studies and researches in the areas of institutional racism and therapeutic itineraries.

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