Co-production of autonomy in Primary Health Care

Abstract

An objective of primary health care (PHC) refers to the development of comprehensive care that impacts on health and autonomy. However, the practices carried out are based on a biomedical model of care that focuses on a prescriptive logic. This study reflects on how PHC offers these practices and their possibilities to promote autonomous care. it aims to analyze possible processes of coproduction of autonomy in health practices in the Belo Horizonte PHC; to analyze elements workers and users associate with a practice of care in PHC that expands the conditions for users to think about and intervene in their health; and to analyze the limits and potential for the coproduction of autonomy in PHC. Open-ended interviews with workers and users and thematic analysis were carried out. Both associated self-care, accountability, and bonding with autonomous elements. Workers found conditions that enable or prevent users from reflecting and acting on their health. They identified structural and organizational difficulties in PHC for the co-production of autonomy. Thus, it is necessary to pressure the predominant prescriptive logic and open it to the production of diverse and plural subjectivities.