Occupational Therapy and the health of the person with disabilities in the Municipal Health Secretary: a discussion on a ten-year professional incorporation

Abstract

This study regards the insertion of occupational therapists (OT) in the municipal public system to better comprehend the network distribution and the assistance for people with disabilities. It was undertaken in 2002 through interviews with professionals of the Municipal Health Secretary (MHS), documentary research and questionnaires to characterize the activities, answered by 46 OTs (31,1%). In 1993 there were 180 active professionals and in 2002 only 148. Between 1997 and 2000 the municipal services network was dismantled and other health units were created for the follow-up of pharmacodependents and people with STDs, respectively with, 11,5% and 8,1% of the professionals, by relocating them from the Basic Health Units (BHU) and mental health services. In 2002, a concentration of professionals in the municipal central areas could be observed due to their relocation and the prioritization of specialized services, distributing the OTs as such: 21% BHU, 17,7% (Center of Conviviality and Cooperative), 13,8% (Out-patient units) and 13,8% (Day Hospitals). Creation of alternative assistance for people with disabilities remains an individual commitment of the professionals, not being structured as a specific programme. Since 2001, MHS has been qualifying reference services for people with disabilities for the Health Ministry without increasing the number of professionals. Much the same occurred with the development of priority programmes, such as, Born Well (Nascer Bem), Holding (Acolhimento), Citizen Rescue (Resgate-Cidadão), A New Mind (Cabeça-Feita) and the Family Health Program. Observing the health policy of the country´s largest city is to comprehend the challenges for the health assistance and the professional group.