| Territorial dynamic |
“I now have four thousand six hundred and thirty-some people enrolled, plus about a thousand more who don’t have a taxpayer number or ID. They’re extremely poor, because within the favela there’s a smaller favela where I have 500 enrolled. But besides the ones I don’t have enrolled, whom I also see, there must be eleven hundred, so it’s a lot of people” (M17) |
| “So, I’ve seen many diseases that I’d really never seen before, that I’d only seen in the textbooks. For example, tuberculosis, I’d only seen one case of tuberculosis in my life. Nearly ten years since I graduated before seeing a tuberculosis patient. Just one. And here I’m treating fourteen. All at once, understand?” (M16) |
| “We hold, at least I hold, on Friday, every Friday morning, I hold a lot of groups. I go out into the community. We go there, thank God, they know me, I’ve worked there for practically three years. And they say, ‘Doctor, hello there. How are you? Hey doctor!’ Understand? And we have a partnership. ‘Let’s go, we’re going to do the little test for everybody.’ The ‘little test’ from the scale. We go there, take the sample, do the rapid test [for syphilis and HIV] out there, too. We give a lot of talks and distribute condoms” (M6) |
| “All the doctors I supervise form a group. The patient received the doctor at home, opened the doors to his home, to be able to hold the group inside the community. In the patient’s home. Everybody knew them” (S1) |
| Centrality and autonomy of the person |
“Each person has their view of life, illness, and health. That’s how I assess patients. And always remembering that the patient is a biopsychosocial being. The patient is not just a heart, not just a liver, not a finger, not a hand. The patient here is seen as a whole, let’s say” (M4) |
| “The patient comes here in pain, needing a kind word. When they come here, they sit over there. They’re not used to it. I do like this with the patient [pulls the chair over next to the table]. I want to speak with them, so I sit here [next to the patient]” (M12) |
| “If in the exercise the method [person-centered clinical method] works - you realize in their relationship with the patient, in the bond they create, in the exercise of discovering the patient’s relationship with the illness itself, etc. - I don’t know if we have to be all that academic” (S2) |
| “Because the patient may know about the illness, but he doesn’t know anything about medicine, understand? So, you orient them on treatments and tests, for example. And you talk with them about the importance of what to do, what’s going to be done. And sometimes they make suggestions, and you may or may not agree with their suggestions” (M3) |
| Inter-sector collaboration |
“We hold scheduled and planned activities in the school with these children. We hold activities here in the shipyard. But mainly with the School Health Program” (M1) |
| “The neighborhood association lets us use their center for any activities here by the health unit. It’s a big place, and they help the Family Clinic to hold any activity” (M7) |
| “The CRAS [Reference Center for Social Assistance]? I’m not familiar with it personally, but I know the reference. So, we have the support of the NASF, I don’t know if you know it, the Support Nucleus, and they have a social worker. So, when we have any problem like that, we rely on their support the same way. I can’t make this kind of link because it’s too complicated for me to leave my consultations to go there” (M16) |
| “When inter-sector collaboration works a little better or exists, it’s because the manager is more involved or more proactive in this sense. And that’s how they’re able to practice linkage in the territory. Or with the community health agent, but the community health agents have more to do with the neighborhood association. With other sectors, it’s more with the managers” (S3) |
| Valorization of social determinants |
“The doctors I supervise are able to set priorities, organizing care for the vulnerable population. Most of them work with the vulnerable population. So, when I do supervision and talk with them, they tell me, ‘I saw such-and-such a case, and I’m doing home visits every week, or the nurse goes first and I go the same week” (S1) |
| “When I live in a community that has no places for leisure-time activities, no options for recreation, only the drug traffic, only violence, only gunfire, only police raids, substandard housing, the person may not be sick right now, but the disease can come any time. The main problem for being able to make changes is to combine this desire for health, the knowledge that health workers have, to achieve change with this outside social investment” (M5) |
| Active participation in collectives in building health projects |
“We consult the neighborhood association and community leaders to learn about the community’s history. Because when I arrived here, for example, I didn’t know anything. In each micro-area, we need to identify the leaders to facilitate our work. They mainly point to the piled-up garbage, the streets full of potholes” (M8) |
| “We work together, and work with formal and informal leaders. With the head of the community, we try to talk even with the head of the drug traffic” (M6) |
| “The analysis of the health situation involves numerous variables and multiple stages that have to be complemented. So, to survey the health situation, we use the patient charts. But we don’t say that everything’s done, because not everything can be done. This discussion with the entire community, we can’t get there now. We can’t get there, because it’s very difficult to convene the entire community” (M14) |
