Aproximação e distanciamento entre Terreiros de Candomblé e Atenção Primária à Saúde na produção de cuidado

Abstract

This research analyzes the relationship and distance between Candomblé Terreiros and Primary Health Care in the production of care. The relationship between terreiros and health units is relevant, since terreiros are sacred spaces with extensive knowledge of traditional practices transmitted between generations. On the other hand, Primary Health Care represents the first level of the health system and encompasses actions of promotion, prevention, diagnosis, treatment, palliative care, harm reduction and health surveillance, including in terreiros. However, a fragile relationship between the Terreiros and Primary Health Care is observed, which compromises the potential of this articulation. This is a qualitative study, based on the methodology of the case study with a comprehensive approach, given the still little explored nature of the theme. The data were collected in two family health units in the municipality of Camaçari-BA. Six health professionals, four priests from Candomblé Terreiros and four health managers participated. The collection took place between September and October 2024. The textual material was organized in the NVivo 15 software and submitted to Thematic Content Analysis. The results indicate that the interaction between the health care model and the terreiros is marked by systematic exclusion, invalidation of this knowledge and weakening of the relationship due to issues related to the training and performance of the professionals. In contrast, the spiritual practices that occur in the terreiros articulate body and spirit, demonstrating the production of comprehensive care. Distancing practices mediated by cultural and religious barriers, prejudice and demonization of religion were identified and manifested as actions or omissions that exclude the terreiros from health services, management, practices and policies. Difficulties in accessing health services, lack of staff and refusal of care corroborate the vulnerability of this relationship. The initiatives for rapprochement originating from health units proved to be limited and punctual, while the practices of the terreiros recognize the limits of spirituality in solving health problems. Possibilities of articulation between traditional practices and conventional treatments were identified, as well as the formalization of partnerships between terreiros and health units that can alleviate barriers and expand the population's access to comprehensive care. The study considered that the current health care model is discriminatory and exclusionary. It is expected that the findings of this research will contribute to the expansion of an intercultural perspective in the Unified Health System, to the fight against structural racism and to the inclusion of African-based religions in health care processes, as well as the production of technical and technological products of the Professional Master's Degree: technical note, book and intervention project produced during the research.