Problem-solving in the Indigenous Health Care Subsystem (SASI-SUS): analysis in a reference service in Amazonas, Brazil

Abstract

Problem-solving is one of the princi-ples of the Unified Health System (SUS) in Brazil, with its ability to solve the health problems of the population at different levels of complexity. The Indigenous Health Care Subsystem (SASI-SUS) is part of this service, respecting the specificities of indigenous populations. The scope of this article is to analyze the perception of professionals and managers of an Indigenous Health Center (CASAI) regarding its ability to cope with the circumstances of the pandemic. It involved qualitative and descriptive research under the National Health Care Policy for Indigenous Peoples (PNASPI) and Paul Ricoeur’s hermeneutic theo-ry. Interviews were conducted with participants in order to record the experiences in the work process of the actors who assist the indigenous people housed at CASAI. Four essential themes were identified in the interviews: cultural care; permanent education in health & health educa-tion; negotiation & improvisation; and reception & infrastructure. CASAI is an institution that is more than a support center or accommodation, being a crossover point between the different levels of care and knowledge production of the indigenous people, as well as a place for establishing a relationship, resulting in a problem-solving space.