Comprehensive health services to women in gender violence situation--an alternative to primary health care/ Atencao integral a saude de mulheres em situacao de violencia de genero--uma alternativa para a atencao primaria em saude

This paper deals with the possibilities of the health sector to approach violence against women in its practices as a gender issue. It is presented a conceptual and theoretical comprehension of gender violence linked to a care proposal, as the definition of the problem is essential to the intervention, answering to different social ends. To do that, is necessary to think what the objectives of the work in health are and where it is placed within the production and reproduction of the ways of living and falling ill. It is argued the possibility of full assistance, in order that violence itself, and not only its repercussions, are considered in the health work. The proposal of care for sexual violence in Brazil is recovered, and a model of primary health care implemented at Samuel B. Pessoa Health School Center is presented. This model is integrated in the Women's Integral Health Care Program (PAISM) and attends women in severe domestic conflicts (CONFAD) conceptualized as a specific technique of detection, listening and counseling, featuring a "chat technique" as a professional action. To conclude, aspects related to the connections of the health sector with the intersectorial network are discussed presenting its principal difficulties. Keywords Primary health care, Domestic violence, Violence against women, Intimate partner violence, Women's health services Resumo Este artigo trata das possibilidades de atuacao do campo da saude na abordagem da violencia contra a mulher desde suas praticas assistenciais nos servicos e baseadas na perspectiva de genero. Apresenta-se uma dada compreensao teorico conceitual da violencia de genero contra as mulheres articulada a uma proposta de cuidado, pois a forma como o problema e delimitado e essencial para a intervencao, respondendo a finalidades sociais diversas. Trata-se, portanto, de pensar quais os objetivos da acao em saude e qual o seu lugar na producao e reproducao de modos de viver e adoecer. Defende-se a possibilidade de atendimento integral, para que tambem a violencia, e nao apenas suas repercussoes, seja considerada no trabalho em saude. Recupera-se a proposta de atencao dirigida a violencia sexual no Brasil e debate-se uma possibilidade de atuacao na atencao primaria tal como implantada no Centro de Saude Escola Samuel B. Pessoa. As acoes propostas e integradas ao Programa de Atencao Integral a Saude da Mulher (PAISM) da Unidade constituem uma atividade de atendimentos a conflitos familiares dificeis (CONFAD)