Obstáculos para el abordaje de familias con necesidades complejas en el sistema de salud de atención primaria en la región de Maule, Chile

Abstract

This study starts with the premise that in the primary health services in Chile, there is a preponderance of the use of conservative approaches towards the normative structural family type, which is at variance with the range of contemporary family structures and which does not reflect the transformations that families have undergone. In order to respond to this premise, the theoretical approaches with regard to families set forth in the health policies which guide the actions of those who implement the said policy were explored, and the various ways in which the public officials who deliver the services under examination interpret them were described. A case study was carried out at four primary health clinics in the region of Maule (Chile), during 2010. Eleven semi-structured interviews and six non-participating observations were carried out, which were then analysed using the constant-comparison method. Subsequently the theoretical model was developed and its implications were examined. The results revealed that the public health policy is characterized by the promotion of traditional and standardized conceptual frameworks with regard to families, which do not reflect reality. Furthermore, it was found that the majority of the subjects studied had a conservative and traditional outlook with regard to the family, deriving from the weight of this political agenda and from the significant influence of the structural approaches in health science.