Street Clinics and the Healthcare of Vulnerable Homeless Communities in Brazil: A Qualitative Study

(1) Background: homeless people are characterized by serious social vulnerability and difficulty in accessing health services worldwide. In Brazil, this population is supported by the Street Clinic teams who are challenged to establish intersectoral networks to expand access and promote unique and humanized care from the perspective of harm reduction. The study aimed to analyze the practices of professionals working at the Street Clinic in a city in the interior of São Paulo, Brazil, to tackle the vulnerabilities of the homeless population and expand access to the health care network. (2) Methods: a qualitative study was conducted with a social approach in which we interviewed eight workers from the Street Clinic. Data were analyzed using the thematic content analysis tool. (3) Results: three nuclei of meaning were built: stigma and prejudice as the main barriers to accessing services, harm reduction as a humanized care practice and valuing autonomy, and Street Clinic as a gateway to the health system and main interlocutor with other services. (4) Conclusions: the articulation with network services is marked by contradictory relationships, of conflict and trust, signaling the need for greater investment in educational qualifications and working conditions for professionals at all levels of care to expand access to health care

Enfermagem do Consultório na Rua para o enfrentamento das vulnerabilidades

Objective: to unveil the perceptions of the Street Clinic nursing staff about coping with vulnerabilities. Methods: qualitative study, carried out by means of participant observation of the team’s activities, recording in a field diary and semi-structured interviews with the nursing team, totaling 17 participants. Results: situations experienced by people living on the streets that deepen health inequities by violating rights were revealed. Among the nursing work tools, the potential of collaborative work, listening, and welcoming technologies stand out as mediators of a more humanized care. There is a need for specific strategies to guide nursing care on the streets. Conclusion: nursing has great potential for addressing the vulnerabilities of the homeless population using soft and soft-hard technologies.Objetivo: desvelar as percepções da enfermagem do Consultório na Rua voltadas para o enfrentamento das vulnerabilidades. Métodos: estudo qualitativo, realizado por meio de observação participante das atividades da equipe, registro em diário de campo e entrevistas semiestruturadas com equipe de enfermagem, totalizando 17 participantes. Resultados: revelaram-se situações vivenciadas pelas pessoas em situação de rua que aprofundam as iniquidades em saúde pela violação dos direitos. Dentre os instrumentos de trabalho da enfermagem, destacam-se a potencialidade das tecnologias de trabalho colaborativo, escuta e acolhimento como mediadoras de um cuidado mais humanizado. Carece-se de estratégias específicas norteadoras do cuidado de enfermagem na rua. Conclusão: a enfermagem possui grande potencialidade de enfrentamento das vulnerabilidades da População em Situação de Rua por meio do uso das tecnologias leves e leves-duras