Atenção Primária e Hanseníase: desafios educacionais e assistenciais

Leprosy remains a challenge within Brazilian public policies. Brazil still registers a high number of cases, which keeps the country in the second place in absolute number of cases and first in relative values arround que World. Even if the country meet the target assumed with the World Health Organization, less than one case per ten thousand nhabitants, the challenge of controlling the disease will still remain. The number of new cases in children under fifteen years demonstrates that the challenge is greater than assumed, since there is active transmission, and so patients still undiagnosed. Primary Health Care (PHC), although responsible for major advances, was not able to solve this specific health problem, despite recognized as the most appropriate level of care and which more specifically works with health education tools. The objective of this work was to evaluate leprosy as a target for PHC and Health Education actions, and for this purpose both PHC and educational strategies as means of health promotion and communication were evaluated. It was found that PHC, although the most appropriate level for care, curses with barriers of access and quality that wastes health care opportunities. Issues such as ambiance, professional qualification, work overload and excessive population coverage directly interfere in care. Specifically regarding education for leprosy, PHC professionals were not properly qualified during undergraduation, and the mechanisms of continued education are not able to modify clinical practice. Moreover, the way health education is done within public policy was ineffective, still contaminated by stigma and beliefs concerning "leprosy" and dissociation of disease severity with the nomenclature "hanseniasis". We conclude that the approach to leprosy inevitably leds to the qualification of primary care by reducing the number of users per team, by modifying educational strategies and by the need to tailor the undergraduate curricula to the real scenario of health care units, both in terms of direct contact with the disease leprosy as in terms of the appropriate use of educational tools.