The instituted and the real in the training of community health agents: a scoping review

Abstract

Objective: To map the formation processes and ongoing education actions experienced by Community Health Agents (CHAs) in the context of family health, anchored in the concept of culture. Methodology: Scope review following the Joanna Briggs Institute (JBI) methodology and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The search in databases such as BVS, EBSCO – Academic Search Premier, CINAHL, GreenFILE, SocINDEX, Embase, ERIC, Global Index Medicus, PUBMED, Scielo, Scopus, WOS, took place in November and December 2022. The search terms were: Community Health Workers, Professional Training, Continuing Education, Family Health Strategy, Primary Health Care. Studies analyzing training experiences and actions of Permanent Education in Health (PEH) for CHAs in the context of family health were included. Endnote and Rayyan software were used in managing the selection of findings. The review protocol was registered on the Open Science Framework (OSF). Results: The sample included 25 studies, generating two categories: The primacy of instrumental technical training culture; and The biomedical culture guiding PEH. CHA training involves disinvestment and invisibility, focusing on the biomedical model. On the other hand, even if sporadic, PEH actions are guided by emerging health themes. Final Considerations: The formative processes and PEH for CHAs involve paths of construction and deconstruction, progress, and setbacks, based on a culture that often restricts established rights.