Este relato apresenta a experiência de implantação de jardins terapêuticos como parte das Práticas Integrativas e Complementares em Saúde (PICS) no município de Vitória, Espírito Santo. A iniciativa, desenvolvida no âmbito da política municipal de PICS, tem como objetivos promover bem-estar, autonomia e sustentabilidade, integrando saberes tradicionais e científicos sob os princípios da Saúde Única e do cuidado integral.
Desde a década de 1990 até os dias atuais, os jardins terapêuticos vêm se consolidando como ferramenta de promoção da saúde, educação popular, fortalecimento da atenção primária e integração comunitária. A prática envolve o cultivo de plantas medicinais, oficinas de preparo de fitoterápicos, atividades de cuidado com o jardim e ações educativas em parceria com a Prefeitura de Vitória e instituições externas. Atualmente, estão presentes em 16 serviços, sendo 13 vinculados à Secretaria Municipal de Saúde e 3 a serviços parceiros. As atividades incluem oficinas de cultivo, preparo de chás, sais aromáticos e outras práticas integrativas, reforçando o uso racional das plantas medicinais e a articulação intersetorial com meio ambiente, educação e assistência social.
Os jardins terapêuticos foram concebidos como resposta a múltiplos desafios em saúde pública, entre eles:
* necessidade de práticas de cuidado mais naturais e com menor medicalização;
* dificuldade de acesso a terapias naturais;
* oferta de espaços de acolhimento e uso de tecnologias leves em CAPS;
* distanciamento entre saberes tradicionais e prática clínica;
* carência de espaços de convivência comunitária e de cuidado coletivo nos territórios;
* baixo reconhecimento das ações de promoção da saúde no modelo assistencial e perda de saberes populares.
Ao longo dos anos, foram criados 23 jardins terapêuticos na rede municipal de Vitória, dos quais 10 foram descontinuados. Atualmente, permanecem ativos 13 jardins em serviços de saúde e 3 em instituições parceiras. Para cada jardim, em média 10 pessoas foram capacitadas como guardiãs, totalizando cerca de 200 pessoas treinadas para cuidar e manter os espaços.
São realizadas aproximadamente 50 oficinas anuais, com média de 20 participantes cada, abordando cultivo, manejo e uso consciente das plantas medicinais. Entre os principais impactos, destacam-se:
* maior adesão e participação de usuários nas atividades;
* integração das práticas com serviços de saúde e parceiros;
* ampliação do número de guardiões capacitados para manter os jardins;
* fortalecimento da educação em saúde, cuidado ambiental, autocuidado e sustentabilidade;
* incentivo ao uso racional e seguro de plantas medicinais;
* maior protagonismo comunitário e ampliação das formas de cuidado disponíveis.
Outro destaque é o Fórum Municipal de PICS, realizado anualmente em novembro, que inclui o Encontro Municipal de Jardins Terapêuticos, reunindo cerca de 30 participantes a cada edição para troca de experiências entre guardiões e profissionais.
Apesar dos avanços, alguns desafios persistem:
* ampliar a formação em PICS para profissionais da rede SUS e parceiros;
* monitorar e acompanhar de forma sistemática os jardins terapêuticos;
* integrar ainda mais a prática às atividades dos serviços de saúde;
* fortalecer a articulação entre políticas de educação, saúde e meio ambiente;
* expandir a implantação de jardins terapêuticos em novas unidades de saúde.
This report describes the experience of implementing therapeutic gardens as part of the Integrative and Complementary Practices (PICS) within the Unified Health System (SUS) in the municipality of Vitória, Espírito Santo. It contextualizes their development within the municipal policy of Integrative and Complementary Practices (PICS), where therapeutic gardens were implemented to promote well-being, autonomy, and sustainability. The initiative was built on the principles of One Health and comprehensive care, incorporating traditional and scientific knowledge. From the 1990s to the present day, therapeutic gardens have been consolidating themselves as a tool for health promotion, popular education, strengthening primary care, and community integration. The use of this practice, combined with intersectoral public policies, demonstrates the potential to reduce social determinants, promoting autonomy, well-being, and the connection between health, the environment, and local culture. Description The practice of therapeutic gardens was developed in the municipality of Vitória, Espírito Santo, as a strategic health initiative. The city has been a pioneer in implementing PICS since 1990. Located in an urban area with social and cultural diversity, the practice emerged from the appreciation of folk knowledge, traditional medicines, and the need to offer gentler, more natural care methods. Beginning in the 1990s, with the inclusion of phytotherapy as the city's first PIC, the first therapeutic garden projects emerged, linked to health units, schools, and psychosocial care centers. The practice involves the cultivation of medicinal plants, workshops on herbal medicine preparation, garden cultivation and care workshops, and educational activities, in partnership with both the Vitória City Hall and external institutions. Today, therapeutic gardens are present in 16 services, 13 of which are run by the health department and another 3 by partner services. They offer activities such as cultivation workshops, tea preparation, aromatic salts, and other integrative practices. The proposal emerged as a strategy to promote health and strengthen primary care, fostering the rational use of herbal medicines and intersectoral collaboration with the environment, education, and social assistance.
Issues Addressed Therapeutic gardens were conceived as a response to multiple public health challenges, including:
• Offering more natural health-promoting practices that can reduce medicalization;
• Lack of access to natural therapies;
• Provision of welcoming spaces and therapy with soft technologies in CAPS (Personal Care Centers).
• Disconnection between traditional knowledge and clinical practice;
• Lack of spaces for community life and collective care in the territories;
• Low recognition of health promotion actions in the healthcare model and loss of traditional and popular knowledge.
Over the years, 23 therapeutic gardens were established in the municipal health network of Vitória, Espírito Santo. Of these, 10 were discontinued for various reasons. Today, the health services have 13 therapeutic gardens, in addition to another 3 in partner services. During the implementation process of each therapeutic garden, guardians were trained to care for the space. An average of 10 people were trained per garden, totaling approximately 200 people.
Another point to consider is the holding of workshops on the topic, involving the participation of service users and staff. These workshops discuss topics such as plant cultivation, plant care, and the conscious use of medicinal plants, according to service needs. The average number of workshops is no less than 50 per year, with an average attendance of 20 people per workshop. However, the same people often participate in multiple workshops, making it difficult to quantify the total.
With the implementation of therapeutic gardens and the activities developed, we can affirm that:
• Improved user acceptance and participation in therapeutic gardens;
• Integration and improvement of practices with health services and partners;
• Increased the number of therapeutic garden guardians, with skills to care for and ensure the quality of the final product;
• Conducted workshops on health, the environment, self-care, and sustainability;
• Expanded the rational and safe use of medicinal plants;
• Coordination between popular education initiatives, food security, self-care, and mental health;
• The acceptance of the gardens by the community and professionals has provided greater autonomy and the provision of new forms of care.
Furthermore, in November the Municipal Forum of Integrative and Complementary Practices is held, where on the last day the Municipal Meeting of Therapeutic Gardens is held, with approximately 30 participants per year who share their experiences with guardians of the therapeutic gardens.
Although progress has been significant, there are still challenges to be overcome and achievements to be achieved, including:
• Expansion of PICS training for more professionals in the SUS network and partners;
• Monitoring and tracking therapeutic gardens, their potential and care;
• Integrating the practice with other service activities, enhancing care;
• Strengthening and integrating education, health, and environmental policies;
• Incorporating therapeutic gardens into more health facilities;
