BackgroundThis study analyzed the reasons why physicians migrated from the Program to Value Primary Healthcare Professionals (PROVAB) to the Mais Médicos (More doctors) Program in 2015, opting to become physicians of the Primary Health Care.MethodsThe focal group techniques were used consisting of six doctors that made the option to remain in the PHC, being the results analyzed through content monitoring as well as the respective categories, which were identified as theme analysis.ResultsIt was evidenced that the physician’s retention on primary care has a strong relationship with the acquisition of knowledge that is consistent with the context and the health needs of the population. Thus, appropriate competencies for the management of the different biopsychosocial characteristics of the territories, in consonance with abilities that use the communication centered on the patient as well as on the interdisciplinarity, producing health projects that include the uniqueness of the people, essential factor for the daily confrontation of the work of these physicians, strengthened by the training component of the program. Personal factors related to the empathetic profile with this level of care and the possibility of continuous improvement, besides the factors related to the adequate infrastructure and organizational climate with guaranteed salary in keeping with the complexity of Primary Care, positively influenced the permanence of these professionals and were drivers of changes in healthcare and management in the health units they were related to. The bond created with the team and patients was a great satisfaction factor for the professional, being identified by them as a possibility to make a difference in the treatment process of patients, strengthening the promotion of a healthier life through health education.ConclusionsPROVAB had an unparalleled contribution to the qualification of care in Primary Health Care, contributing to the birth of a new logic of medical training in Brazil. Its effective cooperation with the consolidation of the Mais Médicos Program, still in progress, is a great movement of resistance to the disarticulation and deconstruction of Unified Health System (SUS) which is in charge of public health in Brazil.
ResumoO presente estudo teve por objetivo analisar o desenvolvimento da competência emocional em crianças encontradas realizando trabalho informal nas ruas de duas cidades do nordeste brasileiro. Foram entrevistadas sessenta e sete crianças, com idades compreendidas entre quatro e doze anos, de ambos os sexos. O instrumento utilizado foi o Teste de Compreensão das Emoções. A coleta realizou-se no espaço da rua. Os resultados revelaram que apesar das crianças mais velhas terem obtido resultados melhores do que as mais novas estas diferenças não foram significativas. Foi observado que o Teste de Compreensão das Emoções foi bem aceito pelas crianças investigadas e revela-se como um instrumento de fácil utilização e que atinge os seus objetivos, no entanto sugerem-se novas investigações em contextos como o investigado. Palavras-chave: Crianças em situação de trabalho na rua; Emoções; TEC. AbstractThe goal of the current research was to examine the development of nine components of emotions. For this purpose, 67 children, between 4 and 12 years old, who were found informally working on the streets of two cities in the Northeast of Brazil were interviewed. Children were given a version of the Test of Emotion Comprehension (TEC) to assess their understanding of nine different aspects of emotions. The collection of data happened in the space of the street. The results revealed that the oldest children obtained better results than the youngest ones. But these differences were not significant. It was observed that the TEC was well accepted by the investigated children and it is revealed as an instrument of easy use that reaches its objectives.
SUMMARY OBJECTIVE To analyze the working process of the professionals of the More Doctors Program and its relationship with socioeconomic indicators. It is a quantitative study, in which secondary data from supervision reports of PMM were used. The dependent variable was the quality of work processes in Primary Care facilities, and the independent ones were the type of municipality, education, Gini index, Primary Health Care investments, and health facilities coverage. Data were analyzed with multiple modeling based on Poisson regression with robust variance. RESULTS 16,000 doctors within 3816 municipalities were analyzed. Variables related to the working process the remained significant in the final model were the investments in Primary Health Care and the health facilities coverage. The results expressed the equity principle, as those municipalities with more vulnerable conditions and with higher coverage are prone to perform more activities in their working process. CONCLUSIONS The implementation of the More Doctors Program and hence the provision of doctors in deprived regions promoted the consolidation of three main aspects, namely the health working process, primary health care and equity, making it possible to carry out a health working process focused on PHC. This implies performing a greater number of activities that are inherent to PHC, which were not carried out due to the absence of doctors. The More Doctors Program fulfills its role in the combat of inequalities, particularly regarding more vulnerable municipalities.
RESUMO Atrair profissionais médicos para o trabalho na Atenção Primária em Saúde (APS) tem sido um desafio permanente para o Sistema Único de Saúde. A impossibilidade de educação continuada e permanente configura-se como um dos principais fatores impeditivos do provimento e da fixação de médicos na APS. O Programa de Valorização do profissional da Atenção Básica (PROVAB) trouxe como pressuposto o incentivo à Educação Permanente em Saúde (EPS) com ênfase na interação ensino-serviço-comunidade (IESC), contando com a presença de uma supervisão pedagógica composta por médicos capacitados para tal fim. O objetivo do presente estudo foi analisar os motivos que levaram um grupo de médicos de Natal, Rio Grande do Norte, participantes do Programa de Valorização do Profissional da Atenção Básica (PROVAB), a permanecerem na Atenção Primária em Saúde por meio da precedência ao Programa Mais Médicos (PMM), a partir da percepção de seus supervisores. Para tanto, foi realizado estudo qualitativo por meio da técnica de grupo focal com sete supervisores médicos do PROVAB e do PMM. A análise de conteúdo identificou cinco categorias de análises temáticas: Contexto político do início dos programas; Perfil do supervisor pedagógico; Perfil do médico que fez precedência do PROVAB para o Programa Mais Médicos; Motivos de fixação do provabiano à APS; e Porque não escolher a APS para a vida? Evidenciou-se que o PROVAB funcionou como uma estratégia inicial de enfrentamento aos desafios de se fixar médicos à APS em consonância à remodelação da formação médica. Apesar do contexto político desfavorável nos anos que se seguiram à implementação do PROVAB, houve uma sinergia entre a supervisão e os médicos que se empoderaram para desenvolverem suas atividades proporcionando condições para enfrentamento das condições desfavoráveis. A aproximação com o contexto do território e as competências adquiridas no programa acerca da Atenção Primária em Saúde com desenvolvimento de vínculo com a comunidade funcionaram como fatores de estímulo para a permanência do médico na Atenção Primária em Saúde traduzindo-se na mudança do perfil do profissional que assimilou e adquiriu o componente social de trabalhar em áreas de grande vulnerabilidade. Esse movimento deve favorecer as mudanças previstas nos cursos de graduação em Medicina, evitando um retrocesso que tange aos vazios assistenciais, animando a luta que se constitui na busca por um Brasil em que o acesso universal à saúde e a um profissional médico não seja um privilégio de poucos, mas o direito garantido de todos.
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