Privatization and geographic inequalities in the distribution and expansion of higher nursing education in Brazil

Abstract

Objectives: to analyze the influence of privatization and geographic inequalities in the distribution and expansion of higher education in nursing in Brazil. Methods: a cross-sectional study, with online data of 1,244 courses and 190,610 nursing vacancies, started between 1890 and 2019. Proportions were estimated and differences were verified with statistical tests (α=5%), vacancy rate per 10,000 inhabitants and private ratio/public. Results: there was an accelerated, disorderly and heterogeneous growth in the number of courses and vacancies for nursing over 129 years, with strong private influence, favoring their concentration in large urban centers, capitals and richer states. Conclusions: the significant expansion of higher education in nursing in Brazil occurred with excessive private supply and unequal distribution between its locations, indicating the need for state regulation in the opening of new courses and vacancies, which can minimize the negative repercussions on the quality of education, health care and workforce imbalances.