2016: um ano de perplexidade

Lima, Luciana Dias de; Travassos, Cláudia; Carvalho, Marília Sá; Coeli, Cláudia Medina

doi:10.1590/0102-311xed011216

Cited by 2 publications

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“…Outra dimensão a ser observada é que apesar dos esforços de atores e do governo em transformar a atenção primária como ordenadora do sistema, na verdade o sistema brasileiro ainda é muito voltado para a assistência hospitalar, com o foco em especialidades médicas e o predomínio da cultura medicalizante, agravada por uma não organização da formação baseadas nas necessidades de saúde e de serviço. (GIRARDI et al, 2016, PINTO et al, 2016, CARVALHO et al, 2016, acesso, infraestrutura, produção e efeitos e APS (MIRANDA et al, 2016, GIOVANELLA et al, 2016, LIMA et al, 2016, LIMA et al, 2016, formação e tutoria (THUMÉ et al, 2016, LIMA et al, 2016 e gestão e planejamento local de recursos humanos e arranjos institucionais…”

Section: A Estratégia De Saúde Da Família No Brasil E O Trabalho Médicounclassified

Análise do ciclo de política do Programa Mais Médicos no Brasil: cooperação Cuba Brasil e seus efeitos para o trabalho médico

Paula¹

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The education and provision of health professionals are the main strategies to increase capacity and respond to health systems' needs among countries worldwide. Recently, the Brazilian government passed a law to create a national program, called the More Doctors Program, to improve the capacity to respond to the demand for doctors in underserved areas. The law was designed with three main axes: provision, education and infrastructure. The first, provision, would increase the provision of medical doctors through monetary and non-monetary incentives to attract national and foreign doctors to work in remote areas. The education axis was related to opening new Courses and Institutions to graduate new doctors in remote areas. The third axis was to improve primary care facilities. However, the most controversial aspect of this Program was the partnership between Cuba and Brazil, through an international cooperation mediated by the Pan-American Health Organization. It involved 18,240 new primary care physicians. Focusing on provision, mainly in the Brazil-Cuba international cooperation, a qualitative study was designed and conducted, analyzing the More Doctors policy cycle, using Howlet & Ramesh, 2003 as well as Ball, 1992 as a reference. This study examined the five stages of the policy cycle: agenda preparation, policy formulation, decision making, implementation and evaluation and Practitioners. In addition, there could be an influence of the Cuban socialist model. The Cuban doctors bring a new perspective to Brazilian health professionals on how to build linkages with the users and how to deal with poverty and inequity. On the micro level, both groups benefited from ongoing learning strategies, supervisions in locus, distance learning courses, round tables on the main health problems, group practice sharing, and the interchange on health local planning. The main problems involve the temporary nature of the provision strategy, which is not well resolved with the Brazilian medical corporations and professional bodies. Furthermore, the supervisions are not always well organized by the Universities. The study also shows the fragilities of federative integration regarding policy implementation and management.

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