Perceptions about the “Mais Médicos” Program and the Academic Supervision Process

Abstract

Introduction: This study aims to analyze the perceptions of the involved actors about the “Mais Médicos” Program (PMM) and the academic supervision process, its strengths and weaknesses aiming to improve Primary Heath Care practices. Method: Qualitative study carried out through 05 in-depth interviews with PMM supervising doctors, and 24 interviews with unit managers, 12 Primary Heath Care coordinators, and 07 Secondary Health Care doctors. Results: Three thematic axes emerged from de analysis: benefits of the program for the municipalities and for the population; the challenges of the supervisory process and the difficulties of the fragmented health system. Conclusions: The actors’ perception of the “Mais Médicos” Program are positive, especially because it brought doctors to municipalities with vulnerable areas, where doctors did not go to and where they did not stay. Supervision is an important support for continuing in-service training; however, it requires a better articulation with the different levels of the health system management. The precariousness of the service network limits the performance of both doctors and supervisors, demonstrating that it is necessary to invest in a solid and effective care network. Moreover, it was once again evident that the population will face a shortage of doctors due to changes in health policies. It is necessary to build more comprehensive policies, that will not only result in sporadic provision of medical care. There is a need for continuous actions, better integrated to the healthcare networks, aiming at an efficient and effective healthcare system.

Implementation of Academic and Managerial Supervision Policy at State Elementary School 3 Palu City

“…From the results of interviews conducted regarding the first dimension, namely the Standard Dimensions and Policy Objectives, there are still some things that have not been understood by the informants, including the legal basis used as the basis for carrying out supervision activities [6]. Likewise, from secondary data processing, it can be seen that the supervisor has not been able to fully describe in detail the follow-up activities that must be carried out [7].…”

Percepções acerca do Programa Mais Médicos e do Processo de Supervisão Acadêmica

“…The perceptions of the actors involved in the PMM are quite positive, of a program that brought doctors to the municipalities located in remote and vulnerable areas, where doctors did not go and did not stay, therefore allowing the population to have access to basic health services [21][22][23][24] , which is guaranteed in the current Constitution as a right of all citizens, but still finds difficulties to be guaranteed, especially in the PHC, which provides the services to the vast majority of the population 7,21 .…”

“…In this sense, several studies have shown that the PMM mainly allowed the concretization of the principle of equity, through the distribution of doctors in PHC according to the criteria of social vulnerability and of specific populations [21][22][23][24][25] . It provided the presence of doctors in areas of difficult access, of extreme poverty, far from large centers, in the outskirts of metropolitan regions, and indigenous populations, as well as riverside, quilombolas, and rural populations [21][22][23][24][25] , who were previously excluded from the system. Nevertheless, it must be considered that, initially, part of the medical corporation was in opposition to the program, mainly due to the arrival of a large number of Cuban doctors 26 , which contributed to the creation of negative perceptions of these doctors and the program [27][28][29] .…”