Artigo Original | Original article INTRODUCTION

The inadequate placement and distribution of health professionals are problems that occur in various countries. The scope of the " Pro-grama Mais Médicos " (More Doctors Program) was to reduce the shortfall of physicians and diminish regional inequalities in health. A descriptive study on the placement of physicians between 2013 and 2014 using the Ministry of Health database is presented. There was an allocation of 14,168 physicians to the 3,785 municipalities that signed up to the program: 2,377 met the priority and/or vulnerability criteria and received 77.7% of the physicians; 1,408 received 22.3% of the physicians , but did not meet the established priorities. This study reveals the reduction in the lack of physicians , mainly in the North and Northeast. These regions account for 36% of the Brazilian population and 46.3% of the physicians were allocated there. However, the introduction of an eligibility profile, which allocated 3,166 physicians in 1,408 non-priority municipalities is questionable. The conclusion drawn is that this may have hindered the ability of the Mais Médicos Program to fully achieve its objectives as a public policy aimed at reducing regional inequalities of access to primary healthcare. Further studies are necessary to evaluate the impact of the Mais Médicos Program.

Revista de Saúde Pública, 2009

OBJECTIVE: To analyze trends relating to physicians' vocational integration and income composition from the Pesquisas Nacionais por Amostra de Domicílio (PNAD-National Household Sampling Surveys).

Arquivos Brasileiros de Oftalmologia, 2012

Artigo Original | Original article INTRODUCTION The Social Security, comprised of Health, social security and as sistance, was conceived in the Constitution of 1988 and allowed the implementation of the National Health System (SUS) (1) , which the main principle is health as universal right. The SUS guidelines are: equality, universality and integrality. The equity, although not present in the terms, has become one of the main references to formulate public policies, arguing the inequalities in the health area. There are several challenges in the health sector and they mainly involve the universality and equity principles, considering the occur rence of population groups with no access to any type of service, in all regions of Brazil (2). Actually, health service provision to remote and poor regions is an issue in almost all countries worldwide, as well as inadequate geo graphical distribution of service providers specially physicians (37). Even when the ratio physician/inhabitant is adequate, physicians' distribution tends to be concentrated in certain regions, leading to an undesirable result from the public health point of view and from the organizational principle of decentralization (8,9). Even in developed countries, these professionals are usually con centrated in larger cities, leaving small cities, rural areas, remote com munities and poorer regions unattended (3,7). In the United States, approximately 54 millions of people live in communities and regions with lack of health professionals, with no access to basic care due to economic, geographical and cultural barriers (10). Gross Domestic Product (GDP) per capita and geographical distribution of ophthalmologists in Brazil Produto Interno Bruto (PIB) per capita e a distribuição geográfica dos oftalmologistas no Brasil

Rural and remote health, 2016

The Mais Médicos program was introduced in 2013 with the aim of reducing the shortage of doctors in priority regions and diminishing regional inequalities in health. One of the strategies has been to offer 3-year contracts for doctors to work in primary healthcare services in small towns, inland, rural, remote, and socially vulnerable areas. This report describes the program's implementation and the allocation of doctors to these target areas in 2014. To describe the provision of doctors in the first year of implementation, we compared the doctor-to-population ratio in the 5570 municipalities of Brazil before and after the program, based on the Federal Board of Medicine database (2013), and the official dataset provided by the Ministry of Health (2014). In its first public call (July 2013) 3511 municipalities joined the Mais Médicos program, requesting a total of 15 460 doctors; although the program prioritizes the recruitment of Brazilians, only 1096 nationals enrolled and were...

Revista Latinoamericana De Psicopatologia Fundamental, 2010

Journal of global health reports, 2021

Background The inequality in the access to health services in Brazil is one of the consequences of the poor distribution of doctors throughout the country. This is observed by the scarcity of these professionals working in primary health care (PHC) in the Brazilian health care system (SUS), particularly in rural and poor suburban areas. This paper analyzes the policies of the Brazilian federal government aiming to increase access to health services by encouraging physicians to work in PHC. The study examines the policies' effects regarding the availability of doctors, and the participation of Brazilian doctors on the "Mais Médicos" Project, leading to recommendations for future strategies. Methods The research combined a scope review, based on documents produced by the federal government, and analysis of secondary data obtained from the Ministry of Health, as well as from official websites of the Brazilian government. Results The results indicate advances in innovative strategies to expand the number of physicians, increasing the availability of these professionals, and PHC coverage. However, it is still necessary to fight the scarcity of professionals and fill healthcare positions primarily in municipalities far from urban centers, poor and suburban areas, and Special Indigenous Sanitary Districts. Conclusions Improving health coverage in Brazil through strengthening primary health care will require further efforts to overcome the challenge of attracting and retaining doctors to work in disadvantaged areas, increasing the availability and accessibility of health workers. In addition, new policies need to emphasize the participation of other health professionals such as nurses, auxiliary nurses, and community health agents, as well as incorporate new technology able to reduce distances between health professionals and users of the Brazilian health care system.

Research, Society and Development

In Brazil, primary health care counts with multidisciplinary teams, comprising doctors, nurses, dentists, nutritionists, psychologists, pharmacists, physiotherapists, social workers and veterinarians, working in a complementary way. The objective of this study was to analyze the increase of these nine health professions from the censuses of the Brazilian Institute of Geography and Statistics (IBGE) for 2000 and 2010, identifying the panorama of the Work Force in health in all health regions in Brazil. There was an increase in the numbers of all professions in the period, especially induced by public policies. However, there are still problems, especially with doctors and dentists, due to uncovered areas such as remote and rural regions with difficult access. We underscore the importance of conducting health education, training and allocation of professionals, based on the needs of the health sector in Brazil for the provision of the labor force in areas with some degree of vulnerabi...

Healthcare, 2023

The aim of this study was to analyze the scenario of medical residency programs (MRPs) in the north region of Brazil as well as the contextual determinants (socioeconomic, structural, and epidemiological) influencing the number of MRPs in this region. An ecological study was conducted using MRPs data from 2022. This study used multiple data sources. MRP indicators were described based on the Brazilian state and specialty. The dependent variable was the number of MRPs. The independent variables included sociodemographic, structural, and epidemiological factors. Poisson regression was performed to analyze the association between contextual variables and the number of MRPs. The results showed that only 3.6% of the municipalities had authorized MRPs. The idleness rate in the region was 46.0%, with family and community medicine as the specialties with the greatest idleness. The total density of authorized vacancies in the MRPs was 14.0 vacancies per 100,000 inhabitants. The models showed that with each increase of one unit of the vulnerability index (Socioeconomic Index in the Geographic Context for Health Studies-GeoSES), the number of MRPs increased, ranging from 8122 (p value < 0.001) to 11,138 (p value < 0.001). With each increase in undergraduate degrees in medicine, the number of MRPs increased by 0.945 (p value < 0.001). With each increase of 1 physician per 1000 population, the number of MRPs increased from 0.537 (p value < 0.001) to 0.845 (p value < 0.001). With each increase of one unit in general hospitals, specialized hospitals, teaching hospitals, and primary healthcare units, the number of MRPs increased by 0.176 (p value < 0.001), 0.168 (p value < 0.001), 0.022 (p value < 0.001) and 0.032 (p value < 0.001), respectively. Finally, with each increase of one death per 100,000 inhabitants, the overall mortality rate increased, ranging from 0.006 (p value < 0.001) to 0.022 (p value < 0.001). The study showed a low supply of MRPs in the northern region, a high rate of idleness, and important socioeconomic, structural, and epidemiological determinants of the number of MRPs.

Bulletin of the World Health Organization, 2017

Interface - Comunicação, Saúde, Educação, 2015

A escassez de profissionais de saúde em áreas remotas e vulneráveis é um importante obstáculo para a universalização do acesso à saúde em diversos países. Este artigo examina as políticas de provimento de profissionais de saúde na Austrália, nos Estados Unidos da América e no Brasil. Apesar do sucesso parcial de iniciativas anteriores, foi apenas com o Programa Mais Médicos que a provisão de médicos em áreas vulneráveis teve a magnitude e a resposta em tempo adequado para atender a demanda dos municípios brasileiros. Estão em curso, no país, mudanças quantitativas e qualitativas na formação médica, que buscam garantir não apenas a universalidade, mas, também, a integralidade e sustentabilidade do Sistema Único de Saúde. O êxito dessas iniciativas dependerão da continuidade da articulação interfederativa, de políticas regulatórias de estado, bem como, do constante monitoramento e aprimoramento do programa.