"More doctors for Brazil": a political approach

Interface - Comunicação, Saúde, Educação

The More Doctors Program (PMM) was created in 2013. Guided by social needs, it set a new regulatory framework for medical education and residency in Brazil. This study is based on public policies and their actions aimed at implementing changes in medical education in PMM, as well as their results until 2015, by analyzing documents from official sources and the literature. The following results were identified: decrease in regional inequalities in the distribution of undergraduate course seats; education internalization; increase in medical residency seats specialized in Family and Community Medicine; expansion of preceptorship qualification; and creation of the National Registration of Specialists. The challenges faced by PMM to effectively achieve its goals, the need for State commitment and the current threats to this vital dimension of the program (ensure the right to health) are pointed out.

Ciência & Saúde Coletiva

Access to medical care is essential to achieve quality primary health care (PHC). In Brazil, access difficulties still persist. The Doctors for Brazil Program (PMpB in Portuguese) aims to expand the offer of medical services in places of difficult provision or high vulnerability. It innovates insofar as it prioritizes smaller and rather isolated cities, by selecting professionals through an isonomic process, offering them training in Family and Community Medicine and a chance to build their first federal medical career in PHC. The program offers competitive salaries, progression and financial incentives that value long-term commitment and performance. The PMpB is rolled out by the Agency for the Development of Primary Health Care (Adaps), which allows better management of public policies. The first nine months of the program showed promising results, as approximately 23,000 candidates seeking to join the program through its selection process, i.e., 97.1% vacancies were filled and re...

Brazil's Mais Médicos Program goes beyond just temporarily hiring foreign (primarily Cuban) doctors as an emergency measure. It includes major improvements in primary health care infrastructure, the considerable expansion of medical school admissions, residencies and scholarships, and their redistribution to underserved areas; new primary care faculties in underserved municipalities, and most importantly, medical school curriculum reform to focus on primary health care in support of identified needs. The aim was to achieve universal access and coverage to ensure equity, and thereby meet the Constitutional right to health for all. This paper discusses the historical background leading up to the Mais Médicos Program, the Program itself, as well as preliminary results after two years in execution. It also reviews risks and sustainability issues at that time.

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.

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.

2017

O Projeto Mais Medicos para o Brasil (PMMB) foi criado em 2013 visando prover medicos para areas de dificil fixacao de profissionais e oferecer treinamento em Saude da Familia para medicos brasileiros e estrangeiros. Neste artigo, sao analisados aspectos relacionados as motivacoes, ao processo e condicoes de trabalho na Atencao Basica, a situacao de saude nos municipios, ao funcionamento do Sistema Unico de Saude (SUS) e a relacao com os gestores, a partir de entrevistas com 44 medicos cubanos, trabalhando em 32 municipios de todas as regioes do Brasil. As falas mostram que os cooperados tem um agudo senso de observacao e conseguem fazer um detalhado diagnostico situacional de suas areas de atuacao, demonstrando a precariedade ainda prevalente na Atencao Basica nos municipios. Porem, eles tambem evidenciam que, com a adequada formacao, e possivel fazer atencao primaria de qualidade, mesmo diante de grandes adversidades.

Revista da Escola de Enfermagem da USP, 2014

Analyzes publications related More Medical Program from July to September of 2013 and its impact on Correio Braziliense and Folha de São Paulo. This is a descriptive study using a qualitative-quantitative methodology. The analyzed and related data represent what the program takes in print. 363 publications were found, 262 in Folha de São Paulo and 101 in Correio. The word "Doctor" appeared in more titles, and Folha de São Paulo were 110 negative titles; to Correio neutral character was in 50 publications. In the character of news, 178 of these are pessimistic. The "neutral" and 101 representing "optimistic" 83. Was found that the media is critical to the impact of the program, but the truth is not apparent, but the opinion of journalists who wrote the stories related to the theme.

2021

The Welcoming and Assessment Module (Módulo de Acolhimento e Avaliação) is the first contact of the candidate for the More Doctors Program with the Brazilian health system and composes one of the formative cycles of the More Doctors for Brazil Project, the provision of physicians in priority areas of the Unified Health System (SUS). It is a selective training for Brazilian physicians graduated abroad and for foreigners who wish to participate in the More Doctors Program. The organization and success of the Welcoming and Assessment Module are essential for the continuity of the subsequent formative cycles, foreseen in the Project. This article describes and analyzes the planning and operationalization of the Welcoming and Assessment Modules taken place in Brazil and in Cuba, from 2014 to 2017, recommending adjustments in the management of education so that health work can be qualified and resolutive and, thus, contribute to the strengthening of primary care in Brazil.

Interface - Comunicação, Saúde, Educação

Interface, 2019

The More Doctors Program has been considered, in recent studies, the most important normative change of the State's attributions in the organization of the education of human resources for the Brazilian National Health System (SUS). This article analyzes the most structuring axis of the program, education in health, by revising literature, and analyzing documents and databases in order to describe its model as a public policy and discuss which normative changes had an effect on the State's action. The article identifies institutional changes in the Brazilian Ministry of Health and Ministry of Education, in the reorientation of medical education, in the expansion and redistribution of undergraduate and residency seats, and in the creation of public policy instruments to plan, regulate and assess the education of specialists. The paper is concluded by identifying interruptions in the program's structuring actions and objectives, and goals and objectives that will probably not be met within the established deadlines.