Dissertações de mestrado

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Navegando Dissertações de mestrado por Assunto "Acesso aos serviços de saúde"

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    Programa mais médicos: análise da implantação no Espírito Santo
    (Universidade Federal do Espírito Santo, 2020-05-29) Moraes, Priscila Lube; Neto, Edson Theodoro dos Santos; https://orcid.org/0000000273517719; http://lattes.cnpq.br/5430137427291413; https://orcid.org/0000-0003-4980-896X; http://lattes.cnpq.br/2811619296777491; Szpilman, Ana Rosa Murad; https://orcid.org/0000-0003-1399-3753; http://lattes.cnpq.br/0758783435748999; Oliveira, Adauto Emmerich; https://orcid.org/0000-0002-9679-8592; http://lattes.cnpq.br/1534956621971641
    The need of medical professionals to work in the Unified Health System (SUS) is unquestionable. Considering the difficulty of accessing health services and the shortage of medical professionals in rural areas that are difficult to access, the objective of this work was to characterize the process of implementing the Mais Médicos (More Doctors) Program (Programa Mais Médicos – PMM) in Espírito Santo (ES) in the first cycle of the program from 2013 to 2016, in order to get to know the profile and factors involved during the implementation in the state, making it possible to discuss this policy and contribute to processes that make it possible to reduce inequalities between citizens and health services. This research has quantitative and qualitative aspects to the study. The quantitative study, based on secondary information collected from the State Health Secretariat (SESA), the National Register of Health Establishments of the Sus Informatics Department (CNES), the Brazilian Institute of Geography and Statistics (IBGE) and the Jones dos Santos Neves Institute (IJSN) aimed to analyze the scenario of implantation of the PMM in the 78 municipalities of the state ES, grouped by population sizes. The information was analyzed using descriptive and inferential statistics. In the qualitative study, 23 interviews were conducted, through a semi-structured script, with managers who worked from 2013 to the end of 2016. They were transcribed and analyzed using the Content Analysis Technique, in order to understand the implementation of PMM in two different scenarios in the state of ES, both of which were in areas of extreme poverty. During the PMM implantation period in ES, there were statistically significant differences for all variables evaluated in the municipal profile between the different population sizes. Municipalities with a smaller population size had a higher poverty rate, while larger municipalities had a higher rate of population using private health care. There was a great disparity in the coverage of the Family Health Strategy (ESF) between the municipalities of the same population group, being progressive with the increase of the population group. There was a progressive increase in the number of doctors from the implementation of the program in 2013 until 2016, with an increase in the average for all population groups, in addition to an increase in the average number of doctors from the ESF, from 2012 to 2016. Thus, the results demonstrated the greater possibility of access to medical services obtained with the permanence of the doctor in the communities, both in the interior and in the capital, even with the presence of regional inequalities. Four categories of the interviews: possibility of access to medical services; appeal to the figure of the scientific doctor; proximity versus distance in the doctor-community relationship; and sociocultural interaction of foreign doctors. It was concluded that there was a strengthening of primary health care in ES through the implementation of the PMM, caused by the increase and fixation of medical professionals regardless of the population size of the municipality; the importance of proximity in the relationship between medical professionals and the community, facilitated better communication obtained through humanized experiences. The need to organize health services is evident in order to contemplate the geopolitical context and, also, the need of salary plan policy in the search for a resolute and equitable SUS