Oliveira Ana Paula Cavalcante de, Gabriel Mariana, Poz Mario Roberto Dal, Dussault Gilles
Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa. R. da Junqueira 100. 1349-008 Lisboa Portugal.
Departamento de Odontologia Social, Faculdade de Odontologia, Universidade de São Paulo. São Paulo SP Brasil.
Cien Saude Colet. 2017 Apr;22(4):1165-1180. doi: 10.1590/1413-81232017224.31382016.
Shortages and imbalances in the distribution of the health workforce, are social and political problems that, along with the socio-economic inequality, reduce the access of the population to the health services. This study aims to understand the challenges of SUS policy-makers and managers to ensure the availability and geographical accessibility to health service providers. The analysis was guided by a framework of the health labour market and health policy interventions. Two main problems have been identified: shortage of doctors and maldistribution of professionals between levels of health care and between geographical areas. This review focused on eight interventions in the last 30 years, whose mainly aim was to correct the maldistribution of physicians in the SUS such as Rondon Project, Interiorization of Health Work Program, Medical Specialists Training Program, PHC Program and More Doctors Program. The discussion focuses on the factors that influence the outcome of these interventions.
卫生人力分布的短缺和不均衡是社会和政治问题，它们与社会经济不平等一道，减少了民众获得卫生服务的机会。本研究旨在了解统一卫生系统（SUS）政策制定者和管理者在确保卫生服务提供者的可获得性和地理可及性方面所面临的挑战。分析以卫生劳动力市场和卫生政策干预框架为指导。已确定两个主要问题：医生短缺以及专业人员在医疗保健层级之间和地理区域之间分布不均。本综述聚焦于过去30年中的八项干预措施，其主要目的是纠正统一卫生系统中医师分布不均的问题，如朗多尼亚项目、卫生工作内部化计划、医学专家培训计划、初级卫生保健计划和更多医生计划。讨论集中在影响这些干预措施结果的因素上。
