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Objective To analyse the health human resource allocation of all tertiary maternal and child healthcare(MCH)hospitals from 2015 to 2022 in China,and to propose basis for further strengthening the talent team construction and management of MCH hospitals.Methods Data were collected through the national MCH institution monitoring system to provide a descriptive analysis of the health human resources of all tertiary MCH hospitals in China.Results From 2015 to 2022,the number of health technicians in tertiary MCH hospitals increased with an average annual growth rate of 10.2%;The proportions of highly educated and professional health technicians increased year by year;The proportion of tertiary MCH hospitals with qualified health technicians has increased to 93.8%;The ratio of doctors to nurses has exceeded 1:1.4.Conclusion The allocation of health human resources in the tertiary MCH hospitals in China shows a good upward trend,which lays a foundation for improving the overall service level and service capacity of MHC hospitals.
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【Objective:】 To explore the current situation and problems of village-level health human resource allocation based on the theory of policy change, and to help rural revitalization and healthy rural construction from the perspective of "consolidating the basic level foundation as fundamental policy". 【Methods:】 a) Information census method. A round-the-box survey on the distribution of health human resources at village-level in 14 rural towns and villages in H district was conducted. b) In-depth interview method. Based on the principle of information saturation, three township and villages clinics and community stations were selected for field observation, and in-depth personal interviews were conducted with key insiders. 【Results:】 The health policy environment changed significantly with the spatiotemporal changes. "Hollow village" and "inverted village" coexisted. The change of registered population and permanent resident population accelerated, old village doctors and new village doctors continued on the same hand, village clinics and community station were in "double track" of management progress. With the change of internal and external environment of the above-mentioned policies, the allocation of health human resources at village level needs to be studied urgently. 【Discussion:】 Under the dual function of external and internal environment, the policy change is inevitable. The health human resource distribution at village-level should be integrated with the system in terms of policy. The career development mechanism is connected up and down. Team construction revolves around suitable and applicable for batch training.
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Introduction In-service training is an incentive to work and improve the quality of services of health human resources. In-service training for health human resources requires multi-sectoral efforts across relevant institutions, including the Ministry of Health (MOH), which is responsible for policy, and higher education institutions, teaching hospitals, etc. The only national medical university of Bhutan, KGUMSB has developed a nationwide distance in-service training system using ICT, which had been prepared during the COVID-19 pandemic. Prior studies have reported that there are benefits to the use of ICT for in-service training in low- and middle-income countries to compensate for resource shortages. In January 2023, a Memorandum of Understanding (MOU) was signed between the MOH and KGUMSB, etc. to cooperate and collaborate in the in-service training of health human resources across Bhutan. This paper provides an overview of Bhutanese health systems and introduces how to establish a nationwide in-service training system by connecting central and regional health institutions through distance education using ICT, in the case of Bhutan.Methods Participant observation, online interviews with stakeholders from KGUMSB, MOH, JICA, and documentary researches were conducted till July 2023.Results ICT environment and simulation training center at KGUMSB and two regional referral hospitals (teaching hospitals) developed. KGUMSB developed facilities and systems for distance education (digital education equipment, learning management system, etc.), training of trainers, and distance education content. In addition, the MOU for in-service training was signed between the MOH, KGUMSB, etc.Conclusion Through the efforts of KGUMSB, a specialized institution for health human resource development in Bhutan, to develop a distance education system, the MOU was concluded with MOH, and a nationwide in-service training system for health human resources was formed. For this system to work, in low- and middle-income countries with limited resources, a collaboration between the MOH, medical university, and teaching hospitals is essential.
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O objetivo do estudo foi analisar os desafios da formação desenvolvida pelos docentes atuantes em cursos de Enfermagem da região norte do Brasil, na perspectiva da Educação Interprofissional. Trata-se de uma pesquisa descritiva, exploratória e qualitativa realizada em universidades públicas. Doze docentes participaram de entrevista semiestruturada. Utilizou-se a análise de conteúdo e cinco categorias foram selecionadas: 1) Compromisso do ensino e do trabalho com a integralidade do cuidado; 2) Aprimoramento do ensino, pesquisa e extensão na perspectiva da educação interprofissional; 3) Atuação integrada entre os profissionais da Saúde; 4) Necessidade de desenvolvimento docente alinhado aos princípios da educação interprofissional; e 5) Educação Permanente em Saúde como estratégia indutora do ensino e prática interprofissional. A Educação Interprofissional é um campo robusto e complexo. Logo, é fundamental uma prática docente capaz de empreender processos formativos inovadores, induzindo mudanças que impactem positivamente a formação e o trabalho em saúde.(AU)
Resumen Análisis de los desafíos de la formación desarrollada por los docentes que actúan en cursos de enfermería en la región norte de Brasil, desde la perspectiva de la educación interprofesional. Se trata de una investigación descriptiva, exploratoria y cualitativa realizada en universidades públicas. Doce docentes participaron en la entrevista semiestructurada. Se utilizó el análisis de contenido y se seleccionaron cinco categorías: 1) Compromiso de la enseñanza y del trabajo con la integralidad del cuidado; 2) Perfeccionamiento de la enseñanza, investigación y extensión desde la perspectiva de la educación interprofesional; 3) Actuación integrada entre los profesionales de la salud; 4) Necesidad de desarrollo docente alineado a los principios de la educación interprofesional; y 5) Educación permanente en salud como estrategia inductora de la enseñanza y de la práctica interprofesional. La educación interprofesional es un campo robusto y complejo. Por lo tanto, es fundamental una práctica docente capaz de emprender procesos formativos innovadores, induciendo cambios que impacten positivamente la formación y el trabajo en salud.(AU)
Abstract Study analyzing the challenges of training developed by teachers working in nursing courses in the Northern Region of Brazil, from the interprofessional education perspective. A descriptive, exploratory, qualitative research conducted in public universities in which twelve professors participated in a semi-structured interview. Content analysis was used, and five categories were selected: 1) Commitment to teaching and working with comprehensive care; 2) Improvement of teaching, research, and community extension from the perspective of interprofessional education; 3) Integrated action among health professionals; 4) Need for teaching development aligned to interprofessional education principles; 5) Continuing education in health as a strategy to induce interprofessional teaching and practice. Interprofessional education is a robust and complex field. Therefore, a teaching practice capable of undertaking innovative formative processes is key, inducing changes that positively impact training and work in health.(AU)
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Resumo O objetivo deste estudo foi identificar o papel dos/as agentes comunitários de saúde na implementação das ações de atenção primaria na pandemia da COVID-19 no município de Peruíbe, São Paulo. Trata-se de um estudo de caso qualitativo, orientado pela perspectiva teórica proposta por Lipsky, segundo a qual os burocratas de nível de rua (BNR) têm um papel central na implementação das políticas públicas. A ferramenta de pesquisa foi a entrevista semiestruturada, realizada com quatro BNR (dois agentes comunitários de saúde, um médico e uma enfermeira) e quatro gestores da saúde local. A análise dos discursos possibilitou identificar três dimensões da ação municipal no combate à crise sanitária: a organização do sistema de saúde; as atividades das/dos ACS; e a retomada da rotina da APS. Concluímos que os agentes comunitários tiveram um papel ativo nas diversas ações desenvolvidas localmente para o enfrentamento da COVID-19.
Abstract This study examined the role of community health workers in implementation of primary care actions during the COVID-19 pandemic in the municipality of Peruíbe, São Paulo, Brazil. This is a qualitative case study, guided by the theoretical perspective proposed by Lipsky, according to which street-level bureaucrats play a central role in policy implementation. The research tool was semi-structured interviews of two community health agents, a doctor, a nurse and four local health managers. Analysis of the transcripts identified municipal action in three dimensions to address the health crisis: health system organisation; community health workers' activities; and restoration of primary health care routines. Community health workers were found to play active roles in the various local measures to combat COVID-19.
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O relato descreveu o primeiro curso presencial visando capacitar profissionais de saúde pública na realização de vigilância genômica em tempo real, durante períodos pandêmicos. Relato de experiência sobre um curso teórico-prático com foco em pesquisa e vigilância genômica, incluindo tecnologias de sequenciamento móvel, bioinformática, filogenética e modelagem epidemiológica. O evento contou com 162 participantes e foi o primeiro grande treinamento presencial realizado durante a epidemia de covid-19 no Brasil. Não foi detectada infecção pelo SARS-CoV-2 ao final do evento em nenhum participante, sugerindo a segurança e efetividade de todas as medidas de segurança adotadas. Os resultados do evento sugerem que é possível executar capacitação profissional com segurança durante pandemias, desde que seguidos todos os protocolos de segurança.
The objective of this report was to describe the first face-to-face course aimed at training public health professionals in performing real-time genomic surveillance during the pandemic period. Experience report on a theoretical-practical course focusing on genomic research and surveillance, including mobile sequencing technologies, bioinformatics, phylogenetics and epidemiological modeling. There were 162 participants in the event and it was the first major face-to-face training course conducted during the COVID-19 epidemic in Brazil. No cases of SARS-CoV-2 infection was detected among the participants at the end of the event, suggesting the safety and effectiveness of all safety measures adopted. The results of this experience suggest that it is possible to conduct professional training safely during pandemics, as long as all safety protocols are followed.
Este estudio tuvo como objetivo describir el primer curso presencial para capacitar a los profesionales de la salud pública para llevar a cabo la vigilancia genómica en tiempo real durante los períodos de pandemia. Este es un informe de experiencia en un curso teórico-práctico centrado en la investigación y vigilancia genómica, que incluye secuenciación móvil, bioinformática, filogenética y tecnologías de modelado epidemiológico. Este evento contó con la asistencia de 162 participantes y fue la primera gran capacitación presencial realizada durante la epidemia de COVID-19 en Brasil. No se detectó infección por SARS-CoV-2 al final del evento en ningún participante, lo que sugiere la seguridad y efectividad de todas las medidas de seguridad adoptadas. Por lo tanto, los resultados del evento sugieren que es posible realizar entrenamientos profesionales de manera segura durante pandemias, siempre y cuando se sigan todos los protocolos de seguridad.
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Humans , Male , Female , Technology Transfer , Computational Biology/education , Health Human Resource Training , Professional Training , COVID-19/epidemiology , Brazil/epidemiology , Public Health , Health Personnel/education , Genomics/education , Epidemics , SARS-CoV-2/isolation & purification , COVID-19/geneticsABSTRACT
Objective:To understand the incentive effect and influencing factors of the current economic incentive policy for medical alliances in Longhua District of Shenzhen(the alliance for short) on doctors′ willingness to work at primary medical institutions(the primary for short) from the perspective of mental account, and to explore the economic incentive effect of different economic incentive distribution methods on doctors′ willingness to work at the primary.Methods:The questionnaire was designed based on mental account theory. Random sampling was made in November 2019 for a questionnaire survey among doctors in two district-level medical institutions of the alliance in Longhua District of Shenzhen. The purpose was to analyze their inclination to work at the primary and their selection preferences for economic incentive distribution methods under the current economic incentive policy. The data were analyzed by descriptive analysis, and the influencing factors of doctors′ willingness to work at the primary were analyzed by χ2 test and binary logistic regression. Results:A total of 254 valid questionnaires were collected with an effective recovery rate of 90.7%. Among the respondents, 189(74.4%) were willing to work at the primary, 168(66.1%) chose to receive the economic incentives specifically for working at the primary, and 148 people(58.3%) hoped to receive such economic incentives immediately. Education background, self-rated economic income level of doctors and different payment methods of economic incentive for working at the primary had significant effects on their willingness to work at the primary( P<0.05). Conclusions:The current economic incentive policy of the alliance can meet the demands for economic incentives in terms of doctors′ material accounts, and doctors′ overall inclination to work at the primary was strong. If the amount of economic incentives is constant, doctors preferred to receive the economic incentives specifically, mainly affected by income accounts and additional income accounts. In addition, education and self-assessment of economic income level were important factors affecting the willingness of doctors to work at the primary, which may be affected by mental accounts other than material accounts.
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Los cursos en línea masivos y abiertos han surgido como una estrategia pedagógica con un crecimiento exponencial en la última década. Han sido catalogados como la próxima evolución del aprendizaje a través de las redes, con la capacidad de romper las barreras hacia la formación académica y de promover habilidades, tanto teóricas como prácticas, en todas las áreas del conocimiento. El objetivo de este estudio consiste en exponer evidencia respecto a la utilidad de los cursos en línea en el desarrollo integral del estudiante y profesional de la salud. Se realizó una búsqueda no sistemática de la literatura, sin límite de fecha y hasta octubre del año 2020; se utilizaron términos como health personnel, health occupations students, distance education y massive open online courses, además de sinónimos combinados con los operadores AND y OR, en las bases PubMed, Science Direct y EBSCO. Los cursos en línea masivos y abiertos enfocados en el área de la salud, pueden ser una estrategia fuerte y efectiva para estimular un cambio educativo a nivel global, con el fin de mitigar las necesidades que actualmente azotan al mundo; además, la educación es la herramienta primordial para garantizar el crecimiento social, por lo tanto, si se refuerza el acceso al conocimiento para las poblaciones más vulnerables y grupos de cualquier edad, se puede esperar que el autocuidado y los estilos de vida saludable se conviertan en la prioridad de cada ser humano, y contribuyan a disminuir tasas de morbilidad, mortalidad y costos en salud(AU)
Massive open online courses have become an exponentially growing pedagogical strategy in the last decade. They have been categorized as the next evolution of network learning, with the capacity of breaking the barriers toward academic training, fostering theoretical and practical skills in all areas of knowledge. The purpose of this study is to present evidence of the usefulness of online courses for the comprehensive development of medical students and health professionals. A non-systematic search was conducted of the literature on the topic published in the databases PubMed, Science Direct and EBSCO on any date until October 2020, using search terms such as health personnel, health occupations students, distance education and massive open online courses, as well as their synonyms, combined with the operators AND and OR. Massive open online courses on health topics may be a strong, effective strategy to encourage a massive worldwide educational change aimed at mitigating the needs currently posed to the world. Education being the main tool to achieve social growth, if access to knowledge is reinforced among the most vulnerable populations of all age groups, it may be expected that self-care and healthy lifestyles will become a priority for all human beings, thus contributing to improve morbidity and mortality rates and reduce health care costs(AU)
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Humans , Male , Female , Health Personnel , Education, Distance/methods , Education, Continuing , Training Courses , Health Human Resource TrainingABSTRACT
ABSTRACT Objective. To identify patient- and provider-related factors associated with the success of multidrug-resistant tuberculosis (MDR-TB) treatment in the six municipalities of Colombia with the highest number of MDR-TB cases. Methods. Bivariate and multivariate logistic regressions were used to analyze the association between treatment success (cure or treatment completion) and characteristics of the patients and physicians, nursing professionals, and psychologists involved in their treatment. The importance of knowledge in the management of MDR-TB cases was explored through focus groups with these providers. Results. Of 128 cases of TB-MDR, 63 (49.2%) experienced treatment success. Only 52.9% of the physicians and nursing professionals had satisfactory knowledge about MDR-TB. Logistic regression showed that being HIV negative, being affiliated with the contributory health insurance scheme, being cared for by a male physician, and being cared for by nursing professionals with sufficient knowledge were associated with a successful treatment outcome (p ≤ 0.05). Qualitative analysis showed the need for in-depth, systematic training of health personnel who care for patients with MDR-TB. Conclusions. Some characteristics of patients and healthcare providers influence treatment success in MDR-TB cases. Physicians' and nurses' knowledge about MDR-TB must be improved, and follow-up of MDR-TB patients who are living with HIV and of those affiliated with the subsidized health insurance scheme in Colombia must be strengthened, as these patients have a lower likelihood of a successful treatment outcome.
RESUMEN Objetivo. Identificar los factores asociados con el éxito del tratamiento de tuberculosis multidrogorresistente (TB-MDR) relacionados con los pacientes y el personal sanitario en seis municipios de Colombia con mayor número de casos. Métodos. Mediante regresiones logísticas bifactorial y multifactorial se analizó la asociación entre el tratamiento exitoso (curación o cumplimiento del tratamiento) y las características de los pacientes, y de los médicos, profesionales de enfermería y psicólogos vinculados al tratamiento. Se exploró la importancia del conocimiento en el manejo de los casos de TB-MDR mediante grupos focales con esos profesionales. Resultados. De los 128 casos con TB-MDR, 63 (49,2%) tuvieron un tratamiento exitoso. Solo 52,9% de los médicos y profesionales de enfermería tenía conocimientos satisfactorios sobre TB-MDR. La regresión logística mostró que ser negativo al VIH, estar afiliado al régimen de aseguramiento de salud contributivo, estar atendido por un médico del sexo masculino y por profesionales de enfermería con conocimientos suficientes se asociaron con un desenlace exitoso del tratamiento (p ≤ 0,05). El análisis cualitativo mostró la necesidad de profundizar y sistematizar la capacitación del personal sanitario que atiende los casos de TB-MDR. Conclusiones. En el éxito del tratamiento de los casos de TB-MDR influyen algunas características de los pacientes y el personal sanitario. Se requiere fortalecer los conocimientos sobre TB-MDR de médicos y enfermeros, y reforzar el seguimiento de los pacientes con TB-MDR positivos al VIH y de los que pertenecen al régimen subsidiado, dada su menor probabilidad de éxito al tratamiento.
RESUMO Objetivo. Identificar os fatores associados ao êxito do tratamento da tuberculose multirresistente (TBMR) relacionados ao paciente e à equipe de saúde nos seis municípios da Colômbia com o maior número de casos. Métodos. Mediante regressão logística bifatorial e multifatorial, analisou-se a associação entre o êxito do tratamento (cura ou completude do tratamento) e as características dos pacientes e dos médicos, profissionais de enfermagem e psicólogos envolvidos neste. Explorou-se a importância do conhecimento no manejo de casos de TBMR mediante grupos focais com os mesmos profissionais. Resultados. Dos 128 casos de TBMR, 63 (49.2%) lograram êxito no tratamento. Somente 52.9% dos médicos e profissionais de enfermagem tinham conhecimentos satisfatórios sobre TBMR. A regressão logística demonstrou que soronegatividade para o HIV, cobertura pelo sistema de saúde sob o regime de contribuinte, atendimento por um médico do sexo masculino e atendimento por profissionais de enfermagem com conhecimento suficiente foram fatores associados ao êxito do tratamento (p ≤ 0,05). A análise qualitativa demonstrou necessidade de aprofundar e sistematizar a capacitação do pessoal de saúde que atende casos de TBMR. Conclusões. Algumas características do paciente e da equipe de saúde influenciam no êxito do tratamento de casos de TBMR. É preciso fortalecer os conhecimentos dos médicos e profissionais de enfermagem sobre a TBMR e reforçar o seguimento dos pacientes com TBMR que vivem com HIV e os filiados ao sistema de saúde colombiano pelo regime subsidiado, os quais têm menor probabilidade de êxito do tratamento.
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Humans , Male , Female , Adult , Middle Aged , Attitude of Health Personnel , Clinical Competence , Tuberculosis, Multidrug-Resistant/therapy , Remission Induction , Logistic Models , Cross-Sectional Studies , Treatment Outcome , ColombiaABSTRACT
ABSTRACT Objective: to analyze the teaching implications with the pedagogical training in a Technical School of SUS. Method: a qualitative study that has the Institutional Analysis as theoretical and methodological framework, Institutional Socio-Clinical modality, whose data were collected from July 2017 to August 2018, with 07 health professionals. Results: they were presented from two themes: implications of teachers with training: the old Technical School; New directions are evidenced in the implied behavior of teachers: a new Technical School? Final considerations: knowing the factors that hinder and facilitate the pedagogical training in health, and especially to clarify how the behaviors instituted opened loopholes for instituting movements present in that setting, revealing the nuances of a new institutionalization, contributed to the collective construction of strategies related to the training of new teachers.
RESUMEN Objetivo: analizar las implicaciones docentes con la formación pedagógica en una Escuela Técnica del SUS. Método: el estudio cualitativo, que tiene como referencial teórico y metodológico el Análisis Institucional en la modalidad Socioclínica Institucional, cuyos datos fueron recolectados en el período de julio de 2017 a agosto de 2018, con 07 profesionales de salud. Resultados: se presentaron a partir de las temáticas: las implicaciones de los docentes con el proceso de formación: la antigua Escuela Técnica; Los nuevos rumbos son evidenciados en el comportamiento implicado de los docentes: una nueva Escuela Técnica? Consideraciones finales: conocer los factores que dificultan y facilitan el proceso de formación pedagógica en Salud, y principalmente aclarar cómo los comportamientos instituidos abrieron brechas para movimientos instituyentes presentes en aquel escenario, revelando los matices de una nueva institucionalización, contribuyó a la construcción colectiva de estrategias relacionadas a la formación de nuevos docentes.
RESUMO Objetivo: analisar as implicações docentes com a formação pedagógica em uma Escola Técnica do SUS. Método: estudo qualitativo que tem como referencial teórico e metodológico, a Análise Institucional na modalidade Socioclínica Institucional, cujos dados foram coletados no período de julho de 2017 a agosto de 2018, com 07 profissionais de saúde. Resultados: foram apresentados a partir de duas temáticas: implicações dos docentes com o processo de formação: a antiga Escola Técnica; Novos rumos são evidenciados no comportamento implicado dos docentes: uma nova Escola Técnica? Considerações finais: conhecer os fatores que dificultam e facilitam o processo de formação pedagógica em Saúde e, principalmente, esclarecer como os comportamentos instituídos abriram brechas para movimentos instituintes presentes naquele cenário, revelando as nuances de uma nova institucionalização, contribuiu para a construção coletiva de estratégias relacionadas à formação de novos docentes.
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Adult , Female , Humans , Middle Aged , Professional Competence , Teaching/standards , Universities/organization & administration , Universities/statistics & numerical data , Brazil , Health Education/trends , Health Education/methods , Qualitative ResearchABSTRACT
Objetivou-se compreender as experiências de estudantes e profissionais em processo de formação com uma atividade vivencial em saúde mental, denominada Grupo Comunitário de Saúde Mental (GCSM) e os desdobramentos de sua apropriação no percurso de formação profissional. Adotou-se uma abordagem qualitativa, de natureza exploratória, tendo como instrumento a entrevista aberta. Participaram cinco estudantes e 10 profissionais em formação de diferentes áreas da saúde. Para a análise utilizou-se o método de Análise de Conteúdo Temática. Foram elaboradas duas categorias: O lugar profissional no GCSM; A horizontalidade das relações no GCSM. Considera-se que a proposta vivencial, presente no modelo do GCSM apresenta contribuições tanto do ponto de vista técnico da formação, quanto em relação ao desenvolvimento humano dos profissionais. Destaca-se que este estudo traz avanços para se pensar a formação realizada em serviços-escola no campo da saúde mental e que tal compreensão pode colaborar com a consolidação do modelo psicossocial de atenção.
The objective of this study was to understand the experiences of students and professionals in process of education in an experiential activity in mental health, named Mental Health Community Group (MHCG), and the unfolding of its appropriation throughout professional education. A qualitative exploratory approach was adopted, and open interviews were used as data collection instrument. Study participants were five students and 10 professionals studying in different healthcare areas. Analysis was conducted using the thematic content analysis technique. Two categories were created: The professional place in the MHCG, and The horizontality of relationships in the MHCG. The experiential proposal, in the MHCG model, presents contributions both from the technical point of view of education, and in relation to the human development of professionals. This study promotes reflection on the education provided in teaching services in the mental health area and this understanding can contribute to consolidate the psychosocial care model.
Se trató de comprender las experiencias de estudiantes y profesionales en proceso de formación con una actividad vivencial en salud mental, denominada Grupo Comunitario de Salud Mental (GCSM) y los desdoblamientos de su apropiación en el curso de formación profesional. Se adoptó un enfoque cualitativo, de naturaleza exploratoria, teniendo como instrumento la entrevista abierta. Participaron cinco estudiantes y 10 profesionales en formación de diferentes áreas de la salud. Para el análisis se utilizó el método de Análisis de Contenido Temático. Se elaboraron dos categorías: El lugar profesional en el GCSM y la horizontalidad de las relaciones en el GCSM. Se considera que la propuesta vivencial, presente en el modelo del GCSM ofrece contribuciones tanto desde el punto de vista técnico de la formación, como con relación al desarrollo humano de los profesionales. Se destaca que este estudio trae avances para pensar la formación realizada en servicios-escuela en el campo de la salud mental y que tal comprensión puede colaborar con la consolidación del modelo psicosocial de atención.
Subject(s)
Humans , Students , Mental Health , Health Personnel , Mental Health Assistance , Professional Training , Brazil , Interview , Qualitative ResearchABSTRACT
Objective To learn the effects of family supportive supervisors on medical staff turnover intention. Methods The scales of family supportive supervisor behavior scales, work-family conflict scale and turnover intention scale were used in the study. The data were collected from a questionnaire survey of 214 army tertiary hospitals′ medical staff during October to December 2017. Hierarchical regression analysis was used to establish a model to understand the influence of family supportive supervisor behavior, two-way conflict between work and family, using the independent variables, on turnover intention of medical staff. Results The and family supportive supervisor behaviors had a negative explanation to medical staff turnover intention ( β = - 0. 211, P < 0. 01), work interference with family had a positive explanation to it (β = 0. 358, P < 0. 01), family interference with work had an obscure explanation to medical staff turnover intention (β = 0. 104, P > 0. 05). Work interference with family had a partially mediating effect which influenced family supportive supervisor behaviors on medical staff turnover intention. Conclusions Family supportive supervisor behavior, as an organizational support, can effectively alleviate the work interference on family for medical staff and thus minimize their turnover intention.
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Abstract The objective of this article is to analyze the National Curricular Guidelines of medical courses based on Foucauldian discourse analysis. This analysis goes even deeper under the scope of health promotion presented by the National Health Promotion Policy (PNPS), since it is closely related to a comprehensive care proposal. The new National Curricular Guidelines are in accordance with PNPS, since it aims at a general, human, critical, reflective and ethical education that is able to prepare medical students to work with social responsibility and commitment to advocate for citizenship and human dignity in different levels of care in the health-disease process. On the other hand, the analysis reveals that, although there is an attempt to place graduates as active subjects in their educational process, there is no sign of inclusion of these social agents in the creation of their educational practices.(AU)
Resumo O objetivo deste artigo é realizar uma análise foucaultiana das Diretrizes Curriculares Nacionais (DCN) do curso de Medicina. Aprofunda-se essa análise no âmbito da promoção da saúde presente na Política Nacional de Promoção da Saúde (PNPS), por esta estar estreitamente relacionada à proposta de integralidade. As novas DCN estão em uníssono com o que se preconiza na PNPS, uma vez que se almeja uma formação geral, humanista, crítica, reflexiva, ética e capaz de atuar com responsabilidade social e compromisso com a defesa da cidadania e dignidade humana nos diferentes níveis da atenção do processo saúde-doença. Por outro lado, a análise revela que, embora exista a tentativa de situar o graduando como sujeito ativo no seu processo formativo, não há indicação de inclusão desse ator social na formulação de suas práticas formativas.(AU)
Resumen El objetivo de este artículo es realizar un análisis foucaultiano de las DCN para el curso de medicina. Se profundiza este análisis en el ámbito de la promoción de la salud presente en la Política Nacional de Promoción de la Salud (PNPS), por estar estrechamente relacionada a la propuesta de integralidad. Las DCN están en consenso con lo que se preconiza en la PNPS, una vez que se anhela una formación general, humanista, crítica, reflexiva y ética, capaz de actuar con responsabilidad social y compromiso con la defensa de la ciudadanía y la dignidad humana en los diferentes niveles de la atención. Por otro lado, el análisis revela que, aunque existe el intento de situar al graduado como sujeto activo en su proceso formativo, no hay indicación de inclusión de ese actor social en la formulación de sus prácticas formativas.(AU)
Subject(s)
Humans , Schools, Medical/trends , Curriculum/standards , Education, Medical, Undergraduate/trends , Health Policy , Students, Medical , Universities , Health PromotionABSTRACT
A Estratégia Saúde da Família (ESF) possui como uma de suas principais diretrizes a atenção à família.\r\nAlguns estudos vêm mostrando que os profissionais da ESF não conseguem trabalhar com a família,\r\ndificuldades estas associadas à falta de conhecimentos e habilidades. O objetivo do estudo foi compreender como os profissionais das equipes de saúde da família percebem sua formação para o trabalho com famílias na ESF. O estudo foi do tipo exploratório e descritivo com abordagem qualitativa. Os sujeitos foram médicos, enfermeiros, técnicos em enfermagem e agentes comunitários de cinco unidades de saúde da família. A coleta de dados foi através de grupo focal e os dados foram analisados pela análise\r\nde conteúdo temática. Observou-se que a formação dos profissionais de saúde ainda está muito centralizada na formação clínica e a ESF é vista de forma pontual. Mesmo com investimentos na formação\r\nem saúde, esta ainda não engloba aspectos essenciais para se trabalhar nesse cenário.
The Family Health Strategy (FHS) has as one of its main directives attention to the family. Some studies come showing that the professionals of the ESF do not obtain to work with the family, diffi culties these associates to the lack of knowledge and abilities. The study objective was to understand how the professionals of family health perceive their training to work with families in the FHS. The study was an exploratory and descriptive qualitative approach. Study subjects were physicians, nurses, nursing technicians and community workers of five units of health of the family. Data collection was carried through focus groups and data were analyzed using the technique of thematic content analysis. It was noted that training of health professionals is still very centered on clinical training and ESF is seen in a timely manner and shifted the practice services. Same with investments in the formation in health, this not yet engloba aspects essential to work in this scene
La Estrategia de Salud de la Familia (ESF) tienen como uno de sus principales la atención a las directrices\r\nde la familia. Algunos estudios vienen demostrando que los profesionales del ESF no obtienen para\r\ntrabajar con la familia, las dificultades estos asociados a la carencia del conocimiento y las capacidades.\r\nEl objetivo del estudio era comprender cómo los profesionales de la salud de la familia consideran su\r\nformación para trabajar con familias de la ESF. El estudio fue un enfoque cualitativo, exploratorio y descriptivo. Los sujetos del estudio fueron los médicos, enfermeros, técnicos y trabajadores comunitários\r\nde cinco unidades de salud de la familia. La recolección de datos se realizó a través de grupos focales\r\ny los datos fueron analizados mediante la técnica de análisis de contenido temático. Se observó que la\r\nformación de profesionales de la salud es todavía muy centrada en la formación clínica y el ESF se ve\r\nde una manera oportuna. Iguales con inversiones en la formación en salud, aspectos de este no todavía\r\nengloba esenciales trabajar en esta escena.
Subject(s)
Humans , Family , Evaluation Studies as Topic , Family Health , Epidemiology, Descriptive , Staff DevelopmentABSTRACT
RESUMO O estudo teve como objetivo avaliar a efetividade da atenção primária, identificando as distinções entre os modelos de serviços com estratégia saúde da família em comparação a unidades básicas tradicionais, com e sem profissionais do programa mais médicos.Pesquisa quantitativa, avaliativa, realizada com 128 profissionais - médicos, enfermeiros e coordenadores de unidades de atenção primária, por meio do instrumento Primary Care Assessment Tool (PCATool - Brasil), versão profissionais de saúde, em 2015 e 2016eadotou análise estatística inferencial. Os resultados indicaram escores acima de 6,6 naquelas unidades que adotam a estratégia saúde da família e abaixo do ponto de corte nas unidades básicas de saúde tradicionais.Coordenação - sistemas de informações (5,8) e longitudinalidade (6,2) mostraram baixa efetividade dos serviços na unidade tradicional. O acesso obteve baixo escore (4,0), em ambos os modelos.A avaliação da APS nos distintos modelos de atenção revelou que as ações e serviços em saúde oferecidos no município foram mais efetivos quando executados em unidades de ESF, em comparação a UBS tradicional, independentemente da presença de profissionais do programa mais médicos.
RESUMEN El estudio tuvo como objetivo evaluar la efectividad de la atención primaria, identificando las distinciones entre los modelos de servicios con estrategia salud de la familia (ESF) en comparación a unidades básicas (UBS) tradicionales, con y sin profesionales del programa "mais médicos". Investigación cuantitativa, evaluativa, realizada con 128 profesionales - médicos, enfermeros y coordinadores de unidades de atención primaria (APS), por medio del instrumento Primary Care Assessment Tool (PCATool - Brasil), versión profesionales de salud, en 2015 y 2016 y adoptó el análisis estadístico inferencial. Los resultados indicaron puntuaciones arriba de 6,6 en aquellas unidades que adoptan la estrategia salud de la familia y abajo del punto de corte en las unidades básicas de salud tradicionales. Coordinación - sistemas de informaciones (5,8) y longitudinalidad (6,2) demostraron baja efectividad de los servicios en la unidad tradicional. El acceso obtuvo baja puntuación (4,0) en ambos los modelos. La evaluación de la APS en los distintos modelos de atención reveló que las acciones y los servicios en salud ofrecidos en el municipio fueron más efectivos cuando ejecutados en unidades de ESF, en comparación a UBS tradicional, independientemente de la presencia de profesionales del programa "mais médicos".
ABSTRACT The study had as objective to evaluate the effectiveness of primary care, identifying the distinctions between the models of services with the family health strategy in comparison to traditional basic units, with and without professionals of the program more medical. Quantitative research, evaluative, performed with 128professionals -physicians, nurses and coordinators of primary care units, by means of the instrument Primary Care Assessment Tool (PCATool - Brazil) version to health professionals, in 2015 and 2016 and adopted inferential statistical analysis. The results indicated scores above 6.6 on those units that adopt the family health strategy and below the cut-off point in the basic units of traditional health. Coordination- information systems (5.8) and longitudinally (6.2) showed low effectiveness of services in traditional health units. The access obtained a low score (4.0), in both models. The evaluation of the primary care in different models of services revealed that the health actions and services offered in the municipality were more effective when performed in family health units, in comparison to traditional ones, regardless of the presence of professionals in the program more medical.
ABSTRACT
The multi-sited practices (MSP) policy in China is expected to exert found implications upon uneven distribution of high-quality medical resources,coupled with the widespread phenomenon of physician's informal practices on multiple sites.Since 2009,the Chinese government has upheld a policy that allows medical doctors to take on secondary jobs for the purpose of encouraging talented physicians to work in medical institutions and underdeveloped areas where their expertise is badly needed.This paper focuses on the MSP policy in China by examining how it has been implemented at the national and provincial levels through a review of government documents,statistical information,academic papers,and newspaper accounts.Despite the MSP policy is to offer incentive to physicians at first-tier public hospitals to work in primary care centers or areas where their expertise,the evidence is hard to find.This paper identifies several outstanding challenges to the MSP policy:(1) The importance of the MSP policy which is made by the central government is perceived differently at the provincial level by health officials and hospital administrators;(2) Interest in implementing the policy varies among physicians and hospitals;(3) Concerns about quality control and legal responsibilities for medical doctors to take on secondary jobs are widespread.China's MSP policy differs from the "dual practice" policy in many countries because of its top-down approach,with its emphasis on government's role and administrative intervention.This paper's findings may be useful for other developing countries where medical expertise is unevenly distributed due to market forces.On the special occasion of the Alma Ata Declaration's 40th anniversary and for the sake of promoting Universal Health Coverage,this paper also aims at sharing with other countries China's experience in trying to develop an adequate force of primary care professionals.At the end of this paper,a four-point proposal is made for policy makers in China.
ABSTRACT
Resumo O estudo teve por meta compreender o processo de implantação e acompanhamento da Estratégia Saúde da Família em um município do Rio Grande do Sul, utilizando como metodologia a pesquisa qualitativa. Foram entrevistados 16 gestores e analisadas fontes documentais no período de agosto de 2011 a maio de 2012. O material foi submetido à proposta operativa de análise. Verificou-se que a primeira gestão da Estratégia desencadeou um processo efervescente para transformar uma realidade considerada fragmentada e insuficiente, tendo optado por terceirização na contratação dos trabalhadores, participação da comunidade e educação permanente. A segunda gestão optou por fortalecer as unidades de pronto atendimento, sem a participação do controle social. Apareceram como fragilidades da Estratégia a gestão do trabalho e as escolhas da gestão municipal. A reestruturação da atenção básica, objetivo da Estratégia, foi postergada. Como conclusão, identificou-se a complexidade de se fazer gestão municipal do Sistema Único de Saúde e sedimentar a atenção básica como porta preferencial dos cidadãos.
Abstract The study aimed to understand the Family Health Strategy process implementation and monitoring at a municipality in the state of Rio Grande do Sul, Brazil, using as qualitative research methodology. Sixteen managers were interviewed and documentary sources analyzed in the period ranging from August 2011 to May 2012. The material was submitted to the operative analysis proposal. It was noted that the first management team of the strategy triggered an effervescent process of transformation of a reality considered as fragmented and insufficient, having opted for outsourcing in worker hiring, for community participation, and for permanent education. The second management team chose to strengthen the emergency units, with no participation of social control. Work management and the municipal management's choices were Strategy weaknesses. The restructuring of primary care, which the Strategy aimed at achieving, was postponed. In conclusion, the study showed the complexity of undertaking the municipal management of the Unified Health System and of sedimenting primary care as the citizens' preferred port.
Resumen El estudio tuvo como meta comprender el proceso de implantación y seguimiento de la Estrategia Salud de la Familia, en un municipio del estado de Río Grande do Sul, Brasil, utilizando como metodología la investigación cualitativa. Se entrevistaron 16 gestores y se analizaron fuentes documentales en el período de agosto de 2011 a mayor de 2012. El material se sometió a la propuesta operativa de análisis. Ser constató que la primera gestión de la estrategia desencadenó un proceso efervescente para transformar una realidad considerada fragmentada e insuficiente, optando por la tercerización en la contratación de los trabajadores, participación de la comunidad y educación permanente. La segunda gestión optó por fortalecer las unidades de primeros socorros, sin la participación del control social. Aparecieron como fragilidades de la Estrategia la gestión del trabajo y las selecciones de la gestión municipal. La reestructuración de la atención básica, objetivo de la Estrategia, fue postergada. Como conclusión, se identificó la complejidad de la gestión municipal del Sistema Único de Salud y sedimentar la atención básica como puerta preferencial de los ciudadanos.
Subject(s)
Humans , Unified Health System , Health Management , National Health Strategies , Health WorkforceABSTRACT
Em 2013, chegaram os primeiros médicos pelo Programa Mais Médicos. O seu processo de implantação foi cercado de disputas judiciais e embates ideológicos advindos de médicos brasileiros e suas entidades representativas. A iniciativa de criação do programa foi creditada pelas entidades médicas como uma medida unilateral do Governo Federal, eleitoreira e sem planejamento. O artigo resgata o processo histórico que deu origem ao Programa Mais Médicos, destacando a tensão entre governo e entidades médicas. Trata-se de estudo exploratório com pesquisa bibliográfica e documental. Analisando dados e tendências nacionais e internacionais e discursos de médicos e suas entidades representativas, é possível inferir que o programa não está sendo compreendido na sua totalidade, que vai além da provisão imediata de médicos. Além disso, o papel regulador do Estado para cumprir a Constituição Federal está sendo confundido com interferência na autonomia da profissão médica.(AU)
In 2013, the first physicians arrived for the More Doctors Program. The process of implementation was engulfed in legal disputes and ideological conflicts sparked by Brazilian physicians and their representative associations. The initiative to create the program was seen by the medical associations as a unilateral measure of the federal government, lacking in planning and designed to win votes. This paper presents the historical process that gave rise to the program, highlighting the tension between the government and medical associations. It is an exploratory study with biographical and documental research. Through analyzing data and national and international trends, as well as statements from physicians and their representative associations, it can be inferred that the program is not understood in its entirety, which goes beyond the immediate provision of physicians. In addition, the regulatory role of the State, in its responsibility to comply with the Federal Constitution, is being misinterpreted as undermining the autonomy of the medical profession.(AU)
En 2013 llegaron los primeros médicos del Programa Más Médicos. Su proceso de implantación estuvo cargado por disputas judiciales y embates ideológicos provenientes de médicos brasileños y sus entidades representativas. La iniciativa de creación del Programa fue considerada por las entidades médicas como una medida unilateral del Gobierno Federal, con fines electorales y sin planificación. El artículo rescata el proceso histórico que dio origen al Programa, destacando la tensión entre gobierno y entidades médicas. Se trata de un estudio exploratorio con investigación bibliográfica y documental. Analizando datos y tendencias nacionales e internacionales y discursos de médicos y sus entidades representativas, es posible inferir que el Programa no se ha entendido en su totalidad, que va más allá de la provisión inmediata de médicos. Además, el papel regulador del estado para cumplir la Constitución Federal se está confundiendo con interferencia en la autonomía de la profesión médica.(AU)
Subject(s)
Humans , Health Workforce , Health Planning , National Health Programs , Physicians Distribution , Health Policy , Brazil , Internship and Residency , Program EvaluationABSTRACT
In China's new healthcare reform, the pilot local governments explore the practice of establishing a new model of hierarchical diagnosis and treatment system.Zhejiang Province has adopted a special policy of effectively allocating hospital resources and human resources, and efficiently improving primary healthcare institution capability and patient satisfaction(hereinafter referred to as double allocation, double improvement), focusing on the implementation of the 'Healthcare Talents Project', in order to fill a vacancy of human resources in primary healthcare institutions.This paper uses system dynamics modeling and the WISN method of WHO to estimate the gap in physician supply in primary healthcare institutions.After building the system dynamics model of 'Healthcare Talents Project', this paper simulates the influence of the policy on the vacancy of doctors in primary healthcare institutions and analyzes the sensitivity of regulatory factors.The simulation results show that, there are a big gap in physician supply of about 14,000 to build the hierarchical diagnosis and treatment system.The project can gradually increase the number of primary doctors, and the policy may fill the vacancy by 2021.However, if the efficiency of the hospital doctors who give assistance to primary institutions is increased by 10%, the targeted training and recruitment 100% achieve the policy plans and objectives, the project goal may be achieved by 2020.Therefore, this project can effectively adjust the human resources structure quickly and reasonably, and it can be used as reference for the reform of hierarchical diagnosis and treatment system.
ABSTRACT
Objective To study the present development of human resource allocation and development trends of traditional Chinese medicine.Methods Literature review was used to study the present development of such human resources in China.Results As of 2015, TCM institutions accounted for 4.73 percent of the total medical institutions in China, and Chinese medicine personnel accounted for 7.40 percent of the total medical workers in the country.The number of staff with education below undergraduate degree in TCM hospital accounted for 35.6% of the total.Conclusions Education level of TCM hospital staff is expected to elevate, and their education needs to respect the law of growth for such human resources and professional development.Continuing education calls for greater attention for elevation of the human resources in general.