Analysis of the experience of Cuban physicians in a Brazilian metropolis in accordance with the Paideia Method. / Análise da experiência de médicos cubanos numa metrópole brasileira segundo o Método Paideia.

We had hoped that the Mais Médicos Program (More Doctors Program) would have generated several changes and reflections in each municipality in which it was deployed. In order to observe those changes, we sought to analyze the experience of Cuban physicians in the Mais Médicos program from an actor-centered perspective, based on the Paideia Method - an approach that seeks to enhance the ability of the subjects to analyze and intervene in their practice. We performed semi-structured interviews to analyze our research object that consisted in the experience of those actors included professionally in the Mais Médicos program in a metropolis with unique characteristics. In order to assess the interviews, we applied Content Analysis followed by Thematic Analysis. From the discourse of the actors, of which illustrative excerpts are transcribed in this article, we can affirm that the program's potential surpassed any initial barriers, presenting itself as fine-tuning instrument for replacing the biomedical model in line with the Paideia Method.

Análise da experiência de médicos cubanos numa metrópole brasileira segundo o Método Paideia / Analysis of the experience of Cuban physicians in a Brazilian metropolis in accordance with the Paideia Method

Resumo Esperávamos que o Programa Mais Médicos (PMM) tivesse provocado mudanças e reflexões diversas em cada município onde foi inserido. A fim de observar tais mudanças, buscamos analisar a experiência dos médicos cubanos de trabalho no PMM numa perspectiva centrada em atores, orientados pelo Método Paideia – metodologia que busca aumentar a capacidade dos sujeitos de analisar e intervir sobre a práxis. Lançamos mão de entrevistas semiestruturadas para perscrutar nosso objeto de pesquisa, que se constitui na experiência desses atores sociais inseridos profissionalmente no PMM numa metrópole com características singulares. Trabalhamos o material empírico instruídos pela Análise de Conteúdo e procedemos a Análise Temática. A partir do discurso dos sujeitos podemos dizer que as potencialidades do programa ultrapassaram barreiras iniciais, apresentando-se como uma ferramenta de tensão para a superação do modelo biomédico, em consonância com o método Paideia.

Abstract We had hoped that the Mais Médicos Program (More Doctors Program) would have generated several changes and reflections in each municipality in which it was deployed. In order to observe those changes, we sought to analyze the experience of Cuban physicians in the Mais Médicos program from an actor-centered perspective, based on the Paideia Method – an approach that seeks to enhance the ability of the subjects to analyze and intervene in their practice. We performed semi-structured interviews to analyze our research object that consisted in the experience of those actors included professionally in the Mais Médicos program in a metropolis with unique characteristics. In order to assess the interviews, we applied Content Analysis followed by Thematic Analysis. From the discourse of the actors, of which illustrative excerpts are transcribed in this article, we can affirm that the program's potential surpassed any initial barriers, presenting itself as fine-tuning instrument for replacing the biomedical model in line with the Paideia Method.

Was access to health care easy for immigrants in Spain? The perspectives of health personnel in Catalonia and Andalusia.

Until April 2012, all Spanish citizens were entitled to health care and policies had been developed at national and regional level to remove potential barriers of access, however, evidence suggested problems of access for immigrants. In order to identify factors affecting immigrants' access to health care, we conducted a qualitative study based on individual interviews with healthcare managers (n=27) and professionals (n=65) in Catalonia and Andalusia, before the policy change that restricted access for some groups. A thematic analysis was carried out. Health professionals considered access to health care "easy" for immigrants and similar to access for autochthons in both regions. Clear barriers were identified to enter the health system (in obtaining the health card) and in using services, indicating a mismatch between the characteristics of services and those of immigrants. Results did not differ among regions, except for in Catalonia, where access to care was considered harder for users without a health card, due to the fees charged, and in general, because of the distance to primary health care in rural areas. In conclusion, despite the universal coverage granted by the Spanish healthcare system and developed health policies, a number of barriers in access emerged that would require implementing the existing policies. However, the measures taken in the context of the economic crisis are pointing in the opposite direction, towards maintaining or increasing barriers.