[Dual practice in the Spanish health system: problem or solution? SESPAS Report 2024]. / La práctica dual público-privada en la sanidad española. ¿Solución o problema? Informe SESPAS 2024.

The Spanish public health system is overburdened. As a result, heath care professionals are showing symptoms of burnout, while private health services are expanding more than ever. As revealed by numerous strikes in recent years, health care professionals want better pay and work conditions and feel frustrated by their inability to give proper time and care to their patients. The institutional response from regional governments in Spain has been to remove the exclusivity clause that provided a salary bonus for physicians who worked entirely in the public sector; now all physicians receive this bonus, effectively promoting dual (public and private) practice. Although dual practice may increase the income of physicians and other health professionals, it poses several challenges that are analyzed in this paper. We also discuss alternative and more far-reaching policies that we believe should be implemented by the government in order to deal with the current crisis of the health system.

[The challenges of human resources governance in public healthcare. SESPAS Report 2024]. / Los retos de la gobernanza de los recursos humanos de la sanidad pública. Informe SESPAS 2024.

Recurrent imbalances between supply, demand and personnel needs are one of the main challenges facing the National Health System (NHS). This situation has its origin both in supply factors and in the conditioning factors of the demand for human resources in the public health sector. The demographic structure of the NHS health professionals is generating an increasing number of outflows of doctors and nurses. On the other hand, the complex institutional architecture of the public health system produces dysfunctions in the structure of demand and in the form of recruitment. This paper argues for the need to articulate a strategic response that addresses the improvement of the governance of the human resources of the NHS and the reform of the instruments of coordination and harmonization of actions at the three levels of government of public healthcare.

Distribución de nutricionistas en el sistema de salud peruano: un panorama por niveles de atención

La prestación de servicios para la atención integral de la salud requiere la participación de diversos profesionales con competencias específicas para brindar la mejor atención posible a la población. La inclusión del nutricionista en los diferentes niveles del sistema de salud es crucial para garantizar una atención integral en las diversas etapas de la vida. Una distribución inequitativa de nutricionistas en los niveles de atención puede conducir a una fragmentación de la atención y la pérdida de oportunidades para abordar los problemas relacionados con la alimentación y nutrición. Por ello, se desarrolló un estudio con el objetivo de describir la distribución de nutricionistas en los establecimientos de salud según el nivel de atención, y evaluar el cumplimiento de las recomendaciones de recursos humanos establecidas por la norma técnica de las UPSS de Nutrición y Dietética. Se desarrolló un estudio descriptivo y transversal, mediante el análisis de fuentes secundarias. Se utilizaron los datos de recursos humanos por IPRESS de SUSALUD, del año 2022. Se consideró la Norma técnica de UPSS de Nutrición y Dietética para evaluar el cumplimiento de las recomendaciones de recursos humanos. Entre los principales resultados, se identificó que el 7.93% de los establecimientos de salud del primer nivel de atención tienen al menos un nutricionista. En el segundo nivel de atención, el 96.35% de los establecimientos de salud no cumplen con las recomendaciones de recursos humanos de la norma técnica, y ningún establecimiento del tercer nivel de atención cumplió esta recomendación. La distribución de nutricionistas en los diversos niveles de atención del sistema de salud peruano es desigual. Es necesario mejorar la planificación de recursos humanos en el sistema de salud peruano para garantizar una atención integral de la salud a la población.

The provision of services for comprehensive healthcare requires the involvement of various professionals with specific competencies to provide the best possible care to the population. The inclusion of nutritionists at different levels of the healthcare system is crucial to ensure comprehensive care at various stages of life. An unequal distribution of nutritionists across healthcare levels can lead to fragmented care and missed opportunities to address nutrition-related issues. Therefore, a study was conducted with the aim of describing the distribution of nutritionists in healthcare facilities according to the level of care and evaluating compliance with the human resources recommendations established by the technical standard of Nutrition and Dietetics UPSS. A descriptive and cross-sectional study was conducted using the analysis of secondary sources. Human resources data from SUSALUD for the year 2022 were used. The Technical Standard of UPSS of Nutrition and Dietetics was considered to assess compliance with human resources recommendations. Among the main findings, it was identified that 7.93% of first-level healthcare facilities have at least one nutritionist. In the second level of care, 96.35% of healthcare facilities do not comply with the human resources recommendations of the technical standard, and no third-level healthcare facility met this recommendation. The distribution of nutritionists across various levels of care in the Peruvian healthcare system is unequal. It is necessary to improve human resources planning in the Peruvian healthcare system to ensure comprehensive healthcare for the population..

[Experiences in human resources planning for health: The case of physicians. Data and models. SESPAS Report 2024]. / Experiencias de planificación de recursos humanos para la salud. El caso de los médicos. Datos y modelos. Informe SESPAS 2024.

Virtually all developed countries conduct physician planning exercises. We can learn from successful experiences. The modeling and projection of supply is technically complex, but it is a technical matter, whereas the assessment of demand or need, and therefore the outcome in terms of deficit or surplus, requires standards, usually in population ratios, which are based on expert judgments and belong to the normative universe. One type of technical problem insufficiently solved is that of converting "heads" into full time equivalents. Fortunately, progress is being made in the right direction. We need more and better information, in particular the State Register of Health Professionals, but even with the limitations of the data, it is necessary to plan. The Ministry of Health, the Autonomous Regions and other professional and union organizations regularly carry out planning exercises. We have high rates of physicians and graduates, and low rates of nurses, a growing number of physicians in both public and private practice, and short-term deficits in some specialties, particularly family medicine, which urgently needs specific incentives to stimulate vocations. The numbers tell only part of the story. The imbalances in the educational and labor markets are not resolved by creating vacancies, but rather by reforming the regulatory framework, incentive systems and public management slack to compete with the private sector in attracting and retaining talent.

[Pay for performance in public directly managed healthcare centers. Part 1: General framework. SESPAS Report 2024]. / Evaluación del rendimiento y compensación en centros sanitarios de gestión directa. Parte 1: marco general. Informe SESPAS 2024.

Assessing and compensating performance in professional organizations is extremely difficult in direct public management settings of health services. Performance assessment is technically complex and, more so, with multiplicity of principals influencing goal setting. Incentives are a lever to generate directionality and motivation, both structural (for attracting and retaining workers) and specific ones (rewarding performance and directing behavior towards institutional goals). Incentives influence the behavior of workers in various ways, and their effectiveness seams weak and controversial in publicly run health services. To overcome the problems of deciding and evaluating performance, both good governance models and the revitalization of contractual management are required. To improve the effectiveness of incentive models, it is convenient to: 1) widen the conceptual framework of incentives, to incorporate the structural aspects of employment contract and payment; 2) improve the designs from a greater understanding of the determinants of motivation; and 3) broaden the lens to survey the extra-mural factors that alter the behavior of workers, trying to counter them.

[Pay for performance in public directly managed healthcare centers. Part 2: The Spanish National Health System. SESPAS Report 2024]. / Evaluación del rendimiento y compensación en centros sanitarios de gestión directa. Parte 2: el Sistema Nacional de Salud. Informe SESPAS 2024.

In Spain, the compensation model for statutory health personnel is complex, heterogeneous, and more oriented to rewarding complementary functions and activities, than to paying for the actual performance in the position of employee. The various attempts to incorporate incentives have been distorted by a civil service egalitarianist culture, and weak systemic governance. External attractors (private practice, etc.) for healthcare professionals are becoming more important and neutralize many intramural incentives. There are few prospects of relevant or general changes, since the main actors involved are reforms-averse; but some environmental factors can lead to incremental improvements in employment contracts, in the information available to improve benchmarking, and in the creation of islands of good clinical governance and management. The economic scenario, increasingly concerned about inflationary trends and sustainability risks, may have a revitalizing effect of some governance and management reforms.

Prioritization criteria in policies and management of human resources for health: a proposal for a validated methodology / Criterios para la asignación de prioridades en materia de políticas y gestión de recursos humanos para la salud: propuesta de una metodología validada / Critérios de priorização em políticas e gerenciamento de recursos humanos em saúde: proposta para uma metodologia validada

ABSTRACT Objective. To create and validate criteria for prioritizing problems related to policies and management of the health workforce. Methods. This methodological study was divided into three stages. First, the criteria were elaborated by means of a systematized literature review. Second, the criteria were evaluated online by a committee of judges comprised of eight specialists. In the third stage, an evaluation was carried out by the target audience in a hybrid workshop. The participants evaluated the material using the Suitability Assessment of Materials instrument, adapted for the research. Results. Three prioritization criteria (relevance, window of opportunity and acceptability) and a scoring scale were developed based on the literature review. In the evaluation by the committee of judges, the approval percentage of the criteria and prioritization method was 84%. Modifications were made based on suggestions in relation to the material presented to the specialists. In the pre-test stage, the approval percentage varied by item, with six of them reaching a maximum approval of 100% (corresponding to approximately 46% of the items), four reaching 92% and three achieving 83% each, indicating positive results. Conclusions. The developed criteria were considered valid for use in the context of policies and management in the area of human resources for health.

RESUMEN Objetivo. Crear y validar criterios para priorizar los problemas relacionados con las políticas y la gestión de los recursos humanos para la salud. Métodos. Este estudio metodológico se dividió en tres etapas. En la primera se elaboraron los criterios mediante una revisión sistematizada de la bibliografía. En la segunda un comité de ocho especialistas evaluó en línea los criterios. Y la tercera consistió en una evaluación por parte del público destinatario en un taller híbrido. Los participantes evaluaron el material utilizando el instrumento de evaluación de la idoneidad de los materiales, que fue adaptado para la investigación. Resultados. Sobre la base de la revisión de la bibliografía, se elaboraron tres criterios para la asignación de prioridades (relevancia, ventana de oportunidad y aceptabilidad) y una escala de puntuación. En la evaluación realizada por el comité de especialistas, el porcentaje de aprobación de los criterios y del método de asignación de prioridades fue del 84%. Se realizaron modificaciones basadas en sugerencias planteadas con respecto al material presentado a los especialistas. En la etapa posterior de prueba preliminar, el porcentaje de aprobación varió en los distintos puntos, de tal manera que en seis puntos (es decir, en aproximadamente el 46% de los puntos) se alcanzó una aprobación máxima del 100%, en cuatro una aprobación del 92% y en tres una aprobación del 83% en cada uno, lo que indica unos resultados positivos. Conclusiones. Se consideró que los criterios elaborados son válidos para su uso en el contexto de las políticas y la gestión en el ámbito de los recursos humanos para la salud.

RESUMO Objetivo. Criar e validar critérios para priorizar problemas relacionados a políticas e gerenciamento da força de trabalho em saúde. Métodos. O presente estudo metodológico foi dividido em três fases. Primeiro, foram elaborados critérios por meio de revisão sistematizada da literatura. A seguir, os critérios foram avaliados on-line por uma comissão de juízes composta por oito especialistas. Na terceira fase, o público-alvo fez uma avaliação dos critérios em uma oficina de formato híbrido. Os participantes avaliaram o material usando o instrumento Suitability Assessment of Materials, adaptado para esta pesquisa. Resultados. Com base na revisão da literatura, foram elaborados três critérios de priorização (relevância, janela de oportunidade e aceitabilidade) e uma escala de pontuação. Na avaliação da comissão de juízes, a porcentagem de aprovação dos critérios e do método de priorização foi de 84%. Foram feitas alterações com base em sugestões relacionadas ao material apresentado aos especialistas. Na fase de pré-teste, a porcentagem de aprovação variou de acordo com o item. Seis deles (aproximadamente 46% dos itens) atingiram aprovação máxima de 100%, quatro atingiram 92% e três atingiram 83%, indicando resultados positivos. Conclusões. Os critérios desenvolvidos foram considerados válidos para uso no contexto de políticas e gerenciamento na área de recursos humanos em saúde.

Estilos de liderazgo y desempeño laboral en médicos del Hospital Vitarte - Lima 2018

Objetivo: Determinar la relación entre los estilos de liderazgo y el desempeño laboral del personal médico del Hospital Vitarte Lima, en 2018. Métodos: Estudio descriptivo, correlacional y transversal. Se hizo un muestreo no probabilístico intencionado y se seleccionó a 64 trabajadores. La recolección de datos se hizo mediante un cuestionario previamente validado y un análisis de consistencia interna, por el alfa de Cronbach. Resultados: La estadística descriptiva determinó un 50% en el estilo de liderazgo democrático de las dimensiones y un nivel superior a 60% para el desempeño laboral. La estadística inferencial, mediante la prueba de hipótesis por el coeficiente de correlación de Spearman (rho = 0,85), evidenció una correlación positiva alta en ambas variables. Conclusión: Existe correlación positiva entre el estilo de liderazgo democrático de las dimensiones y el desempeño laboral, por lo que se recomienda la creación de proyectos de mejora de la calidad y capacitación en los trabajadores.

Objective: To determine the relationship between leadership styles and work performance of the medical staff of Hospital Vitarte Lima in 2018. Methods: Descriptive, correlational and cross-sectional study. A non-probabilistic purposive sampling was done and was selected 64 workers. The data collection was done through a previously validated questionnaire and internal consistency by Cronbach's alpha. Results: The descriptive statistics determined a 50% in the democratic leadership style of the dimensions and a level higher than 60% for job performance, the inferential statistics through the hypothesis test by Spearman's correlation coefficient (rho = 0.85) showed a high positive correlation in both variables. Conclusion: There is a positive correlation between the dimensions Democratic Leadership Style and work performance, so it is recommended the creation of quality improvement projects and training for workers.

Multiempleo en salud en provincia de Buenos Aires: estudio transversal de profesiones afectadas al cuidado de pacientes con COVID-19 / Multi-employment in health in the province of Buenos Aires: cross-sectional study of professions involved in COVID-19 patient care

RESUMEN INTRODUCCIÓN La pandemia de COVID-19 expuso el impacto del multiempleo en los servicios de salud. El objetivo de este estudio fue caracterizar el multiempleo en médicos y enfermeros que trabajaron en internación general y cuidados críticos durante la pandemia en la provincia de Buenos Aires. MÉTODOS Se realizó un estudio exploratorio, descriptivo y transversal. Los datos se recolectaron en el primer trimestre de 2021 con una encuesta estructurada anónima autoadministrada mediante muestreo no probabilístico en cadena. RESULTADOS El 96,3% de los médicos y el 68,1% de los enfermeros declararon estar multiempleados. La media de empleos fue 3,1 para médicos (entre 1 y 5) y 1,9 para enfermeros (entre 1 y 3). Los enfermeros declararon trabajos con mayor carga horaria, predominio del empleo público y contratación estable. Los médicos multiempleados manifestaron mayor diversidad en la forma de contratación. En ambas profesiones el multiempleo es motivado principalmente por razones de índole económica. DISCUSIÓN El multiempleo es difícil de medir mediante los registros oficiales. La proporción de multiempleo autorreportado en este estudio supera las cifras comunicadas por las estadísticas e informes oficiales. Aun así, las diferencias halladas entre médicos y enfermeros respecto al número de empleos son coincidentes con estudios previos. El problema del multiempleo requiere ser abordado desde la desprecarización del empleo, con mejoras en las condiciones económicas y de trabajo.

ABSTRACT INTRODUCTION The COVID-19 pandemic exposed the impact of multi-employment in health services. The objective of this study was to characterize multi-employment among physicians and nurses working in general hospitalization and critical care during the pandemic in the province of Buenos Aires. METHODS An exploratory, descriptive, cross-sectional study was conducted. Data were collected in the first quarter of 2021 with a structured anonymous self-administered survey using non-probabilistic chain sampling. RESULTS A total of 96.3% of physicians and 68.1% of nurses reported being multi-employed. The mean number of jobs was 3.1 for physicians (between 1 and 5) and 1.9 for nurses (between 1 and 3). Nurses reported having jobs with longer hours, mostly public and stable employment. Multi-employed physicians reported greater variety in the form of hiring. In both professions, multi-employment is mainly motivated by economic reasons. DISCUSSION Multi-employment is difficult to measure through official records. The proportion of self-reported multiemployment in this study exceeds the figures shown by official statistics and reports. The differences found between physicians and nurses regarding the number of jobs are still consistent with previous studies. The problem of multi-employment needs to be tackled by making employment less precarious, with improvements in economic and working conditions.

Odontologia UFES em 10 anos perfil profissional e sociodemográfico dos egressos / Odontología UFES en 10 años: perfil profesional y sociodemográfico de los egresados / Dentistry UFES in 10 years: professional and sociodemographic profile of graduates

Desde a sua regulamentação profissional, a Odontologia passou por muitas mudanças até sua consolidação. O aumento indiscriminado e sem planejamento da oferta de cursos de Odontologia resultou em um crescimento exagerado do número de profissionais no mercado de trabalho, culminando no atual momento de saturação e de acelerada reorganização do curso. Tais mudanças não se limitaram ao desenvolvimento tecnológico e científico. Observou-se, também, alteração no perfil do estudante e do profissional de odontologia no decorrer deste percurso, portanto essa pesquisa tem o objetivo de conhecer o perfil da força de trabalho dos profissionais graduados e verificar a inserção regional do Curso de Odontologia da Universidade Federal do Espírito Santo (UFES). Este estudo quantitativo de natureza descritiva e exploratória analisou o perfil profissional e sociodemográfico de 533 egressos do Curso de Odontologia da UFES entre 2008 e 2018, a partir do banco de dados do Conselho Regional de Odontologia do Espírito Santo e do DATASUS. Como resultados observou-se uma maioria feminina (70%), comidade entre 25-40 anos, ativos na Odontologia (85,1%), atuando no estado no setor privado. A maioria é formada por clínicos gerais (65,2%), mas existe uma tendência à especialidade que, quando presente, concentra-se na Ortodontia, Endodontia, Prótese e Implantodontia. Os resultados confirmaram a importante inserção regional do Curso de Odontologia da UFES no desenvolvimento local. Entretanto, apesar das Diretrizes Curriculares Nacionais direcionarem para um perfil generalista, voltado para a coletividade, constata-se maior tendência ao mercado privado, possivelmente pelos honorários mais atrativos (AU).

Desde su regulación profesional, la Odontología ha sufrido muchos cambios hasta su consolidación. El aumento indiscriminado y no planificado de la oferta de carreras de Odontología resultó en un crecimiento exagerado del número de profesionales en el mercado de trabajo, culminando en el momento actual de saturación y reorganización acelerada de la carrera. Tales cambios no se limitaron al desarrollo tecnológico y científico. También se observó un cambio en el perfil del estudiante y del profesional de odontología durante este curso, por lo que esta investigación tiene como objetivo conocer el perfil de la fuerza de trabajo de los profesionales graduados y verificar la inserción regional del Curso de Odontología en la Universidad Federal de Espírito Santo (UFES). Este estudio cuantitativo, descriptivo y exploratorio analizó el perfil profesional y sociodemográfico de 533 egresados de la Carrera de Odontología de la UFES entre 2008 y 2018, a partir de la base de datos del Consejo Regional de Odontología de Espírito Santo y DATASUS. Como resultado, hubo una mayoría femenina (70%), con edad entre 25-40 años, activa en Odontología (85,1%), trabajando en el estado en el sector privado. La mayoría está formada por médicos generales (65,2%), pero existe una tendencia a la especialización que, cuando está presente, se centra en Ortodoncia, Endodoncia, Prótesis e Implantología. Los resultados confirmaron la importante inserción regional de la Carrera de Odontología de la UFES en el desarrollo local. Sin embargo, a pesar de que los Lineamientos Curriculares Nacionales apuntan hacia un perfil generalista, dirigido a la comunidad, existe una mayor tendencia hacia el mercado privado, posiblemente por las tarifas más atractivas (AU).

Since its professional regulation, Dentistry has undergone many changes until its consolidation. The indiscriminate and unplanned increase in the offer of Dentistry courses led to a marked growth in the number of professionals in the job market, culminating in the current moment of saturation and accelerated reorganization of the course. Such changes were not limited to technological and scientific development; changes were also observed in the profile of students and dental professionals during this course. Thus, this study investigated the profile of the workforce of graduated professionals and verified the regional insertion of the Dentistry Course at the Federal University of Espírito Santo (UFES). This quantitative, descriptive and exploratory study analyzed the professional and sociodemographic profile of 533 graduates of the Dentistry Course at UFES between 2008 and 2018, based on the database of the Regional Dental Council of Espírito Santo and DATASUS. As a result, there was majority of females (70%), aged between 25-40 years, active in Dentistry (85.1%), working in the state in the private sector. The majority is formed by general practitioners (65.2%), but there is a tendency to specialize which, when present, focuses on Orthodontics, Endodontics, Prosthodontics and Implantology. The results confirmed the important regional insertion of the UFESDentistry Course in local development. However, despite the National Curriculum Guidelines directing towards a generalist profile, aimed at the community, there is a greater tendency towards the private market, possibly due to the more attractive incomes (AU).

El diálogo político sanitario para el fortalecimiento de enfermería en Uruguay / Health policy dialogue to strengthen nursing in Uruguay / Diálogo político-sanitário para o fortalecimento da enfermagem no Uruguai

RESUMEN Ese artículo presenta la experiencia del diálogo político sanitario en enfermería desarrollado en Uruguay en el 2021, con base en la teoría del cambio. Se realizaron cuatro mesas de trabajo, con participación de 725 personas. Los puntos discutidos incluyeron: que existe un déficit de enfermeros licenciados para el desarrollo de los programas y para la cobertura de las funciones en todos los niveles de la atención a salud; la falta de visibilidad del impacto asistencial de las actividades desarrolladas; los recursos financieros insuficientes para la formación de grado y posgrado y la baja integración de los enfermeros en equipos de gestión y en espacios políticos de toma de decisiones en el país. Los participantes manifestaron la necesidad de implementar el plan nacional de desarrollo de la enfermería con los objetivos de que el país: disminuya el déficit de profesionales; invierta en la creación de cargos para satisfacer la demanda de cuidados profesionales; mejore las dotaciones de personal en los servicios en todos los niveles de atención; mejore las condiciones de trabajo; genere nuevos espacios de inserción de enfermeros ampliando su rol, mediante capacitación de posgrado y mejore continuamente la calidad de la formación. Los participantes hicierón hincapié en la necesidad de aumentar la coordinación intersectorial en los ámbitos de la gobernanza, la regulación y la gestión, y de acelerar los esfuerzos para aumentar la inversión en los profesionales de salud en Uruguay.

ABSTRACT This article presents the experience of the health policy dialogue on nursing held in Uruguay in 2021, based on the theory of change. Four working groups were held, with the participation of 725 people. The points discussed included: the shortage of registered nurses to implement programs and cover functions at all levels of health care; the poor visibility of the healthcare impact of the activities carried out; insufficient financial resources for undergraduate and postgraduate training; and poor integration of nurses in management teams and policy decision-making spaces in the country. Participants expressed the need to implement the national nursing development plan so that the country can: reduce the shortage of professionals; invest in job creation to meet the demand for professional care; improve staffing of services at all levels of care; improve working conditions; create new spaces for nurses by expanding their role through postgraduate training, while continuously improving the quality of training. Participants emphasized the need to increase intersectoral coordination in the areas of governance, regulation, and management, and to step up efforts to increase investment in health professionals in Uruguay.

RESUMO Este artigo apresenta a experiência do diálogo político-sanitário sobre enfermagem realizado no Uruguai em 2021 com base na teoria da mudança. Foram organizados quatro grupos de trabalho, dos quais participaram 725 pessoas. Entre os pontos discutidos, destacam-se: a falta de profissionais graduados em enfermagem para desenvolver programas e cobrir funções em todos os níveis de atenção à saúde; a falta de visibilidade do impacto assistencial das atividades desenvolvidas; a insuficiência de recursos financeiros para programas de graduação e pós-graduação; e a pouca integração desses profissionais às equipes de gestão e aos espaços de tomada de decisão política no país. Os participantes indicaram a necessidade de implementar o plano nacional de desenvolvimento da enfermagem para que o país reduza o déficit de profissionais; invista na criação de cargos para atender à demanda por cuidados profissionais; melhore a dotação de pessoal nos serviços em todos os níveis de atenção; melhore as condições de trabalho; crie novas oportunidades de inserção para profissionais de enfermagem, ampliando suas funções por meio da pós-graduação; e aprimore continuamente a qualidade da formação. Os participantes enfatizaram a necessidade de aumentar a coordenação intersetorial nos aspectos de governança, regulação e gestão, bem como de acelerar os esforços no sentido de aumentar o investimento em profissionais de saúde no Uruguai.

La importancia del enfoque de género en la construcción de sistemas de salud resilientes, equitativos y universales / The importance of a gender focus in building resilient, equitable, and universal health systems / A importância da abordagem de gênero no desenvolvimento de sistemas de saúde resilientes, equitativos e universais

RESUMEN La pandemia de la enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) demostró la necesidad de reforzar el enfoque de género desde una perspectiva integradora y multisectorial para el abordaje de las problemáticas en salud. Este artículo busca destacar la importancia de incorporar y fortalecer el enfoque de género en las políticas de construcción de sistemas de salud resilientes, equitativos y universales. Con este objetivo, se aborda el papel de las mujeres en el sector de salud desde dos ámbitos. El primero da cuenta de las condiciones de acceso de las mujeres a los sistemas de salud de la Región de las Américas, donde resalta la necesidad de superar los obstáculos que impiden la realización plena de su derecho a la salud. El segundo plantea el papel preponderante de las mujeres en el mercado laboral del sector de salud, y la necesidad de aumentar su liderazgo en la toma de decisiones del sector. Por último, se hace un llamado para avanzar en la implementación de recomendaciones para fortalecer el enfoque de género y el papel de las mujeres en las políticas y los sistemas de salud.

ABSTRACT The coronavirus disease 2019 (COVID-19) pandemic demonstrated the need to strengthen the focus on gender from an integrative and multisectoral perspective to address health care problems. This article seeks to highlight the importance of incorporating and strengthening the gender focus in policies for building resilient, equitable, and universal health care systems. With this objective in mind, the role of women in the health sector is addressed from two directions. The first examines women's conditions of access to health systems in the Region of the Americas and highlights the need to overcome the obstacles that prevent the full realization of their right to health care. The second discusses the preponderant role of women in the health labor market, and the need to expand their leadership in decision-making in the sector. Finally, an appeal is made for progress in the implementation of recommendations to strengthen the focus on gender and the role of women in health policies and systems.

RESUMO A pandemia da doença do coronavírus de 2019 (COVID-19) demonstrou a necessidade de fortalecer a abordagem de gênero a partir de uma perspectiva integradora e multissetorial ao tratar das questões de saúde. Este artigo procura ressaltar a importância de incorporar e fortalecer a abordagem de gênero nas políticas para o desenvolvimento de sistemas de saúde resilientes, equitativos e universais. Com esse objetivo, este trabalho aborda o papel das mulheres no setor da saúde a partir de duas perspectivas. A primeira está ligada às condições de acesso das mulheres aos sistemas de saúde na Região das Américas, destacando a necessidade de superar os obstáculos que impedem o pleno exercício de seu direito à saúde. A segunda destaca o papel proeminente das mulheres no mercado de trabalho do setor da saúde e a necessidade de aumentar o seu papel de liderança na tomada de decisões no setor. Por fim, é feito um apelo para avançar com a implementação de recomendações destinadas a fortalecer a abordagem de gênero e o papel das mulheres nas políticas e sistemas de saúde.

Organización y división del trabajo: riesgos para trabajadores de servicios de salud en empresas venezolanas / Organization and division of labor: risks for health services workers in Venezuelan companies

Los modos de producción generan formas de organización y división del trabajo que puede ocasionar la aparición de riesgos psicosociales como la fatiga o el estrés laboral. El objetivo del presente estudio fue, evaluar los factores de riesgo psicosociales, la fatiga y el estrés laboral en profesionales integrantes de Servicios de Seguridad y Salud en el Trabajo, en cuatro empresas venezolanas en el 2020. Estudio de campo, descriptivo, de corte transversal. Participaron 39 trabajadores (muestra censal), 25,6% inspectores, 20,6% enfermeras y 20,6% personal médico. Se usó el cuestionario SUSESO/ISTAS21 versión breve, el cuestionario de Estrés Laboral OIT-OMS, el cuestionario de Síntomas Subjetivos de Fatiga y el cuestionario de Problemas Psicosomáticos. Resultados: Solo el 51% son del sexo masculino, promedio de edad de 35±8,7con antigüedad de 6±4,5años. Todos están bajo el tipo de contratación tercerizada (outsourcing). Resultó un trabajo de alta demanda, pero con alto control (trabajo activo). Niveles de riesgo medio (45%) vinculado al Apoyo Social y Calidad de liderazgo y nivel de riesgo alto (40%) en Compensaciones y Doble presencia. El trabajo es fatigante para el 30,7% y el estresor con mayor puntaje fue la Influencia del Líder. Concluyéndose que en estos servicios hay un número importante de profesionales femeninos, adultos jóvenes, con antigüedad laboral, expuestos a diferentes factores de riesgo psicosociales con importante influencia del líder, generadores de fatiga laboral. Recomendándose la revisión del tipo de contratación, la compensación dineraria, así como evaluaciones periódicas sobre el clima laboral(AU)

The modes of production generate forms of organization and division of labor that can cause the appearance of psychosocial risks such as fatigue or work stress. The objective of this study was to evaluate psychosocial risk factors, fatigue and work stress in professionals who are members of Occupational Health and Safety Services, in four Venezuelan companies in 2020. Descriptive, crosssectional field study. 39 workers (census sample) participated, 25.6% inspectors, 20.6% nurses and 20.6% medical personnel. The SUSESO/ISTAS21 short version questionnaire, the OIT-WHO Work Stress questionnaire, the Subjective Symptoms of Fatigue questionnaire and the Psychosomatic Problems questionnaire were used. Results: Only 51% were male, mean age 35 ± 8.7 with seniority age of 6 ± 4.5 years. All are under the outsourcing type of hiring. It turned out to be a high demand job, but with highly controlled (active work). Medium risk levels (45%) linked to Social Support and Leadership Quality, and high risk level (40%) in Compensations and Double presence. The work is tiring for 30.7% and the stressor with the highest score was the Influence of the Leader. It was concluded that in these services there are a significant number of female professionals, young adults, with seniority, exposed to different psychosocial risk factors with Important Leader Influence, generators of work fatigue. Recommending the review of the type of contract, the monetary compensation, as well as periodic evaluations of the work environment(AU)

[Field epidemiology in times of COVID-19: challenges for public health services. SESPAS Report 2022]. / Epidemiología de campo en tiempos de COVID-19: retos para los servicios de salud pública. Informe SESPAS 2022.

During the COVID-19 crisis, local epidemiology units have been forced to manage an increasing number of cases, contacts and outbreaks for which they were not previously prepared or staffed. Under normal circumstances, the efficient study and control of outbreaks and public health alerts requires human and material resources, situation analysis to identify possible causes and present recommendations, coordination with other health system structures, as well as the providing a written report including control and prevention measures implemented and their results or other recommendations. The field study of outbreaks has been systematized in a way that has made it possible to implement quick and effective measures, for the interruption of transmission chains and management of risk situations. To achieve this, a rapid and extraordinary exercise of digital integration, staff mobilization and creation of ad hoc structures needed to be carried out. Solidarity and cooperation between professionals from different administrations has been the pillar that has sustained the surveillance systems. Despite this, obstacles have been found as a result of the lack of coordination, social inequalities, and later, pandemic fatigue, which have reduced adherence and effectiveness of the implemented measures. It has also come to light the need to properly staff these units with trained professionals, and match working conditions and salaries with other health services.

The value of human resources: Experience of critical care nurses during the COVID-19 epidemic.

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. OBJECTIVE: To learn about the experience of nurses in caring for people with coronavirus in critical care units. METHOD: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. RESULTS: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". DISCUSSION: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. CONCLUSIONS: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

El valor del recurso humano: experiencia de profesionales enfermeros de cuidados críticos durante la pandemia por COVID-19 / The value of human resources: experience of critical care nurses during the COVID-19 epidemic

La pandemia por COVID-19ha supuesto una crisis sanitaria sin precedentes. La presión asistencial sobre el Sistema Nacional de Salud ha generado escenarios insólitos de demanda especialmente llamativos en algunos servicios o unidades asistenciales como las Unidades de Cuidados Críticos.Objetivo: Conocer la experiencia de los profesionales enfermeros referida a la atención de personas infectadas por coronavirus en las Unidades de Cuidados Críticos.Método: Estudio cualitativo de carácter fenomenológico que constituye la segunda fase de un proyecto de metodología mixta. Se realizaron entrevistas a 17 enfermeras que prestaron cuidados en Unidades de Cuidados Críticos a pacientes afectados de COVID-19. Las entrevistas fueron audiograbadas, transcritas y analizadas mediante análisis temático del discurso.Resultados: En este artículo se muestran los hallazgos en torno al tema «el valor del recurso humano» que matiza su significado a través de los subtemas «no son las camas, es el personal experto», «llevando la carga del paciente» y sufriendo por «no haber cuidado bien».Discusión: Los profesionales enfermeros expertos se erigen como profesionales líderes en el cuidado del paciente crítico durante la pandemia por COVID-19. Este liderazgo se ejerce desde un perfil enmarcado en una filosofía integradora donde sabiduría, agilidad e intuición son los elementos clave que dan soporte a la identificación y resolución de problemas de forma creativa adaptándose a las necesidades emergentes de los pacientes y equipo de cuidados.Conclusiones: Los profesionales enfermeros expertos han desempeñado un rol avanzado en la gestión de cuidados y de recursos humanos mediante el ejercicio de un liderazgo eficiente en el entorno clínico. Los cuidados se han visto mermados por la situación de crisis, circunstancia que les genera sufrimiento moral por no haber podido cumplir con los estándares de calidad y excelencia en el cuidado.

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units.Objective: To learn about the experience of nurses in caring for people with coronavirus in critical care units.MethodA qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis.Results: This article shows the findings around the theme “the value of human resources” which is nuanced through sub-themes “it's not the beds, it's the expert staff”, “shouldering the patient's burden”, and suffering because “they have not cared well”.Discussion: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge.Conclusions: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

Características laborales y académicas de los recursos humanos del sistema de salud en ocho países de Latinoamérica / Labor characteristics and postgraduate studies of human resources in health in eight Latin American countries

RESUMEN Introducción: la mayoría de las investigaciones muestran la situación de los recursos humanos del sistema de salud en países primermundistas, por lo que es necesario caracterizar nuestra realidad latinoamericana en este aspecto. Objetivo: caracterizar el tipo de trabajo y la formación de posgrado de los recursos humanos del área de salud en ocho países de Latinoamérica. Métodos: se realizó un estudio descriptivo a través de encuestas autoaplicadas sobre las características de los centros de labores y capacitaciones de posgrado que se han tenido. Resultados: de las 1.283 personas que respondieron la encuesta, el 87,1 % laboraba en un hospital (salario promedio mensual: 840 dólares), el 23,3 % también lo hacía en una clínica (salario promedio mensual: 1.200 dólares). Además, solo el 20,5 % trabajaba en un establecimiento del primer nivel de atención (salario promedio mensual: 420 dólares). El 31,2 % había realizado un curso de posgrado, el 23,2 % un diplomado, el 17,8 % una maestría y, el 5,1 %, un doctorado. Conclusiones: los recursos humanos en salud trabajan principalmente en hospitales con sueldos diferentes según el lugar donde laboran. Los médicos son los que tienen mayor remuneración, pero en el sector privado las diferencias son menos marcadas. Menos de la tercera parte han hecho cursos u otras actividades académicas culminadas hace ya varios años. Esto sirve para la mejora de las características laborales y de capacitación.

SUMMARY Introduction: Most research shows the situation of first world countries regarding human resources of health; therefore, it is necessary to characterize our Latin American reality. Objective: To characterize the type of work and postgraduate training of health human resources in eight Latin American countries. Methods: A descriptive study was carried out, through self-applied surveys on the characteristics of its work center, and post-graduate training that them has had. Results: Of the 1283 people who responded to the survey, 87.1% worked in a hospital (average monthly salary: 840 dollars), 23.3% also worked in a clinic (average monthly salary: 1200 dollars). In addition, only 20.5% worked in an establishment of the first level of care (average monthly salary: 420 dollars). 31.2% had completed a post-graduate course, 23.2% had a diploma, 17.8% had a master's degree and 5.1% had a doctoral degree. Conclusions: The human resources in health work mainly in hospitals and the salaries are different according to the place where they work. The physicians are those who have higher remuneration, but in the private sector the salaries are more similar than in the other sectors. Less than a third have taken courses or other academic activities, having been completed several years ago. This serves to improve the work and training characteristics.

Estratégias internacionais de flexibilização da regulação da prática de profissionais de saúde em resposta à pandemia da COVID-19: revisão de escopo / Estrategias internacionales de flexibilización de la regulación de la práctica de profesionales de salud en respuesta a la pandemia de la COVID-19: revisión de alcance / International strategies for flexibilization of the regulation of health workforce practices in response to the COVID-19 pandemic: a scoping review

A COVID-19 foi classificada como pandemia pela Organização Mundial da Saúde (OMS) em 11 de março de 2020. Diante da sua acelerada propagação, governantes, comunidades e serviços de saúde estão tendo que agir na mesma velocidade para ampliar a capacidade da força de trabalho em saúde. Este estudo objetivou, a partir do método revisão de escopo [scoping review], identificar as principais estratégias relacionadas a medidas de flexibilização de regulações que regem as práticas de profissionais de saúde que vêm sendo adotadas e/ou recomendadas internacionalmente. O estudo seguiu as etapas propostas pelo Instituto Joanna Briggs. Para a construção da questão de pesquisa, utilizou-se o método PCC (população, conceito e contexto). A busca se baseou nas seguintes bases de dados: PubMed, Scopus e Base de Dados da OMS; e na literatura cinzenta. Foram identificados 36 documentos, classificados nas seguintes estratégias: (1) ampliação de escopo de prática; (2) transferência de funções de uma categoria profissional para outra; (3) autorização para atendimento e faturamento via telemedicina; (4) licenciamento e recrutamento de profissionais não ativos; (5) recrutamento de profissionais de outras regiões/estado; (6) mudanças na formação e oferta de treinamento. Uma das estratégias mais importantes em resposta a situações de escassez de profissionais de saúde tem sido e a disponibilidade para adaptar, ampliar e redistribuir as atividades dos profissionais, de modo a atender as rápidas mudanças. Esta revisão reflete a importância em se realizarem reformas nas regulações profissionais de forma a otimizar a força de trabalho em saúde existente para que esta possa atender às demandas constantes de necessidade da população.

La COVID-19 fue clasificada como pandemia por la Organización Mundial de la Salud (OMS) el 11 de marzo de 2020. Ante su acelerada propagación, gobernantes, comunidades y servicios de salud están teniendo que actuar a la misma velocidad para ampliar la capacidad de la fuerza de trabajo en salud. Este estudio tuvo como objetivo, a partir del método revisión de alcance, identificar las principales estrategias relacionadas con medidas de flexibilización de regulaciones que rigen las prácticas de profesionales de salud que vienen siendo adoptadas y/o recomendadas internacionalmente. El estudio siguió las etapas propuestas por parte del Instituto Joanna Briggs. Para la construcción de la cuestión de investigación, se utilizó el método PCC (población, concepto y contexto). La búsqueda se basó en las siguientes bases de datos: PubMed, Scopus, Base de Datos de la OMS; y en la literatura gris. Se identificaron 36 documentos, clasificados en las siguientes estrategias: (1) ampliación de ámbito de práctica; (2) transferencia de funciones de una categoría profesional a otra; (3) autorización para atención y facturación vía telemedicina; (4) permisos y reclutamiento de profesionales no activos; (5) reclutamiento de profesionales de otras regiones/estado; (6) cambios en la formación y oferta de entrenamiento. Una de las estrategias más importantes en respuesta a situaciones de escasez de profesionales de salud ha sido la disponibilidad para adaptar, ampliar y redistribuir las actividades de los profesionales, de modo que atienda a cambios rápidos. Esta revisión refleja la importancia de que se realicen reformas en las regulaciones profesionales, de forma que se optimice la fuerza de trabajo en salud existente para que esta pueda atender a las demandas de necesidades constantes de la población.

COVID-19 was declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Given its rapid spread, governments, communities, and health services are having to act with the same speed to expand their health workforce capacity. Based on the scoping review method, this study aimed to identify the principal strategies related to measures for flexibilization of regulations on healthcare workers' practices that have been adopted and/or recommended internationally. The study followed the stages proposed by the Joanna Briggs Institute. The research question was developed with the PCC method (population, concept, and context). Searches were performed in PubMed, Scopus, WHO Database, and the gray literature. A total of 36 documents were identified, classified in the following strategies: (1) expansion of scope of practice; (2) shifting of roles from one professional category to another; (3) authorization for patient care and billing via telemedicine; (4) licensing and recruitment of inactive workers; (5) recruitment of workers from other regions/states; and (6) changes in basic training and supply of new training. One of the most important strategies in response to health workforce shortages has been the willingness to adapt, expand, and redistribute workers' activities to deal with rapid changes. This review reflects the importance of reforms in workforce regulation to optimize the existing health workforce so that it can meet the population's constant needs and demands.

Implementación del plan de acción de recursos humanos en salud y la respuesta a la pandemia por la COVID-19 / Implementation of the plan of action for human resources for health and the COVID-19 pandemic response / Implementação do plano de ação sobre recursos humanos para a saúde e a resposta à pandemia de COVID-19

RESUMEN Objetivos. Sistematizar y analizar las acciones de respuesta relacionadas con los recursos humanos en salud durante la pandemia reportadas por 20 países de la Región de las Américas en la evaluación de medio término del Plan de acción sobre recursos humanos para el acceso universal a la salud y la cobertura universal de salud 2018-2023 (Organización Panamericana de la Salud, 2018), y valorar la trascendencia de las políticas y la gestión de los recursos humanos expresadas en la Estrategia y el Plan de recursos humanos durante emergencias sanitarias y en tiempos normales. Métodos. Se seleccionaron y sistematizaron reportes sobre las acciones contra la COVID-19 y los recursos humanos en salud de 20 países de la Región. Se clasificaron las acciones en acciones inmediatas de contingencia, acciones relacionadas con capacidades instaladas y acciones emergentes. Resultados. Las capacidades de planificar y gestionar los recursos humanos en salud en los países dependen de las estructuras y competencias instaladas y funcionales. La pandemia visibilizó la necesidad de disponer de nuevos perfiles laborales, mejorar las condiciones laborales y contractuales precarias, visibilizar la perspectiva de género y solucionar brechas numéricas en determinadas áreas y niveles de atención. Conclusiones. La vinculación de acciones contra la COVID-19 con el monitoreo del Plan demostró la importancia de la gobernanza, la gestión y las capacidades instaladas en recursos humanos de salud para dar respuestas en emergencias sanitarias y en tiempos normales. El análisis invita a la revisión de las políticas públicas existentes, los modelos de atención necesarios para orientar las necesidades actuales y futuras de recursos humanos de salud, los perfiles requeridos, las condiciones laborales y la cobertura de brechas numéricas existentes, entre otros temas. La pandemia permitió innovaciones en los países para responder a la demanda. La Estrategia y el Plan siguen vigentes para orientar y fortalecer el desempeño de los recursos humanos en salud.

ABSTRACT Objectives. Systematize and analyze the response actions related to human resources for health during the pandemic, reported by 20 countries of the Region of the Americas in the mid-term evaluation of the Plan of Action on Human Resources for Universal Access to Health and Universal Health Coverage 2018-2023 (Pan American Health Organization, 2018), and assess the importance of the policies on human resources for health (HRH) and on HRH management expressed in the Plan of Action and in the Strategy on Human Resources for Universal Access to Health and Universal Health Coverage during health emergencies and in normal times. Methods. Reports on actions taken in 20 countries of the Region against COVID-19 and for HRH were selected and systematized. These were classified as immediate contingency actions, actions related to installed capacities, and emerging actions. Results. The capacity to plan and manage HRH in countries depends on their installed, functional structures and competencies. The pandemic highlighted the need to have new job profiles, improve precarious working and contractual conditions, emphasize the gender perspective, and address numerical gaps in certain areas and levels of care. Conclusions. Linking the monitoring of the Plan of Action with the COVID-19 response demonstrated the importance of HRH governance, management, and installed capacities when responding to health emergencies and in normal times. The analysis suggests a need to review existing public policies, models of care that can guide current and future needs in HRH, the profiles required, working conditions, and ways to close numerical gaps, among other issues. The pandemic enabled countries to innovate in response to demands. The Strategy and the Plan of Action remain in place to guide and strengthen the performance of human resources for health.

RESUMO Objetivos. Sistematizar e analisar as ações de resposta relacionadas aos recursos humanos para a saúde durante a pandemia, relatadas por 20 países da Região das Américas na avaliação intermediária do Plano de ação sobre recursos humanos para o acesso universal à saúde e a cobertura universal de saúde 2018-2023 (Organização Pan-Americana da Saúde, 2018), e avaliar a importância das políticas e da gestão de recursos humanos expressas na estratégia e no plano durante emergências de saúde e em tempos normais. Métodos. Foram selecionados e sistematizados relatórios sobre ações contra a COVID-19 e recursos humanos para a saúde de 20 países da Região. As ações foram classificadas em ações imediatas de contingência, ações relacionadas às capacidades instaladas e ações emergentes. Resultados. As capacidades de planejamento e gestão de recursos humanos para a saúde nos países dependem das estruturas e das competências instaladas e funcionais. A pandemia tornou visível a necessidade de ter novos perfis de trabalho, melhorar as precárias condições de trabalho e contratuais, tornar visível a perspectiva de gênero e solucionar lacunas numéricas em determinadas áreas e níveis de atenção. Conclusões. A vinculação das ações contra a COVID-19 com o monitoramento do plano demonstrou a importância da governança, da gestão e das capacidades instaladas relacionadas aos recursos humanos para a saúde, para responder a emergências de saúde e em tempos normais. A análise convida à revisão das políticas públicas existentes, dos modelos de atenção necessários para orientar as necessidades atuais e futuras dos recursos humanos para a saúde, os perfis exigidos, as condições de trabalho e a cobertura das lacunas numéricas existentes, entre outras questões. A pandemia permitiu inovações nos países para responder à demanda. A estratégia e o plano continuam vigentes para orientar e fortalecer o desempenho dos recursos humanos para a saúde.

Educación interprofesional en salud en la Región de las Américas desde la perspectiva de la enfermería / Interprofessional health education in the Region of the Americas from a nursing perspective / Educação interprofissional em saúde na Região das Américas na perspectiva da enfermagem

RESUMEN En este estudio se realiza un análisis reflexivo sobre la implantación de la educación interprofesional en cursos de pregrado de enfermería, considerando como ejemplo los planes de estudio de las carreras de pregrado en enfermería de Brasil. A pesar de las inversiones para avanzar en la educación interprofesional, su práctica no está institucionalizada en los planes de estudio de las carreras de pregrado. Estos hallazgos representan una limitación para la implementación de la educación interprofesional en los cursos de enfermería, y el caso de Brasil permite extraer enseñanzas de cara a la formación de profesionales de enfermería en otros países de la Región de las Américas. Se recomiendan medidas para la formación, la gestión y la articulación intersectorial de los servicios de salud y educación, con énfasis en la atención primaria de salud y los Objetivos de Desarrollo Sostenible, a las instituciones educativas que deseen implementar la educación interprofesional.

ABSTRACT This study presents a reflective analysis of the implementation of interprofessional education in undergraduate nursing courses, considering as an example the curricula of undergraduate nursing careers in Brazil. Despite investments to advance interprofessional education, its practice is not institutionalized in the curricula of undergraduate courses. These findings represent a limitation for the implementation of interprofessional education in nursing courses, and the case of Brazil allows to learn lessons for the education of nursing professionals in other countries of the Region of the Americas. Recommendations are provided for training, management and intersectoral articulation of health and education services, with emphasis on primary health care and the Sustainable Development Goals, aimed at educational institutions wishing to implement interprofessional education.

RESUMO Neste estudo, foi realizada uma análise reflexiva sobre a implementação da educação interprofissional em cursos de graduação em enfermagem, considerando como exemplo os currículos dos cursos de graduação em enfermagem no Brasil. Apesar dos investimentos para avançar a educação interprofissional, sua prática não está institucionalizada nos currículos de graduação. Esses achados representam uma limitação para a implementação da educação interprofissional em cursos de enfermagem, e o caso do Brasil fornece lições para a formação de profissionais de enfermagem em outros países da Região das Américas. Medidas de treinamento, gestão e articulação intersetorial de serviços de saúde e educação, com ênfase nos cuidados primários de saúde e nos Objetivos de Desenvolvimento Sustentável, são recomendadas para instituições educacionais que desejam implementar a educação interprofissional.