Should I stay or should I go now? The impact of "pull" factors on physician decisions to remain in a destination country.

BACKGROUND: The recruitment and retention of a competent health care workforce is a worldwide problem. Globalization and increased mobility have provided skilled clinicians the freedom to offer their services in an interconnected global employment market, with multiple studies revealing a pattern of migration from low- and middle-income countries to high-income countries in North America, Western Europe, and more recently, the Middle East. The purpose of this study is to review the United Arab Emirates health care man power strategy and to assess the impact of pull factors on physician retention plans. METHODS: The study employed a mixed-method comparative approach, comprising a comprehensive review of the literature on human resources for health issues and physician migration patterns, along with a cross sectional survey of expatriate physicians working in private and public sectors in the United Arab Emirates (UAE) between November 2018 and March 2019. RESULTS: Of 479 physicians, 374 participated (79% response rate). Issues related to family and social life encouraged remaining in the UAE, including close proximity to extended family, social environment, and spouse's employment opportunities. The government's new policy to provide 10-year visas to health professionals was perceived as an important factor encouraging retention. Only 35% of respondents felt that their income was an important factor in deciding to remain in the UAE. Significant gender differences exist in physician migration decisions. CONCLUSION: Factors influencing retention of the UAE's expatriate physician workforce are primarily lifestyle-related. Physicians also report positive perceptions of newly implemented visa policies.

Remuneraciones, beneficios e incentivos laborales percibidos por trabajadores del sector salud en el Perú: análisis comparativo entre el Ministerio de Salud y la Seguridad Social, 2009 / Remunerations, benefits and labor incentives perceived by health care workers in Peru: an analysis comparing the Ministry of Health and the Social Insurance, 2009

Objetivos. Describir las principales características de la situación remunerativa general y las políticas de incentivos en los trabajadores del sector salud de Perú comparándolos de acuerdo con la institución de procedencia y a la modalidad de contrato. Materiales y métodos. Se realizó un estudio de diseño mixto que incluyó un abordaje cualitativo y componentes cuantitativos durante los años 2008 y 2009 sobre personal profesional y técnico del Ministerio de Salud (MINSA) y la seguridad social (EsSalud); evaluándose la estructura salarial considerando los incentivos, bonificaciones y remuneraciones de acuerdo al puesto de trabajo, modalidad de contrato e institución. Resultados. La política de remuneraciones y bonificaciones está determinada por los cargos y el tiempo de servicio. Las modalidades de contratación se rigen por los regímenes para el sistema público (DL 276) y el sistema privado (DL 728); el Contrato Administrativo de Servicios (CAS) y exclusivamente en el MINSA por los Comités Locales de Administración de Salud (CLAS). La estructura salarial difiere entre ambas instituciones, sobre todo en función a los incentivos y beneficios, siendo menores los ingresos en el MINSA. La Asignación Especial por Trabajo Asistencial (AETA) es propia del MINSA pero la proporción en que se da varía de acuerdo con la región. Los profesionales CAS tienen un menor salario que sus pares nombrados en el MINSA, contrario a lo que ocurre en EsSalud. Los ingresos más bajos se presentan en la modalidad CLAS. Conclusiones. Existe diferencia en la estructura y los montos salariales de acuerdo a la institución y al tipo de contrato suscrito.

Objective. To describe the main characteristics of the general salaries situation and the incentive policies of health care workers of Peru, comparing them by their origin institution and type of contract. Materials and methods. A mixed design study was done including both quantitative and qualitative components during 2008 and 2009 with both professional and technical personnel of the Ministry of Health (MINSA) and the Social Insurance (EsSalud) in Peru. The salary structure was primarily evaluated considering incentives, bonuses and other remunerations according to position, type of contract and work place. Results. Remuneration and bonus policies at the national level are determined by the responsibilities and amount of time served. The type of contract is determined by the programs of the public system (DL 276) and the private system (DL 728), also by the Special Program of Contract Services Administration (CAS) and exclusively in MINSA contracting is determined by local health administration Committees (CLAS). The salary structure differs between both types of institutions, especially with respect to incentives and benefits. An special economic incentive for assistance (AETA) is unique to MINSA, but the proportion of assistance varies by region. The professionals of MINSA have lower salaries than those of EsSalud, in all types of contracts. A professional contracted through CAS generally has a lower salary than staff peers in MINSA, though this situation is reversed in EsSalud. The lowest salaries are found in contracts made through CLAS. Conclusions. The structure and salary amounts differ between MINSA and EsSalud, just as they differ by existing contracting types.

Educação Permanente em Saúde (EPS): Ferramenta para Reestruturação de Componente Curricular do Curso de Graduação em Odontologia da UFPB / Permanent Education in Health: a Tool for Restructuring a Curricular Component of UFPB dentistry Graduation Course

Relatar a contribuição do processo pedagógico daEPS para a reestruturação da metodologia de trabalho docomponente curricular “Ética e Legislação Odontológica”,ministrado no 8º período da Graduação em Odontologia daUFPB. Material e Métodos: O Planejamento EstratégicoSituacional (PES) foi utilizado para identificação, qualificaçãodo problema e seleção de nós-críticos. A equipe de docentesfoi sensibilizada e juntos esses atores propuseram: utilizaçãomais freqüente de metodologias ativas; criação de espaços dediscussão, privilegiando a horizontalidade na construção doconhecimento; consulta a coordenação do curso pararedistribuir a carga horária semanal da disciplina e/ou torná-laconteúdo transversal. Resultados: Após 4 meses de intervenção(semestre 2010.01), constatou-se que o apoio dos docentes foifundamental, reforçando ferramentas – exposição de vídeos eestudos dirigidos – e introduzindo novas perspectivas –avaliação qualitativa e escuta qualificada dos alunos. A adesãodos alunos foi alcançada a partir do interesse e das falas dosmesmos quando da realização de críticas construtivas esugestões, sendo que uma dessas aponta para a maiordificuldade enfrentada: diluir as 4 horas semanais. Quanto aocontato com a coordenação do curso, optou-se por aguardar areformulação do Projeto Político Pedagógico do Curso.Conclusão: Percebe-se que o enfrentamento de problemas éuma valiosa ferramenta a ser trabalhada coletivamente, porémainda é preciso avançar, buscando articular novas parcerias,inclusive com setores externos à universidade...

To describe the contribution of EPS educationalprocess for the workflow restructure of curriculum component“Dental Ethics and Law” taught in the 8th period of UFPB’Graduate Dentistry. Material and Methods: Situational StrategicPlanning (ESP) was used for identification, qualification ofthe problem and selection of critical nodes. The teachers’ teamwas touched and together these actors have proposed: morefrequent use of active methodologies, creation of spaces fordiscussion, emphasizing the horizontality in knowledgeconstruction, consult the course coordinator to redistribute theweekly hours of discipline or make it a cross content. Results:After 4 months of intervention (first period of 2010), it wasfound that the support of teachers was crucial, enhancing tools(videos exhibition and study guides) and introducing newperspectives as qualitative assessment and qualified hearingof students. The students were engaged in and contributed byconstructive criticism and suggestions. They complained aboutthe greater difficulty faced: dilute 4 hours weekly. The course’coordination will be contacted at the moment of reformulationof our Political Educational Project. Conclusion: Theconfrontation of problems is a valuable tool to be worked outcollectively, but we still need to move forward, articulatingnew partnerships and also including some with sectors outsidethe university...

Programa de aprimoramento profissional em terapia ocupacional / Occupational therapy professional improvement program

Objetivo Apresentar a experiência do Programa de Aprimoramento Profissional de Terapia Ocupacional - Adulto I, realizado no Ambulatório de Terapia Ocupacional e no Hospital Maternidade Celso Pierro, da Pontifícia Universidade Católica de Campinas, através de convênio da Pontifícia Universidade Católica de Campinas com a Fundação de Desenvolvimento Administrativo e a Secretaria Estadual de Saúde do Estado de São Paulo. Métodos Estudo de natureza descritiva e qualitativa, realizado a partir de uma pesquisa bibliográfica que focalizou e analisou o tema aprimoramento profissional através do treinamento em serviço nos trabalhos apresentados em eventos científicos, nos artigos publicados em periódicos, nos projetos e relatórios elaborados pelos aprimorandos e pelos supervisores do Programa de Aprimoramento Profissional - Adulto I, bem como nos estudos existentes na base de dados do Programa de Aprimoramento Profissional da Fundação de Desenvolvimento Administrativo. Resultados O Programa de Aprimoramento Profissional - Adulto I desenvolveu diferentes ações/projetos de natureza multi e interdisciplinar, em diferentes contextos e níveis de complexidade de atenção, incluindo variados grupos de clientela, e permitiu a ampliação da capacidade de atendimento, o reconhecimento e a visibilidade da Terapia Ocupacional dentro do contexto dos serviços da universidade, do município e da região. Conclusão O Programa tem se mostrado uma importante política governamental de formação de recursos humanos e trouxe impactos positivos na qualificação dos terapeutas ocupacionais, contribuindo para a melhoria dos serviços prestados à população, de acordo com as diretrizes e princípios do Sistema Único de Saúde

Objective The objective of this study was to present the experience of the Occupational Therapy Professional Improvement Program - Adult I, done in the Occupational Therapy Outpatient Clinic of Hospital Maternidade Celso Pierro, of the Pontifical Catholic University of Campinas, under an agreement among the university, the Administrative Development Foundation and the Department of Health of the State of São Paulo. Methods This is a qualitative and descriptive-type study based on a bibliographical research that focused and analyzed the theme ?professional improvement through hands-on experience,? in works presented in scientific events, articles published in periodicals and projects and reports developed by the participants and supervisors of the abovementioned program, as well as in studies found in the database of the Professional Improvement Program of the Administrative Development Foundation. Results The Professional Improvement Program - Adult I developed different multidisciplinary and interdisciplinary actions/projects in different care contexts and complexity levels, dealt with varied user groups, and allowed an increase in the care capacity, recognition and visibility of Occupational Therapy within the context of the services offered by the university, city and region. Conclusion The Professional Improvement Program has proven to be an important governmental policy in the training of human resources and has positively influenced the qualification of occupational therapists, contributing to improve the quality of the services delivered to the population, in accordance with the guidelines and principles of the Unified Healthcare System

Políticas de formação de recursos humanos em saúde e enfermagem / Development policies of health and nursing human resources

O movimento sanitário trouxe ao cenário da educação demandas de formação em saúde orientada para atenção básica, tendo em vista o descompasso da atuação profissional diante das necessidades de saúde da população. Trata-se de pesquisa documental com objetivo de identificar no marco das Conferências Nacionais e de Recursos Humanos em Saúde, no período de 1986 a 2005, as políticas de formação de recursos humanos. Os resultados revelaram que o debate acerca da formação em enfermagem se inscreve nas seguintes categorias: marcos legais da formação em enfermagem; dimensão curricular na formação em saúde; perspectiva das metodologias de ensino-aprendizagem e capacitação de recursos humanos em saúde. Essa trajetória de debate assinala o caminho a percorrer na atualidade pelas diferentes instâncias de formação.

The sanitary movement brought about, in the educational setting, demands for health training focused on primary care, considering the inconsistency between professional practice and population health needs. This is a documental research with the objective to identify human resources development policies in National and Health Human Resources Conferences, in the period from 1986 to 2005. Results show that the debate concerning nursing education is presented in the following categories: legal landmarks in nursing education; curricular dimension of health education; perspectives of teaching-learning methods; and health human resources training. This course of debate shows the current path that different education instances should trail.

El movimiento sanitario trajo al escenario de la educación demandas de formación en salud orientada para la atención básica, teniendo en vista el descompaso de la actuación profesional delante de las necesidades de salud de la población. Se trata de una investigación documental con el objetivo de identificar en el marco de las Conferencias Nacionales y de Recursos Humanos en Salud, en el período de 1986 a 2005, las políticas de formación de recursos humanos. Los resultados revelaron que el debate sobre la formación en enfermería se inscribe en las siguientes categorias: marcos legales de la formación en enfermería; dimensión curricular en la formación en salud; perspectiva de las metodologías de enseñanza-aprendizaje y capacitación de recursos humanos en salud. Esa trayectoria de debate, señala el camino a recorrer en la actualidad por las diferentes instancias de formación.

Man power and organization of provincial preventive medicine centers in the northern provinces

Background: Investment to meet the man power requirements are recognized as urgent; especially to efficiently implement the National Strategy of Preventive Medicine. To strengthen the capability of provincial preventive medicine centers, the Ministry of Health has approved Decision No 05/2006QD-BYT for functions, tasks, authorization and organizational structure of Provincial Preventive Medicine Centers (PPMCs). Objectives: The study was conducted to evaluate the manpower and organization structure of northern PPMCs and provide recommendations for policy makers. Subjects and method: Using the cross-sectional descriptive method, the study covered the preventive medicine centers of 29 northern provinces between Jan to Jun 2007. The information was collected by interviews and self-reported questionnaires. Results:23/29 PPMCs have not met the criteria of man power stated in the Circular 08/2007/TTLB-BYT-BNV. Only 9/29 PPMCs were well organized in accordance with Decision 05/2006/QD-BYT of the Ministry of Health. The average number of staffs in PPMCs was 50+15. Medical staffs accounted for 53%, out of which 21.1% had postgraduate degrees; 32.2% had graduate degrees and 23.3% had been trained in preventive care. Conclusion: To meet the requirements provided by the Decision No05/2006QD-BYT, the man power and training for staffs in PPMCs should be improved and strengthened.