Provision and fixing of health professionals in basic care in difficult access contexts in the state of Amazonas

Submitted by ROZENILA DOLZANE (rozedolzane@hotmail.com) on 2019-12-06T01:46:09Z No. of bitstreams: 1 DISSERTA????O UFAM ROZE revisada.pdf: 1974924 bytes, checksum: 7b7f042197393d04204aa013f76df083 (MD5) Submitted by ROZENILA DOLZANE (rozedolzane@hotmail.com) on 2019-12-09T14:18:35Z No. of bitstreams: 4 DISSERTA????O UFAM ROZE revisada.pdf: 1974924 bytes, checksum: 7b7f042197393d04204aa013f76df083 (MD5) ATA DEFESA ROZENILA.pdf: 414769 bytes, checksum: 01d56f7b911252772b9df5fc5302afe2 (MD5) FICHA CATALOGRAFICA PPGSSEA.pdf: 1873 bytes, checksum: 76e6208e1a3d749c689e46fd16325e62 (MD5) Carta de Autodep??sito.pdf: 403280 bytes, checksum: 9b184cb9f439921ad91be25d9f44c677 (MD5) Approved for entry into archive by Sa??de, Sociedade e Endemias na Amaz??nia PPGSSEA (ppgssea@ufam.edu.br) on 2019-12-09T23:24:25Z (GMT) No. of bitstreams: 4 DISSERTA????O UFAM ROZE revisada.pdf: 1974924 bytes, checksum: 7b7f042197393d04204aa013f76df083 (MD5) ATA DEFESA ROZENILA.pdf: 414769 bytes, checksum: 01d56f7b911252772b9df5fc5302afe2 (MD5) FICHA CATALOGRAFICA PPGSSEA.pdf: 1873 bytes, checksum: 76e6208e1a3d749c689e46fd16325e62 (MD5) Carta de Autodep??sito.pdf: 403280 bytes, checksum: 9b184cb9f439921ad91be25d9f44c677 (MD5) Approved for entry into archive by Divis??o de Documenta????o/BC Biblioteca Central (ddbc@ufam.edu.br) on 2019-12-10T12:17:32Z (GMT) No. of bitstreams: 4 DISSERTA????O UFAM ROZE revisada.pdf: 1974924 bytes, checksum: 7b7f042197393d04204aa013f76df083 (MD5) ATA DEFESA ROZENILA.pdf: 414769 bytes, checksum: 01d56f7b911252772b9df5fc5302afe2 (MD5) FICHA CATALOGRAFICA PPGSSEA.pdf: 1873 bytes, checksum: 76e6208e1a3d749c689e46fd16325e62 (MD5) Carta de Autodep??sito.pdf: 403280 bytes, checksum: 9b184cb9f439921ad91be25d9f44c677 (MD5) Made available in DSpace on 2019-12-10T12:17:33Z (GMT). No. of bitstreams: 4 DISSERTA????O UFAM ROZE revisada.pdf: 1974924 bytes, checksum: 7b7f042197393d04204aa013f76df083 (MD5) ATA DEFESA ROZENILA.pdf: 414769 bytes, checksum: 01d56f7b911252772b9df5fc5302afe2 (MD5) FICHA CATALOGRAFICA PPGSSEA.pdf: 1873 bytes, checksum: 76e6208e1a3d749c689e46fd16325e62 (MD5) Carta de Autodep??sito.pdf: 403280 bytes, checksum: 9b184cb9f439921ad91be25d9f44c677 (MD5) Previous issue date: 2019-11-25 Introduction: The Unified Health System (SUS) was created as an organizational model to structure health policies in the country. However, despite the progress achieved after its implementation, there are still gaps to be filled in order to effectively incorporate health professionals in Primary Care (PH), especially in those locations farther from urban centers, as presented by the municipalities within the region. state of Amazonas. There is an issue of the provision and settling of health professionals in PH in areas of difficult access because it still represents a challenge for the state's public health policies, in relation to the populations that live in the most remote locations of the capital. Purpose: To analyze the provision and fixation of health professionals in PH in municipalities of Amazonas. Method: Cross-sectional, descriptive-analytical study with a quantitative and qualitative approach, which is part of a broader research called: ???The Scenario of Labor Management in the Amazon: setting and provision of health professionals in SUS???, with 397 professionals, from the PH of Amazonas??? 20 small towns. The professionals were interviewed through a questionnaire with closed and open questions. Descriptive statistics was used to assess the sociodemographic profile of the professionals and content analysis to interpret the interviews as well. Results: Medical professionals were appointed as facilitators of negative statistics regarding provision and settlement in Amazonas???s small towns. The positive highlights that justify that they could stay were family issues, good conditions of the place and the feeling of changes in the population's health. The challenges highlighted for the rotation of professionals were the salary issue, lack of infrastructure and geography of the place and the political issues. Conclusion: Effective health policies, practices aimed at professional qualification and enhancement, structuring of environments that offer health services, in addition, policies that support students from villages and small towns to take courses and, at the same time, expand vacancies of health courses in strategic locations in the state, these are actions that can contribute to the provision and establishment of professionals in places that are difficult to access. Introdu????o: O Sistema ??nico de Sa??de (SUS) foi criado como modelo organizacional para estruturar as pol??ticas de sa??de no pa??s. Contudo, apesar dos progressos alcan??ados ap??s sua implanta????o, ainda existem lacunas a serem preenchidas, para que haja a incorpora????o efetiva de profissionais de sa??de na Aten????o B??sica (AB), especialmente naquelas localidades mais distante dos centros urbanos, como se apresentam os munic??pios inseridos no estado do Amazonas. A quest??o do provimento e fixa????o de profissionais de sa??de na AB em ??reas de dif??cil acesso, ainda representa um desafio para as pol??ticas p??blicas de sa??de do estado, em rela????o ??s popula????es que residem nas localidades mais remotas da capital. Objetivo: Analisar o provimento e a fixa????o dos profissionais de sa??de na AB em munic??pios do Amazonas. M??todo: Estudo transversal, descritivo-anal??tico, de abordagem quantitativa e qualitativa, o qual faz parte de uma pesquisa mais ampla denominada: ???O Cen??rio da Gest??o do Trabalho no Amazonas: fixa????o e provimento de profissionais de sa??de no SUS???, com 397 profissionais da AB de 20 munic??pios do estado do Amazonas. Os profissionais foram entrevistados por interm??dio de question??rio com perguntas fechadas e abertas. Foi utilizada estat??stica descritiva para avaliar o perfil sociodemogr??fico dos profissionais e An??lise de Conte??do para interpreta????o das entrevistas. Resultados: Os profissionais de medicina foram apontados como facilitadores das estat??sticas negativas em rela????o ao provimento e fixa????o nos munic??pios. Os destaques positivos como motivos para perman??ncia foram quest??o familiar, as boas condi????es do local e o sentimento de modifica????es na sa??de da popula????o. Os desafios salientados para que haja a rotatividade dos profissionais foram, a quest??o salarial, falta de infraestrutura e geografia do local e as quest??es pol??ticas. Conclus??o: Pol??ticas de sa??de efetivas, pr??ticas voltadas para a capacita????o e valoriza????o profissional, estrutura????o dos ambientes que oferecem servi??os em sa??de, al??m disso, pol??ticas que valorizem as cotas e apoio para alunos dos munic??pios realizarem curso e, ao mesmo tempo, ampliar as vagas de cursos de sa??de em locais estrat??gicos do Estado, s??o a????es que podem contribuir com o provimento e a fixa????o de profissionais em locais de dif??cil acesso.