title: Emergency supply of doctors by the Mais Médicos (More Doctors) Program and the quality of the structure of primary health care facilities.
abstract: The health policy context in Brazil has featured a series of measures to improve primary health care (PHC), including a national access and quality improvement program (Programa Nacional de Melhoria do Acesso e Qualidade, PMAQ-AB) and the Mais Médicos Program (More Doctors, PMM) and upgrading PHC centers ('Requalifica UBS'). The paper examines the PMM's placement of doctors, by quality of PHC structure, in an endeavor to identify synergies among the three programs. It reports on a transverse study based on secondary data from PMAQ-AB Cycles 1 and 2, the PMM and 'Requalifica UBS'. The PHC facilities inventoried during PMAQ-AB Cycle 1 were classified, on pre-established typology, into five groups ranked from A (best) to E (failed). They were then compared in terms of PMM personnel allocated and Requalifica UBS proposals. The results point to convergences in investments by the three programs. Incentives targeted predominantly PHC facilities of types B and C, indicating a concentration of efforts on PHC facilities with potential for structural quality improvements. In addition to expanding access, the provision of doctors by the PMM, added to infrastructure upgrades and work process improvements, contributes to addressing high turnover and guaranteeing retention of doctors in PHC.
authors.affiliation: Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4036/1001, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil. giovanel@ensp.fiocruz.br.
authors.forename: Ligia
authors.initials: L
authors.lastname: Giovanella
authors.affiliation: Departamento de Administração e Planejamento em Saúde, Escola Nacional de Saúde Pública (ENSP), Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4036/1001, Manguinhos. 21040-361 Rio de Janeiro RJ Brasil. giovanel@ensp.fiocruz.br.
authors.forename: Maria Helena Magalhães de
authors.initials: MH
authors.lastname: Mendonça
authors.affiliation: Vice-direção de Escola de Governo em Saúde, ENSP, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Marcia Cristina Rodrigues
authors.initials: MC
authors.lastname: Fausto
authors.affiliation: Planejamento em Saúde, Universidade Federal Fluminense. Niterói RJ Brasil.
authors.forename: Patty Fidelis de
authors.initials: PF
authors.lastname: Almeida
authors.affiliation: Departamento de Prática de Saúde Pública, Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil.
authors.forename: Aylene
authors.initials: A
authors.lastname: Bousquat
authors.affiliation: ENSP, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Juliana Gagno
authors.initials: JG
authors.lastname: Lima
authors.affiliation: Vice-direção de Escola de Governo em Saúde, ENSP, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Helena
authors.initials: H
authors.lastname: Seidl
authors.affiliation: ENSP, Fiocruz. Rio de Janeiro RJ Brasil.
authors.forename: Cassiano Mendes
authors.initials: CM
authors.lastname: Franco
authors.affiliation: Departamento Intersindical de Estatística e Estudos Socioeconômicos. São Paulo SP Brasil.
authors.forename: Edgard Rodrigues
authors.initials: ER
authors.lastname: Fusaro
authors.affiliation: Departamento de Atenção Básica, Secretaria de Atenção à Saúde, Ministério da Saúde. Brasília DF Brasil.
authors.forename: Sueli Zeferino Ferreira
authors.initials: SZ
authors.lastname: Almeida
mesh_terms: D001938:Brazil; D003430:Cross-Sectional Studies; D004635:Emergency Medicine; D006078:Government Programs; D006268:Health Facilities / Q000592:standards*; D006801:Humans; D010820:Physicians / Q000600:supply & distribution*; D011320:Primary Health Care; D000078329:Workforce