Apresentação em tema: "Ministry of Health, Brazil"— Transcrição da apresentação:
1 Ministry of Health, Brazil The First Conference ofThe Asia Pacific Action Alliance onHuman Resources for HealthOctober 28th to 30th 2006Bangkok, ThailandNon-financial incentives to support HRH retention, productivity and equitable distributionFrancisco CamposMinistry of Health, Brazil
2 Some important information about National Health System (SUS): Universal, equitable and holistic system included in the Constitution.Decentralized and socially controlled system.Provides comprehensive and free medical care to the whole population.82% coverage of influenza vaccination for elderly, rotavirus vaccination provided by SUS, improvements in health outcomes.Is a global reference for STD/AIDS – free public antiretroviral therapy72,000 hearth surgeries132 million high-complexity procedures12,000 organ transplants
3 Implemented in 84% of municipalities/counties (+/- 5,000) Family Health Strategy (FHS)Implemented in 84% of municipalities/counties (+/- 5,000)26K teams (1 physician, 1 dentist, 1 nurse, 1-2 aux. nurse, 6 CHW)Coverage: 50% of the Brazilian population86M people
4 Target and actual number of family health teams – Brazil, 1994 –2005 HFP strategy is growing up…Target and actual number of family health teams – Brazil, 1994 –2005FONTE: SIAB - Sistema de Informação da Atenção Básica
5 FHP strategy is growing up… Target and actual population coverage by the family health teams – Brazil, 1994 –2005(x hab.)FONTE: SIAB - Sistema de Informação da Atenção Básica
6 The rate of changeActual coverage: % of population by the health family teams – Brazil, 1998 –20051998199920002001200320042005*0%0 a 25%25 a 50%50 a 75%75 a 100%FONTE: SIAB - Sistema de Informação da Atenção Básica
7 Population: coverage 20050%0 a 25%25 a 50%50 a 75%75 a 100%
8 Family Health Program: Main Challenges (1) URBAN AREAS: Despite positive difference of salaries, professionals are reluctant to join FHP, due to “lack of prestige”(2) RURAL AREAS: A former federal program encouraging professionals to go to inner cities has failed. Professionals alleged lack of support (second opinion and continuous education) as the main reason for leaving
9 IMPROVING SELF-CONFIDENCE AND “PRESTIGE” OF FHT New professionals joining this area:MOH supports multi professional and Medical Residences in PHC (1K residents in 30 academic programs funded by MOH: US$15K/resident)Incentives to research and doctoral thesis in PHC – management and clinical guidelines and “consensus”Former specialists hired by NHS as FHT members:Incentives to Specialization in Family Health by academic institutions (2K specialists/year in 40 programs: US$3K/sp)Training Platform upgrade: from on-site courses to combined model including distance learningBelo Horizonte as role model: 1K professionals specialized in 2 years.
10 ADDRESSING THE CHALLENGES IN URBAN AREAS MOH has commissioned all the teaching capacity, but it is still insufficient to prepare 26K professionals.Multi Centric Network, to develop shared technologies, exchanges, technical cooperation, knowledge management, clearinghouse and guidelines, …Incentives to academia and professional associations to scale-up supply of specialized training in FHP, both as traditional on-site offer and Distance Learning (and combinations).
11 SYNERGIC PARALEL TRACKS: Assurance that FHT is a trustful and reliable policy and not merely a wishful thinking, a transitory commitment of a specific government or political party. It is a permanent state policy and it won’t change.Mass media communication: Assuring confidence in FHT as gatekeepers and responsible for improvements in health. Research institute find strong popular support towards this policy.Huge financial incentives to M/D/N schools to change their curricula to tackle social and epidemiological needs (PRO-SAÚDE).
12 CHALLENGE 2: RURAL AND REMOTE AREAS: TELE-HEALTH TELEHEALTH comprises assistance and education componentsInitial figure: It is possible to save 1:100 in direct and indirect costs (deployments, bad use of scarce resources, unnecessary examinations and prescriptions, work absenteeism).Institutional partnership: MOH, MOE, Communications, Science and Technology, Defense, Academia, Professional OrganizationsMOH joined the National Network of Research to bring hi-speed internet to all health centers (official protocol signed 4 days ago by 3 Ministers)PHC network will merge the UH already set University Hospital network.
13 TELE HEALTH OBJECTIVES To organize a system of consultancy and second opinionTo promote the use of tele-education health services (training, practical qualification, and evaluation of professional competencies)To promote the digital inclusion of Primary Health professionals