Departamento de Gestão da Educação na Saúde Secretaria de Gestão do Trabalho e da Educação na...

Departamento de Gestão da Educação na Saúde

Secretaria de Gestão do Trabalho e da Educação na Saúde

Ministério da Saúde




Non-financial incentives

to support HRH

retention, productivity

and equitable

distribution Francisco Campos Ministry of Health, Brazil

The First Conference of The Asia Pacific Action Alliance on Human Resources for HealthOctober 28th to 30th 2006Bangkok, Thailand




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 therapy

72,000 hearth surgeries

132 million high-complexity procedures

12,000 organ transplants




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 population

86M people

Family Health Strategy (FHS)




Target and actual number of family health teams – Brazil, 1994 –2005

0

5.000

10.000

15.000

20.000

25.000

30.000

TARGET REACHED

TARGET 328 724 847 1.623 4.000 5.000 10.500 17.000 20.000 21.000 23.000 25.000 27.000 30.000

REACHED 328 724 847 1.623 3.083 4.254 8.604 13.168 16.698 19.068 21.232 23.499

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

FONTE: SIAB - Sistema de Informação da Atenção Básica

HFP strategy is growing up…




-

10,00

20,00

30,00

40,00

50,00

60,00

70,00

80,00

90,00

TARGET REACHED

TARGET 1,13 2,50 2,92 5,60 10,86 17,06 37,95 51,75 69,00 72,45 79,35 86,25

REACHED 1,13 2,50 2,92 5,60 10,64 14,68 29,68 45,43 54,93 59,72 69,10 75,67

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005


(x 1.000.000 hab.)

Target and actual population coverage by the family health teams – Brazil, 1994 –2005

FHP strategy is growing up…




1998 1999 2000 2001

2003 2004 2005*

0% 0 a 25% 25 a 50% 50 a 75% 75 a 100%

Actual coverage: % of population by the health family teams – Brazil, 1998 –2005


20022002

The rate of change




0% 0 a 25% 25 a 50% 50 a 75% 75 a 100%

Population: coverage 2005




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




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.




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).

ADDRESSING THE CHALLENGES IN URBAN AREAS




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).




CHALLENGE 2: RURAL AND REMOTE AREAS: TELE-HEALTH

TELEHEALTH comprises assistance and education components

Initial 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 Organizations

MOH 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.




To organize a system of consultancy and second opinion

To 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

TELE HEALTH OBJECTIVES




RNP

BACKBONE




8 Poles 800 sites

2.400 teams 10.000.000 people

Regions of implementation




Infrastructure of the Pole (University Hospitals)




Remote site technology (800 Units / FTH)







Ministry of HealthSecretariat of Management of Education and Work in Health

Francisco Camposwww.saude.gov.br/sgtes

[email protected]

Departamento de Gestão da Educação na Saúde Secretaria de Gestão do Trabalho e da Educação na...

Documents

Transcript of Departamento de Gestão da Educação na Saúde Secretaria de Gestão do Trabalho e da Educação na...