Trabalho, Educação e Saúde - TES (Work, Education and Health) is an open access scientific journal, edited by the Joaquim Venâncio Polytechnic School of Health, from Oswaldo Cruz Foundation.

More Doctors Program in a municipality at an international border and the challenges of management in health



Abstract

The technical cooperation among Latin American countries has been promoting great debates in the field of collective health and in the consolidation of labor management in the Brazilian Unified Health System (SUS, in the Portuguese acronym). The present paper had the goal of understanding the conceptions of Primary Health Care managers in a municipality located in a border region - which has been historically distant from the Brazilian sanitary reform movement - regarding the implementation of the “More Doctors” Program. The study is of a qualitative nature, and it was based on the hermeneutic-dialectic method, with an exploratory approach, and was conducted in the tri-border area of Brazil, Paraguay and Argentina. We performed open interviews that were recorded, transcribed and analyzed in an interpretive and dialectic manner in the empirical-conceptual context. In the understanding of the managers, the Program contributed to the continuance of the offer of services in the local Primary Health Care, and it is a way to ensure the provision of medical care in a municipality located in a border region. The Program also contributed to the co-responsibilization for the care. We observed a dialectic movement in the longitudinality attribute as well as in the difficulties to operationalize the binomial management-planning, demonstrating a contradiction in the operational praxis of the services. We concluded that, for the managers interviewed, the Program was an important strategy for the management of labor in health, even though there is a critical issue regarding the fleeting period these professionals remain in the Primary Health Care teams.

Keywords

international cooperation,
organization and administration,
primary health care

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