Historical legacies that influenced the formulation of the Mais Médicos Program and those derived from its implementation

• Autor(a) principal: Pinto, Hêider
• Data de Publicação: 2022
• Outros Autores: Lima, Ana Maria
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Baiana de Saúde Pública (Online)
• Texto Completo: https://rbsp.sesab.ba.gov.br/index.php/rbsp/article/view/3572
• topic: Recursos humanos em saúde; Educação médica; Política pública; Recursos humanos en salud; Educación médica; Política pública; Human resources for health; Medical education; Public policy

This paper analyzes the trajectory, from 1960 to 2021, of policies addressing the issue of shortages in the supply and training of physicians for the health care system. Data was collected by means of bibliographic and documental analysis and interviews with government leaders from 2003 to 2019, using the process tracing method. Historical Neo-institutionalism and the Theory of Gradual Institutional Change were used to analyze historical legacies that influenced the formulation of the Mais Médicos Program (PMM), that derived from its implementation, and that continue to influence subsequent policies. Among the main legacies in the pre-SUS period are the Rondon Project, the Program for Interiorization of Health and Sanitation Actions, and the attempts to implement compulsory civil service. After the Unified Health System (SUS) establishment, institutional changes for its implementing stand out: the Family Health Strategy, state experiences of cooperation with Cuba, two provision programs and two incentive programs for curricular changes in medical courses, changes in the student financing law, and in the revalidation process of foreign medical degrees. Although changes have been made to the PMM since 2016, its legacies have made its suspension difficult, continue to influence programs such as Médicos Pelo Brasil (PMPB), and led the current government to use the PMM institutionality, rather than that of the PMPB, to address the COVID-19 pandemic health crisis. The analysis unveiled ruptures, continuities, transformations and inclusions in the policies for regulating, training, and providing doctors for the health system.