Provimento e fixação de profissionais de saúde na atenção básica em contextos de difícil acesso, no estado do Amazonas

Abstract

Introduction: The Unified Health System (SUS) was created as an organizational model to structure health policies in the country. However, despite the progress achieved after its implementation, there are still gaps to be filled in order to effectively incorporate health professionals in Primary Care (PH), especially in those locations farther from urban centers, as presented by the municipalities within the region. state of Amazonas. There is an issue of the provision and settling of health professionals in PH in areas of difficult access because it still represents a challenge for the state's public health policies, in relation to the populations that live in the most remote locations of the capital. Purpose: To analyze the provision and fixation of health professionals in PH in municipalities of Amazonas. Method: Cross-sectional, descriptive-analytical study with a quantitative and qualitative approach, which is part of a broader research called: “The Scenario of Labor Management in the Amazon: setting and provision of health professionals in SUS”, with 397 professionals, from the PH of Amazonas’ 20 small towns. The professionals were interviewed through a questionnaire with closed and open questions. Descriptive statistics was used to assess the sociodemographic profile of the professionals and content analysis to interpret the interviews as well. Results: Medical professionals were appointed as facilitators of negative statistics regarding provision and settlement in Amazonas’s small towns. The positive highlights that justify that they could stay were family issues, good conditions of the place and the feeling of changes in the population's health. The challenges highlighted for the rotation of professionals were the salary issue, lack of infrastructure and geography of the place and the political issues. Conclusion: Effective health policies, practices aimed at professional qualification and enhancement, structuring of environments that offer health services, in addition, policies that support students from villages and small towns to take courses and, at the same time, expand vacancies of health courses in strategic locations in the state, these are actions that can contribute to the provision and establishment of professionals in places that are difficult to access.