Amazon Health – 05/23/2023 – Opinion
Countries of continental dimensions whose territories have vast remote areas, with wild nature and difficult access, face difficulties in offering public health services equally to the entire population. Even rich nations like Canada and Australia have these difficulties.
In Brazil, the challenge is as old as the SUS itself, established by the 1988 Constitution. It is no coincidence that one of the doctrinal principles of the system is regionalization, which seeks to decentralize actions and services to meet the specific needs of each region.
Historically, the Amazon has faced problems such as precarious infrastructure and, mainly, a lack of health professionals.
The new public notice for the More Doctors program, relaunched earlier this year, provides for the hiring of 1,869 doctors in the region. However, even if all vacancies are filled, the rate of professionals per inhabitant will reach a level slightly higher than the average for the rest of the country registered 16 years ago.
According to a survey carried out by Sheet, based on data from the Ministry of Health referring only to professionals working in the SUS, in 2007 there were 0.58 physicians per 100,000 inhabitants in the Legal Amazon (Northern states, Mato Grosso and part of Maranhão), compared to 1.01 in the remainder of the country. This year, the region has 1.02, while the average of the others jumped to 1.76.
It is estimated that an additional 21,000 doctors would be needed in the Amazon to eliminate the disparity.
Experts point out that it is necessary not only to increase the number of professionals but also to improve training for the context of action. In this case, primary care.
In remote areas, usually only one doctor is responsible for the care of the population. Generalist skills focused on prevention, typical of the area of family health, can reduce the need for specialists and more costly procedures.
Telemedicine is also capable of helping to supervise young doctors —who are generally more willing to spend a period of their training in distant areas— and to access care for more complex cases.
There is no immediate solution to the shortage in the Amazon, but it is the role of the government to implement long-term measures, reduce distortions and, above all, not increase them. Dealing with the issue as a State policy, not just a government one, would be the best course of action.