Mais Médicos professionals begin activity in the country – 07/03/2023 – Daily life

The Ministry of Health resumed the Mais Médicos program with two notices abandoned by the Jair Bolsonaro (PL) administration due to budget shortages.

The launch of cycles 26 and 27 of the program, in July and October 2022, was possible due to the recomposition of the budget for health programs.

In the case of Mais Médicos, the budget sent by the previous government to Congress for its maintenance in 2023 was R$ 647.1 million, an insufficient amount for the actions. During the vote on the Ploa (Annual Budget Bill) and the negotiations involving the Transition PEC, the amount requested by the Lula government (PT), of R$ 1.7 billion, was reestablished.

The 26th cycle provided 152 vacancies for 31 of the 34 DSEISs (Special Indigenous Health Districts). Of these, 23 were occupied by Brazilian physicians registered with the country’s Regional Medical Councils.

By the end of February, according to the Ministry of Health, seven had assumed the posts.

In the recomposition of the budget, 129 vacancies were offered to exchange students (Brazilians trained abroad).

As minister Nísia Trindade had announced, the Yanomami territory, in the states of Roraima and Amazonas, will receive 19 professionals from Mais Médicos. The start of activities is scheduled for March 14.

The public notice for the 27th cycle, relaunched in January, provides for 1,022 vacancies in 722 municipalities, only for physicians trained in Brazil. So far, 658 vacancies have been filled (64%) and 484 professionals are already active. The others have until March 15 to present themselves.

Idle vacancies will be offered to foreign doctors trained abroad, without the need for the Revalida (foreign diploma revalidation exam), as he told the Sheet Program Director of the Secretariat of Primary Health Care, Felipe Proenço. He coordinated Mais Médicos from its implementation in 2013 until April 2016.

In 2014, the program reached the mark of 18,240 professionals in 4,058 municipalities and 34 DSEIs. The year 2022 had the highest lack of assistance, with 12,132 professionals, considering the sum of the two main provision programs — Mais Médicos and Médicos pelo Brasil, which was announced in 2019, but started activities in 2022.

Mais Médicos takes professionals to work in primary care, in vulnerable areas, of extreme poverty and with difficulty in attracting and retaining doctors, in addition to the outskirts of large cities.

In the regions contemplated by the program, it will mitigate the impact on the population of an old problem: the deficit of family and community doctors, estimated between 45,000 and 65,000 in the country by the SBMFC (Brazilian Society of Family and Community Medicine) —data corroborated by Proenço.

“There is an important deficit of family and community physicians in the SUS, due to the role that these professionals play in the Family Health Strategy and in primary health care initiatives. We understand that diversified strategies are needed, whether in training, in the field of regulation , from the point of view of incentives and networking”, explains Proenço.

The Lula government says it intends to strengthen Mais Médicos, making it more attractive to professionals trained in Brazil, with incentives, training and qualification.

“More Doctors came to have an important investment in the field of construction, renovation and expansion of the UBS. We have observed in the budget over the years that this is no longer a priority, at the same time that we have seen that our health workers faced longer periods critics of the pandemic and primary care was fundamental to respond to people’s care”, emphasizes Proenço.

For public health physician Adriano Massuda, a professor at the Getulio Vargas Foundation’s School of Administration in the State of São Paulo, there are two problems involving the lack of doctors: bad distribution and the decentralization of the SUS.

“The SUS is decentralized by municipal level. They are responsible for hiring doctors and they need to do this in unequal conditions. This characteristic of the SUS aggravates the chronic problem of medical provision”, he explains.

For the specialist, the return of the Mais Médicos program is necessary so that the Ministry of Health can intervene on structural problems of the SUS. “You can’t do health without doctors and you need these federal incentives to be able to allocate these professionals. The most effective policy in the country’s history for the provision of doctors was More Doctors”, he says.

In the expert’s view, the provision policy should be long-term, with incentives for Brazilian physicians to enroll, residency bonuses and the prospect of a career in the SUS.

Massuda points out that the current health crisis requires a quick call and a large number of doctors. “Health cannot wait to have a new generation of doctors trained to solve the Yanomami crisis, for example”.