Cristiana Leite Carvalho

Disponibilidade de medicamentos essenciais em duas regiões de Minas Gerais, Brasil

OBJETIVO: Avaliar a disponibilidade de medicamentos essenciais em localidades com indice de desenvolvimento humano < 0,699. METODOS: Foram pesquisados 69 estabelecimentos, entre almoxarifados municipais, unidades ambulatoriais publicas, unidades privadas, unidades filantropicas e farmacias comerciais. Foram entrevistados os profissionais de saude diretamente responsaveis pelo controle dos estoques e dispensacao dos medicamentos. Tambem foram consultados documentos e registros institucionais. Uma lista de 21 medicamentos essenciais tracadores, selecionados dentre aqueles mais utilizados no Programa Farmacia Basica do Estado de Minas Gerais, foi definida como parâmetro para as medidas de disponibilidade. Para cada medicamento tracador foi verificada a disponibilidade no momento da visita e ao longo dos 12 meses imediatamente anteriores a pesquisa de campo. Tambem foi calculada a disponibilidade de cada um dos medicamentos essenciais tracadores para cada tipo de estabelecimento incluido na pesquisa de campo. RESULTADOS: A disponibilidade de medicamentos essenciais nos almoxarifados municipais foi de 52,0%; nas unidades publicas de saude, 46,9%; e nas unidades ambulatoriais filantropicas e privadas, 41,0% e 38,1%, respectivamente. Nas farmacias privadas, a disponibilidade de medicamentos essenciais alcancou 81,2%. CONCLUSAO: Ha baixa disponibilidade e descontinuidade na oferta de medicamentos essenciais no setor publico, penalizando individuos vulneraveis. As farmacias privadas sao a principal fonte de medicamentos essenciais. Os resultados indicam a necessidade de divulgar e implementar o conceito de essencialidade no pais.

Impacto do Programa Mais Médicos na redução da escassez de médicos em Atenção Primária à Saúde

The Mais Medicos (More Doctors) Program (PMM) was put in place in Brazil aiming to reduce inequalities in access to Primary Healthcare. Based on diverse evidence that pointed to a scenario of profound shortage of doctors in the country, one of its central thrusts was emergency provision of these professionals in vulnerable areas, referred to as the Mais Medicos para o Brasil (More Doctors for Brazil) Project. The article analyses the impact of the PMM in reducing shortage of physicians in Brazilian municipalities. To do this, it uses the Primary Healthcare Physicians Shortage Index, which identifies and measures the shortage in the periods of March 2003 and September 2015, before and after implementation of the program. The results show that there was a substantial increase in the supply of physicians in primary healthcare in the period, which helped reduce the number of municipalities with shortage from 1,200 to 777. This impact also helped reduce inequalities between municipalities, but the inequities in distribution persisted. It was also found that there was a reduction in the regular supply of doctors made by municipalities, suggesting that these were being simply substituted by the supply coming from the program. Thus, an overall situation of insecurity in care persists, reflecting the dependence of municipalities on the physician supply from the federal government.The Mais Médicos (More Doctors) Program (PMM) was put in place in Brazil aiming to reduce inequalities in access to Primary Healthcare. Based on diverse evidence that pointed to a scenario of profound shortage of doctors in the country, one of its central thrusts was emergency provision of these professionals in vulnerable areas, referred to as the Mais Médicos para o Brasil (More Doctors for Brazil) Project. The article analyses the impact of the PMM in reducing shortage of physicians in Brazilian municipalities. To do this, it uses the Primary Healthcare Physicians Shortage Index, which identifies and measures the shortage in the periods of March 2003 and September 2015, before and after implementation of the program. The results show that there was a substantial increase in the supply of physicians in primary healthcare in the period, which helped reduce the number of municipalities with shortage from 1,200 to 777. This impact also helped reduce inequalities between municipalities, but the inequities in distribution persisted. It was also found that there was a reduction in the regular supply of doctors made by municipalities, suggesting that these were being simply substituted by the supply coming from the program. Thus, an overall situation of insecurity in care persists, reflecting the dependence of municipalities on the physician supply from the federal government.