More Doctors Program: health work process and socioeconomic indicators

Interventions of Brazil's more doctors program through continuing education for Primary Health Care

Introduction

Brazil's More Doctors Program, in its training axis, aims to improve medical training for Primary Health Care through interventions related to the reality of the territory. The research presented here analyzed the interventions implemented by Brazil's More Doctors Program physicians, members of the Family Health Continuing Education Program, and the relationship with Primary Health Care programmatic actions.

Methodology

The research conducted made use of Text and Data Mining and content analysis. In total, 2,159 reports of interventions from 942 final papers were analyzed. The analysis process was composed of the formation of the corpus; exploration of the materials through text mining; and analysis of the results by inference and interpretation.

Results

It was observed that 57% of the physicians worked in the Northeast Region, which was also the region with the most interventions (66.8%). From the analysis of the bigrams, trigrams, and quadrigrams, four constructs were formed: "women's health," "child health," "chronic non-communicable diseases," and "mental health." Terms related to improving access, quality of care, teamwork, and reception were also present among the N-grams.

Discussion

The interventions carried out are under the programmatic actions recommended by the Brazilian Ministry of Health for Primary Health Care, also addressing cross-cutting aspects such as Reception, Teamwork, Access Improvement, and Quality of Care, which suggests that the training experience in the Family Health Continuing Education Program reflects on the way these professionals act.

COVID-19 mortality among Indigenous people in Brazil: a nationwide register-based study

Coronavirus disease 2019 (COVID-19) has disproportionately affected Black people and minority ethnic groups, but there are limited data regarding the impact of disease on Indigenous people. Herein, we investigated the burden of COVID-19 on the Indigenous population in Brazil. We performed a populational-based study including all cases and deaths from COVID-19 among Brazilian Indigenous people from 26 February to 28 August 2020. Data were obtained from official Brazilian information systems. We calculated incidence, mortality and fatality rates for the Indigenous population for each of the five Brazilian regions. Brazil had an incidence and a mortality rate of 3546.4 cases and 65.0 deaths per 100 000 population, respectively. The case fatality rate (CFR) was 1.8%. The Central-West had the higher estimates of disease burden among Brazilian Indians (incidence rate: 3135.0/100 000; mortality rate: 101.2/100 000 and CFR: 3.2%) followed by the North region (incidence rate: 5664.4/100 000; mortality rate: 92.2/100 000 and CFR: 1.6%). Governmental actions should guarantee the isolation, monitoring and testing capabilities of Indigenous people and rapidly to provide social protection and health facilities.

Health production: analysis of doctors' health actions in the More Doctors program

OBJECTIVE Analyze the health actions carried out by the Cuban cooperated physicians and their relationship with socioeconomic characteristics of the municipalities, contained in the first supervision visit report, in 2015. METHODS This is a quantitative research that used secondary data from the reports of the 1st supervision visit of the "More Doctors Program". The dependent variables were the health actions, and the independent variables were the type of municipality, Human Development Index (HDI), Investment in Primary Health Care (PHC), health center coverage, rural population, and total population. Multiple correspondence analysis was used to identify the latent variable, related to the profile of the professional with respect to the actions/procedures carried out to which the characteristics of the municipalities were associated through frequency analysis. RESULTS Three profiles of professionals were obtained, who have their practices associated with the professional training, consolidating as a determining factor for carrying out actions compatible with the actual needs of the population. Such findings were associated with the socioeconomic variables, with emphasis on funding, health center infrastructure, and coverage. CONCLUSIONS From the observed results, we suggest strategies to expand the scope of the practices carried out in Primary Health Care, from the perspective of training and continuing education of health professionals, and the focus on the everyday life of the service being of paramount importance.