Challenges and implementation of the “Programa Mais Médicos Campineiro”

The aim of this study is to describe the experience of implementing the Programa Mais Médicos Campineiro (PMMC) in Campinas city, State of São Paulo, Brazil, from April 2019 to April 2020, as the result of a health policy that suited the municipality’s needs to the doctors’ training program in Family and Community Medicine. For such purpose, information from meeting registries was assembled from several sources, to recover the series of actions taken to achieve an effective proposal. The situation of primary health care in the municipality until 2019 was analyzed in detail, which revealed difficulties in fixating doctors in Health Units. As a solution, the institution of a medical residency program was chosen. To preserve the doctor’s maintenance in the PMMC, he was admitted to the Family Health Strategy. Funding was allocated to guarantee sufficient compensation to attract and engage professionals to the proposal. The selection process of medical residents and preceptors was widely discussed and a pedagogical program was created and the program’s management was established. An increase in the number of vacancies offered was noted, demonstrating that, through public policy aimed at training Family and Community Physicians, it is possible to change the scenario of idleness as well as the high turnover of vacancies in medical residency programs in Campinas.O objetivo deste trabalho é descrever a experiência da implementação do Programa Mais Médicos Campineiro (PMMC) na cidade de Campinas, Estado de São Paulo, no período de abril de 2019 a abril de 2020, como resultado de política de saúde que adequou as necessidades do município à formação de médicos especialistas em Medicina da Família e Comunidade. Para tal, foram compilados registros de reuniões realizadas entre integrantes da Secretaria Municipal de Saúde e instituições de ensino superior do município e recuperada a trajetória percorrida pelos diversos atores envolvidos. A situação da atenção básica de saúde no município até 2019 foi analisada com detalhes, o que revelou dificuldades em fixar o médico nas Unidades de Saúde. Como solução optou-se pela instituição de programa de residência médica. Para preservar a manutenção do médico no programa, garantiu-se a sua vinculação à Estratégia de Saúde da Família, foram estabelecidas parcerias com instituições de saúde e foi planejado o financiamento que garantiu remuneração suficiente para atrair e manter profissionais à proposta. O processo seletivo de médicos residentes e preceptores foi amplamente discutido. Foi criado um programa pedagógico e estabelecida a gestão do programa. Foi verificado incremento da ocupação de vagas oferecida, demonstrando-se que por meio de política pública direcionada à formação de Médico da Família e Comunidade é possível alterar o panorama de ociosidade assim como a alta rotatividade de vagas em programas de residência médica em Campinas

Landfills As Risk Factors For Respiratory Disease In Children.

To investigate the relationship between exposure to a landfill site closed 6 years previously and respiratory symptoms in children aged up to 13 years. This was a cross-sectional study conducted in Várzea Paulista, in the state of São Paulo, Brazil. One adult in every household in a neighborhood close to the landfill and from a randomized sample of households in another neighborhood with similar socioeconomic characteristics but no landfill were interviewed and asked about respiratory symptoms and other variables relating to children aged up to 13. A logistic regression model was used to study this relationship. The likelihood of a child having respiratory symptoms was a function of -2.36 + 0.43 if the child was less than 2 years old; + 0.24 if the child lived in the landfill area; -0.67 if there was a computer at home; + 0.54 if firewood was burnt in the home in the last year; + 0.94 if the child was diagnosed with asthma; + 0.87 if the child visited a health service in the previous 30 days. The authors conclude that living near to a landfill closed 6 years previously may be a risk factor for respiratory disease in children.87319-2

PUBLIC POLICIES TO ENGAGE DOCTORS IN PRIMARY HEALTH SYSTEM: AN EXPERIENCE REPORT FROM THE CITY OF CAMPINAS (BRAZIL)

The present study seeks to report the experience of implementing the Mais Médicos Campineiro Program (PMMC) (More Doctors for the City of Campinas, Brazil). The program fundamentally focuses on training family and community medicine (FCM) specialists, increasing the job opening rate through medical residency programs (MRPs) in FCM, and providing qualified doctors to meet the needs of the population and the municipal health secretariat (SMS) of Campinas-SP. We will detail the program implementation as a model to encourage teaching–service–community integration (IESC). The municipality has brought legislation and taken charge of total or complementary grant funding to increase the number of FCM specialists. The municipal health secretary of Campinas has established partnerships with higher education institutions in FCM undergraduate and MRP courses approved by the Ministry of Education. Those partnerships endeavor to develop an interinstitutional project fostering the training and provision of professionals. Strengthening the IESC improved local primary health care, making it more comprehensive and successfully filling vacancies in the respective MRPs from previous years