evolução entre 2007 e 2016

Introdução: O contexto de formação dos médicos e as suas expetativas em relação à vida profissional são fundamentais para planear a distribuição, retenção e motivação da força de trabalho em saúde. Neste estudo, comparámos a evolução das expetativas profissionais dos alunos de medicina da Guiné-Bissau entre 2007 e 2016. Material e métodos: Comparámos os resultados de dois estudos trans-versais descritivos, obtidos através de um questionário. Procedeu-se a análise estatística e análise de conteúdo dos dados .Resultados: Em ambos os anos, os alunos eram maioritariamente homens, tinham familiares profissionais de saúde, tinham realizado o percurso escolar em Bissau, tencionavam trabalhar no hospital e no sector público. Em 2016, a proporção daqueles dispostos a trabalhar fora de Bissau aumentou. Ainda não se tinham decidido acerca da especialização e tinham expetativas elevadas relativamente aos rendimentos. Discussão: Apesar da forte orientação para o setor hospitalar, houve um aumento da disponibilidade para trabalhar na periferia, o que pode constituir uma oportunidade de adequação entre aquilo que são as necessidades dos sistemas de saúde e as expetativas dos futuros profissionais. As ambições salariais devem ser trabalhadas a nível da formação e das instituições responsáveis pela política de recursos humanos, com possíveis efeitos nefastos para os jovens profissionais caso tal não aconteça. A decisão mais tardia por uma especialidade representa uma oportunidade de convergência com as prioridades da estratégia nacional de saúde. Conclusão: Não se verificaram grandes alterações nas expetativas profissionais dos jovens estudantes de medicina da Guiné-Bissau entre 2007 e 2016 Background: The context where medical students are trained and their expectations towards professional life are paramount to plan the distribution, retention and motivation of the health workforce. In this study we compare the evolution of professional expectations of medical students of Guinea-Bissau, between 2007 and 2016.Material and Methods: We compare the results of two descriptive, cross-sectional studies where we applied a questionnaire. We conducted descriptive statistical analysis and content analysis. Results: In both years, most students were men, had family members who were health professionals, had attended school in Bissau, intended to work in the hospital and in the public sector. In 2016, the proportion of those willing to work outside Bissau had increased. They had not yet decided on the area of specialization and had high expectations towards futures earnings. Discussion: Despite the strong orientation towards hospital among, there was an increase in the proportion of students willing to work outside Bissau which presents an opportunity to bridge the gap between the needs of the health system and the expectations of future doctors. The expectations on future earnings should be worked at training level and in the institutions responsible for the planning of the health workforce to avoid detrimental effects on young doctors. The postponement of a decision on the area of specialization might present an opportunity of convergence with the national health strategy. Conclusion: No major changes occurred in the professional expectations of medical students of Guinea Bissau, between 2007 and 2016.publishersversionpublishe

evolução do perfil, atividade e formação no setor público entre 1971 e 2019

Auxiliares de saúde são trabalhadores com funções de suporte a profissionais mais qualificados na prestação de cuidados. Constituem parte considerável e desconhe-cida dos recursos humanos da saúde em Portugal.Publicados em 2010, o perfil profissional e o referencial de formação de técnico auxiliar de saúde introduziram mudanças ainda por estudar. Integrado numa investigação sobre qualificação da força de trabalho da saúde numa perspetiva de análise de políticas, este estudo visa contribuir para a compreensão dos contextos nacional e internacional de definição e implementação destas medidas. Através de entrevistas e análise documental, procedeu-se à análise da evolução do perfil, atividade e formação dos auxiliares de saúde do setor público entre 1971 até 2019, um percurso de três etapas pontuadas por alterações na sua categoria profissional, designação e funções.Alinhado com as estratégias nacionais e europeias de qualificação, o perfil de técnico auxiliar de saúde, além de um descritivo de atividade claro, impulsionou uma oferta formativa de base até aí inexistente. Contrariamente ao verificado noutros países, não deu origem a mecanismos legais para regulação da atividade ou acesso ao mercado de trabalho, nem teve reflexos diretos no estatuto dos auxiliares do setor público. Healthcare assistants have a supporting role of more qualified professionals. They are a considerable and unknow part of the Portuguese health workforce. The professional profile and the Technical Healthcare Assistant course, published in 2010, brought changes that have not yet been studied. part of an investigation that analyses these policies, this study aims to contribute to the understanding of the national and international contexts of definition and implementation of these measures. Through interviews and documentary analysis, a description and analysis of the evolution of the profile, activity and training of Health Assistants in the public sector from 1971 to 2019 was carried out, a three-stage course punctuated by changes in their professional categories, designation and functions. Aligned with national and European qualification strategies, the profile of Health Assistant Technician, in addition to a clear activity description, boosted a basic training offer that did not exist until then. Contrary to what was seen in other countries, it did not give rise to legal mechanisms to regulate activity or access the labor market, nor did it have a direct impact on the status of healthcare assistants in the public sector.publishersversionpublishe

Strategic planing in Guiné-Bissau´s health sector: evolution, influences and processes

Although it is recognized that strategic planning (SP), when evaluated according to predefined goals and objectives, has a low execution rate, it has value as a complex, participatory and mobilizing procedure in all quarters of society. Strategic health planning has (SHP) has begun to emerge since the 1990s, strongly driven by the global strategy for health for all by the year 2000 (WHO, 1981) and more recently by the Health 21 - Health for All in the 21st Century (WHO, 1998). The Republic of Guinea-Bissau (RGB), one of the poorest countries in the world, presents a context of fragility and deficiencies in health and functioning of it´s health system, which does not respond to the health needs of the country. It is however, a State that over the years has made the exercise of SHP. The strategic management of the RGB´s health system was, until March 2017, guided by a National Health Policy adopted and approved in 1993. It has, over time, framed various thematic policies and guided the preparation of two National Health Development Plans (NHDP). The extension of the first NHDP was framed by the first National Strategy Document on Poverty Reduction (DENARP I 2004-2007) and the second NHDP by the DENARP II (2011-2015). the third NHDP, in preparation, will be guided by the National Health Policy adopted in March 2017, by the Strategic and Operational Plan of the Government Terra Ranka (2015-2025) and by the recommendations that emerged in October 23014 from the 1st National Health Conference. The SHP process in RGB also incorporates and feeds other planning processes by partners, services and civil society bodies, giving rise to a web of guiding documents - policies, plans, programs, projects. The management of this complexity should have been taken over by the NHDP Management Office, which has not happened. This is partly due to the lack of staff in the Office, and also to the fact that the SP is seen not as an element of dynamic strategic management, but as a self-contained process that allows mobilizing funds from donors and guides other thematic planning cycles, not always articulated with the NHDP´s time horizon. The present article makes a review trip to the SHP process in RGB in three moments, each associated with a NHDP: 1998-2002 (extension of 2003-2007); 2008-2017; 2018-2020. In a narrative that intends to keep a memory of these processes, the article reports either to the personal experiences of the authors, or follows a methodology of analysis of documents, mostly unpublished, obtained from key informants in the course of several works in which Authors were involved as directors or consultants of the Ministry of Public Health of RGB.publishersversionpublishe

Can we halt health workforce deterioration in failed states? Insights from Guinea-Bissau on the nature, persistence and evolution of its HRH crisis

The study is based on the findings from a study supported by an unrestricted research grand by The Calouste Gulbenkian Foundation, Portugal