Segundo a OMS, 36 dos 57 países que enfrentam uma crise de RHS são Africanos. Em S. Tomé e Príncipe uma consultoria efetuada identifica três problemas: Gestão de Recursos Humanos, Gestão de processos de capacitação, e Desenvolvimento Institucional da Escola Superior de Quadros de Saúde Vítor de Sá Machado, atual ICSVSM (Dussault et al., 2010). O presente estudo surge da necessidade de avaliar a sustentabilidade do investimento na capacitação de RHS, através do estudo de caso do ICSVSM.
Foi utilizado como metodologia o estudo de caso. Para melhor compreensão da problemática foram desenhados um quadro conceptual e um modelo teórico-lógico. Foram feitas 24 entrevistas a informantes-chave, das quais foram gravadas e transcritas 9 e anotadas 15. A análise das entrevistas e dos documentos analisados foi feita recorrendo à criação de pro formas que permitiram estruturar a análise efetuada de acordo com a operacionalização de variáveis.
Há uma manifesta necessidade de aumentar os números de RHS de acordo com os novos perfis do país, e como definidos no PRHS e PNDRHS. Por outro lado, em termos internos o ICSVSM, apresenta capacidade de responder a essas necessidades, mas verificou-se uma necessidade de criar Conselhos Pedagógico e Científico capazes de delinear e orientar estrategicamente o ICSVSM. Apesar do baixo investimento do OGE, os programas nacionais constituem uma fonte de financiamento através das formações orçamentadas, e que são parte da formação contínua de RHS. A falta de condições, a consequente fuga de quadros, a ausência de um sistema de informação, a má distribuição dos RHS pelos distritos e a forte dependência financeira externa, são os entraves encontrados à sustentabilidade do ICSVSM.
O facto de o ICSVSM ser a única instituição de formação de quadros de saúde em S. Tomé e Príncipe, dota-o de um potencial que importa maximizar. De facto, as melhorias operadas nos últimos anos e as perspetivas que o PNDRHS abre para a formação de RHS mostram a importância do ICSVSM no panorama Santomense. Importa assim, contornar as dificuldades existentes de modo a garantir a sustentabilidade do investimento em RHS.According to the WHO, 36 of the 57 countries facing a human health resource crisis are found in the African continent.. In S. Tomé e Príncipe, previous studies identified three main Human Resources for Health (HRH) problems, namely: human resources management, training processes management, and the institutional development of the Vítor de Sá Machado School of Higher Education for Health Professionals (ICSVSM). This study arises from the need to evaluate the HRH training investment sustainability in São Tomé e Príncipe, by looking specifically at the ICSVSM case study.
A case study methodology was employed to evaluate the issue under analysis. A conceptual framework and a theory-logic model were designed to analyse this issue. Twenty-four interviews to key informants were carried out, of which 9 were recorded and transcribed, and hand notes were taken of the remaining 15.. Interviews and document analysis were developed using a pro forma structure, which allowed for the analysis of the subjects according to the variables identified from the study’s framework of analysis.
The main results of the present work appear to confirm there is a clear need to increase HRH workforce in São Tomé e Príncipe according to the country’s changing demographic profile, as already stated by the Government’ HRH politics, and in particular by the National Human Resources for health Development Plan. On the other hand, the present study suggests that the ICSVSM is in the position to respond effectively to such challenges. Nevertheless, establishing Scientific and Pedagogic Councils capable of strategically guiding ICSVSM seems to be a prerequisite to respond to the rising challenges. Despite the State Budget’s low level of investment, the present study found that national programs may still be able to provide enough financial support for the institute through the budgeted training, programmes which are also part of the HRH continuous training. Poor salary levels, professional’s brain drain, the lack of an adequate information system, poor HRH geographical distribution, and the country’s strong dependence on international financing, were found to remain key constraints to ICSVSM’s sustainability.
The present study arrives at the conclusion that ICSVSM’s relevance as the only HRH training institution in S. Tomé e Príncipe gives it a potential that must be maximized. The improvements occurred over the last few years, as well as the windows of opportunity offered by the national HRH policies and the National Development Plan regarding HRH training, highlight the importance the ICSVSM has acquired in the Santomean health landscape. It will therefore be all too important to overcome the existing difficulties to guarantee the sustainability of the investment made in the country’s HRH
