Uma análise do Grupo Especial de Supervisão do Programa Mais Médicos em áreas remotas e territórios indígenas da Amazônia Legal
Data
2021-07-29
Autores
Carvalho, Natalia de Campos [UNIFESP]
Orientadores
Mendes, Rosilda [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Com enorme extensão territorial e marcado por grandes desigualdades socioeconômicas, o Brasil enfrenta problemas na distribuição de profissionais de saúde em diversas localidades, como nos territórios indígenas e municípios de difícil acesso da Amazônia Legal. Apesar da criação do Programa Mais Médicos (PMM), o escasso número de médicos com formação específica para a Atenção Primária à Saúde na Região Norte e a falta de oferta regular de transporte para as localidades remotas da Amazônia têm limitado nos últimos anos a disponibilização de médicos supervisores para assegurar a permanência do PMM nestes cenários. Neste sentido, foi criado em dezembro de 2014 o Grupo Especial de Supervisão (GES) do PMM, em parceria interministerial, para viabilizar o provimento médico em áreas remotas e Distritos Sanitários Especiais de Saúde (DSEI) da Amazônia Legal. Após mais de seis anos de sua implantação, o GES acumula experiências inovadoras de supervisão acadêmica nos rincões do país, mas quase não é notado dentre as centenas de estudos desenvolvidos sobre o PMM. Esta pesquisa destinou-se a analisar a supervisão acadêmica do GES nestas localidades através de entrevistas semi-estruturadas com cinco médicos do PMM e da narrativa autobiográfica da pesquisadora. Os dados foram submetidos à análise de conteúdo textual, que resultou em três categorias: o “ser médico” do PMM: trajetórias, expectativas e perspectivas de trabalho; a contextualização do trabalho médico nos áreas indígenas e remotas da Amazônia Legal; e as características de funcionamento da supervisão acadêmica do GES/PMM que a tornam “especial” e fundamental para o país. A pesquisa, com isto, ajudou na compreensão da realidade da região, dos desafios enfrentados pelos profissionais e supervisores e das possibilidades de aprimoramento do suporte pedagógico para o PMM e outros programas de provimento médico. Por fim, discute-se o imperativo das questões estruturais de trabalho e vida nestes locais sobre o alcance real da supervisão, o que exige dela uma postura crítica e engajada na luta por melhorias para a região
With an enormous territorial extension and marked by great socioeconomic inequalities, Brazil faces problems in the distribution of health professionals in different locations, such as in indigenous territories and municipalities with difficult access in the Legal Amazon. Despite the creation of the Mais Médicos Program (PMM), the scarce number of physicians with specific training for Primary Health Care in the North Region and the lack of regular transport provision to remote locations in the Amazon has limited in recent years the availability of supervising physicians to ensure the permanence of the PMM in these scenarios. In this sense, in December 2014 the Special Supervision Group (GES) of the PMM was created, in an inter-ministerial partnership, to enable medical provision in remote areas and Special Sanitary Health Districts (DSEI) in the Legal Amazon. More than six years after its implementation, the GES has accumulated innovative experiences in academic supervision in the country's corners, but it is hardly noticed among the hundreds of studies carried out on the PMM. This research aimed to analyze the academic supervision of the GES in these locations through semi-structured interviews with five doctors from the PMM and the researcher's autobiographical narrative. Data were subjected to textual content analysis, which resulted in three categories: the “being a doctor” of the PMM: trajectories, expectations and work perspectives; the contextualization of medical work in indigenous and remote areas of the Legal Amazon; and the functioning characteristics of the academic supervision of the GES/PMM that make it “special” and fundamental for the country. The research, therefore, helped to understand the reality of the region, the challenges faced by professionals and supervisors, and the possibilities for improving pedagogical support for the PMM and other medical provision programs. Finally, it discusses the imperative of structural issues of work and life in these places over the real scope of supervision, which requires a critical and engaged posture in the fight for improvements in the region.
With an enormous territorial extension and marked by great socioeconomic inequalities, Brazil faces problems in the distribution of health professionals in different locations, such as in indigenous territories and municipalities with difficult access in the Legal Amazon. Despite the creation of the Mais Médicos Program (PMM), the scarce number of physicians with specific training for Primary Health Care in the North Region and the lack of regular transport provision to remote locations in the Amazon has limited in recent years the availability of supervising physicians to ensure the permanence of the PMM in these scenarios. In this sense, in December 2014 the Special Supervision Group (GES) of the PMM was created, in an inter-ministerial partnership, to enable medical provision in remote areas and Special Sanitary Health Districts (DSEI) in the Legal Amazon. More than six years after its implementation, the GES has accumulated innovative experiences in academic supervision in the country's corners, but it is hardly noticed among the hundreds of studies carried out on the PMM. This research aimed to analyze the academic supervision of the GES in these locations through semi-structured interviews with five doctors from the PMM and the researcher's autobiographical narrative. Data were subjected to textual content analysis, which resulted in three categories: the “being a doctor” of the PMM: trajectories, expectations and work perspectives; the contextualization of medical work in indigenous and remote areas of the Legal Amazon; and the functioning characteristics of the academic supervision of the GES/PMM that make it “special” and fundamental for the country. The research, therefore, helped to understand the reality of the region, the challenges faced by professionals and supervisors, and the possibilities for improving pedagogical support for the PMM and other medical provision programs. Finally, it discusses the imperative of structural issues of work and life in these places over the real scope of supervision, which requires a critical and engaged posture in the fight for improvements in the region.
Descrição
Citação
CARVALHO, Natalia de Campos. Uma análise do Grupo Especial de Supervisão do Programa Mais Médicos em áreas remotas e territórios indígenas da Amazônia Legal. São Paulo. 2021. 107 f. Dissertação (Mestrado Profissional em Saúde da Família) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo; 2021