This article presents a historical analysis of work management and education in the healthcare field over the three decades since the creation of Brazil's Unified Health System (SUS, acronym in Portuguese). Using the sociology of professions as a frame of reference, it addresses the following topics: the health labor market; trends in healthcare employment; the healthcare workforce; and the regulation and dynamics of undergraduate programs in the health field. It analyzes each of the moments that characterize the area, from the pre-SUS period to the present day. The period has witnessed the following: a boom in health schools, largely in the private sector; an overall increase in the level of education of health professionals , an increase in regional inequity; an alarming increase in distance learning programs; an imbalance between labor supply and demand; the expansion of installed capacity; the municipalization of health employment; an increased focus on multiprofessional teams; and an increase in precarious work and informal contractual relationships and deterioration of pay levels.
The main objective of this article was to examine the context in which professionals
Objetivo: Analisar a situação da equipe de Enfermagem no contexto da pandemia no Brasil, tendo como foco a gestão do trabalho desses profissionais. Método: Trata-se de estudo de reflexão sobre as condições de vida e de trabalho dos profissionais de enfermagem no contexto da pandemia de COVID-19, utilizando dados da Organização Mundial da Saúde, do Ministério da Saúde, do Observatório da Enfermagem do Conselho Federal de Enfermagem e da Pesquisa Perfil da Enfermagem no Brasil. Resultados: Há inúmeras fragilidades nas condições de emprego, renda, trabalho, saúde física e mental desses profissionais. Em relação à pandemia de COVID-19, o quadro é de doença instalada em todo o país, mas diferindo significativamente entre estados e regiões. O país já contabiliza 5.533 casos confirmados e 138 óbitos entre profissionais da equipe. Conclusões: A pandemia reforçou com maior amplitude as precárias condições de trabalho dos profissionais da Enfermagem brasileira, sendo necessários mais estudos e diagnósticos, sobre os efeitos que incidem no processo de trabalho durante período atual e no pós-pandemia para o melhor entendimento da realidade posta e exposta, com o intuito propor sugestões às Entidades de Classe, à sociedade e ao Estado no sentido de aproximar a realidade desses profissionais ao que a Organização Internacional do Trabalho tem denominado de “trabalho decente”.Descritores: Força de Trabalho; Enfermagem; Trabalho; Pandemia; Infecções por Coronavírus. NURSING IN COVID-19 TIMES IN BRAZIL: A LOOK AT WORK MANAGEMENTObjective: Analyze the situation of the Nursing team in the context of the pandemic in Brazil, focusing on the management of the work of these professionals. Method: This is a reflection study on the living and working conditions of nursing professionals in the context of the COVID-19 pandemic, using data from the World Health Organization, the Ministry of Health, the Nursing Observatory of the Federal Council of Nursing and the Nursing Profile Research in Brazil. Results: There are numerous weaknesses in the working conditions, income, work, physical and mental health of these professionals. In relation to the COVID-19 pandemic, the picture is of a disease installed throughout the country, but differing significantly between states and regions. The country already accounts for 5,533 confirmed cases and 138 deaths among the professionals of the nursing team. Conclusions: The pandemic has reinforced to a greater extent the precarious working conditions of Brazilian nursing professionals, requiring more studies and diagnoses, on the effects that affect the working process during the current period and in the post-pandemic for a better understanding of the reality posed and exposed, in order to propose suggestions to Class Entities, to society and to the State in order to bring the reality of these professionals closer to what the International Labor Organization has called “decent work”.Descriptors: Workforce; Nursing; Work; Pandemics; Coronavirus Infections. ENFERMERÍA EN TIEMPOS DA COVID-19 EN BRASIL: UNA MIRADA A LA GESTIÓN DEL TRABAJOObjetivo: Analizar la situación del equipo de enfermería en el contexto de la pandemia en Brasil, centrándose en la gestión del trabajo de estos profesionales. Método: Este es un estudio de reflexión sobre las condiciones de vida y trabajo de los profesionales de enfermería en el contexto de la pandemia COVID-19, utilizando datos de la Organización Mundial de la Salud, el Ministerio de Salud, el Observatorio de Enfermería del Consejo Federal Enfermería e Investigación del Perfil de Enfermería en Brasil. Resultados: Existen numerosas debilidades en las condiciones de empleo, ingresos, trabajo, salud física y mental de estos profesionales. En relación con la pandemia de COVID-19, la imagen es de una enfermedad instalada en todo el país, pero que difiere significativamente entre estados y regiones. El país ya cuenta con 5.533 casos confirmados y 138 muertes entre los profesionales del equipo. Conclusiones: La pandemia reforzó las condiciones de trabajo precarias de los profesionales de enfermería brasileños en mayor medida, requiriendo más estudios y diagnósticos, sobre los efectos que afectan el proceso de trabajo durante el período actual y en la post pandemia para una mejor comprensión de la realidad planteada y expuesta, con el objetivo de proponer sugerencias a las Entidades de Clase, a la sociedad y al Estado para acercar la realidad de estos profesionales a lo que la Organización Internacional del Trabajo ha llamado "trabajo decente".Descriptores: Fuerza de Trabajo; Enfermería; Trabajo; Pandemias; Infecciones por Coronavirus.
IntroductionOne of the components of the Health Observatory for Latin American and the Caribbean (HO-LAC) is the design and implementation of metrics for human resources for health. Under the HO-LAC initiative, researchers from nine countries in the region formed the Collaborative Community on Human Resources for Health in Latin America and the Caribbean to identify common metrics applicable to the field of human resources for health (HRH).Case descriptionThe case description comprises three stages: a) the origins of an initiative in which a non-governmental organization brings together researchers involved in HRH policy in LAC, b) a literature search to identify initiatives to develop methods and metrics to assess the HRH field in the region, and c) subsequent discussions held by the group of researchers regarding the possibilities of identifying an appropriate set of metrics and indicators to assess HRH throughout the region.Discussion and evaluationA total of 101 documents produced between 1985 and 2008 in the LAC region were identified. Thirty-three of the papers included a variety of measurements comprising counts, percentages, proportions, indicators, averages and metrics, but only 13 were able to fully describe the methods used to identify these metrics and indicators. Of the 33 articles with measurements, 47% addressed labor market issues, 25% were about working conditions, 23% were on HRH training and 5% addressed regulations. Based on these results, through iterative discussions, metrics were defined into three broad categories (training, labor market and working conditions) and available sources of information for their estimation were proposed. While only three of the countries have data on working conditions, all countries have sufficient data to measure at least one aspect of HRH training and the HRH labor market.ConclusionsInformation gleaned from HRH metrics makes it possible to carry out comparisons on a determined experience in space and time, in a given country and/or region. The results should then constitute evidence for policy formulation and HRH planning and programs, with improved health system performance ultimately contributing to improved population health. The results of this study are expected to guide decision making by incentivizing the construction of metrics that provide information about HRH problems in LAC countries.
This article discusses some questions related to human resources that act on Brazilian health system. At the beginning, it identifies the trends on health human resources in the last years. Then it shows on a brief discussion the health system reform, pointing out changes in the health model design through the implementation of the Family Health Program. This program tries to reorder the health care model, bringing the primary health care, in order to substitute the traditional model, designed to the cure of diseases and centered on hospitals. It also points out important changes on work conditions, such as: doctors' and dentists' no liberal work, low salaries, consultations paid by the HMO's, flexibilization of work, loss of work guarantees. Finally, it identifies serious problems in the Family Health Program, especially those related to the instability of work process and decreasing of social protection of workers who act on this program.
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