Brazil is the only country in the world to propose a universal health care system with the aim of guaranteeing delivery of all levels of health care, free of charge, to a population of over 200 million inhabitants by means of a unified health system ("Sistema Único de Saúde" [SUS]). The national policy of oral health, also known as Smiling Brazil ("Brasil Sorridente"), was implemented in 2004. Oral health was designated as 1 of the 4 priority areas of the SUS, transforming oral health care in Brazil, with the objective that the SUS achieve the integrality of care envisaged at its creation. The aim of this article is to share part of this experience in order to prompt reflection about the inclusion of oral health care in other health care systems around the world. The most significant results of Smiling Brazil can be seen in 3 areas: (1) oral health epidemiological indicators, (2) financial investment and professional development, and (3) the building of an oral health care network throughout the 10 y of the policy. The "Discovery!" article presented here portrays 10 y of evolution; however, it is important to point out that this is a process undergoing construction and that the oral health care network needs to be further expanded, refined, and solidified so that over time and through changes in the political parties in power, Smiling Brazil prevails as a perennial policy and not merely an action by a single government.
Scarcity and imbalances in the distri
The objective of this study was to identify and analyze the geographic distribution of dentists, in the global context, through available scientific evidence, highlighting the following aspects: 1) the determinants of the geographic distribution of dentists, 2) corrective intervention implemented, and 3) their monitoring and evaluation. A scoping review of the published and gray literature was carried out in scientific databases and in relevant websites. We used an adaptation of a World Health Organization framework to study the distribution of human resources in health to analyze selected publications. After applying the eligibility criteria, 53 publications were included in the review; 10 related to the determinants of geographical distribution, 5 to interventions implemented, and 38 to the monitoring and evaluation process. More studies are needed to identify local determinants of the geographical distribution of dentists and to define adapted intervention strategies to make it more equitable. Knowledge Transfer Statement: The geographic inequality of dentists is a problem for health systems because it has a direct impact on access to services and the oral health conditions of a population. Our study was based on a theoretical conceptual framework formulated in 3 components: 1) determinants of the geographical distribution, 2) strategies implemented to correct the problem, and 3) monitoring and evaluation. It can assist in designing oral health policy and guide decisions by policy makers.
This article aims at: i) describing and analyzing the expansion of dental care in the Unified Health System (SUS); ii) Identifying and analyzing the characteristics of hiring dentists' in the public service; iii) characterizing public vacancies, their duties and remuneration. In this descriptive case study, databases of the Ministry of Health were consulted and public tender notices. The findings indicate that 48% of the dentists enrolled in the National Registry of Health Establishments (CNES) perform care in the SUS, in 13 years there was an increase of 118% of the municipalities with oral health teams (eSB) implanted. The population coverage estimated by eSB increased by 10.46% between the years 2007 and 2015. The main mechanism for joining the Dental Specialties Centers (CEO) was the public tender. Primary care salaries ranged from 1. 05 to 12.67 Brazilian minimum wages, and to CEOs from 3.35 to 7.05. It is concluded that, among other measures, the planning of HRH strategies is necessary. The continuity of successes regulatory measures of labor contracts and support to local managers enter the agenda of priority actions of oral health policy.
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