Potentialities and challenges of the doctors provision program in a State in Northeast Brazil

Abstract

Paraíba has the second largest coverage of Primary Care (PC) in the country, however, it still faces the national trend of disparity in the concentration of doctors between health macro-regions. The expansion in the provision of these professionals over the years gave the state a quantitative increase, between 2012 and 2015, of 21%, of which 3% derived from the Mais Médicos Program (MMP). The goal of this article is to evaluate the perception of physicians and managers participating in the program in Paraíba, pointing out strengths and weaknesses. This is an exploratory-descriptive, qualitative study, in which physicians and managers from 13 municipalities in Paraíba were interviewed. Interviews were carried out with a semi-structured script, which were recorded, transcribed and analyzed through content analysis, with the systematic classification of the reports. Physicians and managers agreed on the positive impact of the program on access to the service and on the quality of PC. Managers reported differences between participating physicians in relation to those not participating in the program: greater professional commitment, a profile more focused on PC and a relationship with the community marked by proximity and bond. Physicians highlighted greater autonomy at work, contractual stability and good remuneration. Both groups complained of displacement, high demand and difficulty finding a doctor in the countryside. Cubans were described as highly dedicated and humane professionals, however, there were criticisms regarding language and therapeutic approaches. The analyzed interviews allow us to infer that Mais Médicos brought changes that go beyond the presence of the doctor in the Family Health Unit, as it led to impacts on the quality of care, on the bond with the community, as well as on the team's relationship.