Formação dos profissionais de saúde no Brasil: os programas interministeriais entre 2003 a 2016.

Abstract

Introduction: The study discuss the professional training in health in Brazil, reoriented by the in-service training integration model that fosters the substitution of more traditional curricula in higher education health schools through programs developed by the Department of Health Labour Management and Education of the Ministry of Health (SGTES / MS) between 2003 and 2016. Problem: to understand the dissociation between advances in the policy options that refocus the model of professional training in health and the institutional pedagogy limitations and the work that are not effectively followed by the curricula substitution within the schools. Objective: To understand the professional training of Human Resources for Health (HRH) developed between 2003 and 2016 by the implementation of Interministerial Programs developed by SGTES / Moth. Method: qualitative and descriptive-exploratory to analyze the formation of the health professional in its components and common elements, which characterize and institute the central axes of change: theoretical direction, pedagogical approach and practice settings, using Integrative Systematic Bibliographic Review and Programmes Mapping. Main data sources were the Portal of the Virtual Health Library (VHL) and the Regional Repertory of Human Resources for Health, helped by secondary data sources. The categories of analysis were a) the central axes of change that guided actions and programs to curricula replacement; and b) the contents within each program implemented by SGTES / MS to carry out the curricular change. Results: theoretical advances and difficulties in the interpretation of the pedagogical approach method are evidenced; conflicts related to the in-service training in the health service settings; challenges in the in-service training approach in inadequate and overloaded settings for health professionals, coupled with the deficiency in relation the an attractive and motivating job and career plan and policy for the SUS, especially in Primary Health Care. The traditional curriculum of higher education for health professional schools share training settings with the model implemented by the programs with gaps that express the conflicts of change as analyzed between the contributing and hindering factors. Conclusions: changes in the training model of health professionals were identified in different pedagogical projects implemented in some schools by their own initiatives when they receive technical and financial support by international technical cooperation agencies and / or resources from interministerial programs to integrate training and health service. However, they followed a parallel path, concomitant with traditional curricula. There was no homogeneity in the design of integrated curricula, recognized in alternative experiences, as seen in the literature, but valid evidence pointed to a consistent theoretical-conceptual basis that gave sustainability to the axis of theoretical orientation. The main barriers faced evidenced the strengthening of Permanent Health Education based on the central axes of change and the struggles of Moth to interpret it as an approach to the in-service training settings. The SUS training settings seems inadequate to accommodate the students, aggravated by the lack of recognition and appreciation of the Health Workforce as critical elements to interpret the change.