Professionals entering and leaving the Portuguese health services system.

In Portugal, the healthcare sector demand for professionals has traditionally outweighed the supply for physicians, nurses and health technicians. However, the capacity of the National Health Service, the main healthcare sector employer, to absorb new professionals is apparently decreasing, and the demand for professionals in the private sector is unclear, but it seems to be growing. With regard to physicians, demand seems to persistently exceed supply, as many physicians work in several institutions or work overtime in the public sector, and the number of foreign physicians practicing in Portugal is increasing. In recent years, the number of medical schools and medical graduates increased, but it may not be sufficient to meet future needs. This paper is limited by the lack of comprehensive data on the private sector and on the number of professionals moving between the public and private sectors. These data are important for the planning and the decision-making process. Human resources policies, supported by an adequate health information system, are fundamental steps for the improvement of the performance of the healthcare system.

The Portuguese contribution to the brain drain from Portuguese speaking African countries.

In the first part of this paper, a secondary analysis of multiple data sources was done to identify how many nurses, physicians, dentists, pharmacists and other health workers have migrated from the Portuguese speaking African countries (PSAC) to Portugal between 1998 and 2002. In the second part, the results of a 2003 questionnaire based survey of 45 nurses, from Guinea-Bissau, residing in Portugal are reported. Health professionals are increasing as a proportion of total immigrants into Portugal. Relatively to the countries' of origin population, the PSAC contribute the most with foreign health professionals to the Portuguese healthcare system. Our study of Guinea-Bissau nurses in Portugal replicates the results of other studies and suggests that the decision to emigrate is multiply determined. The implication for policy makers is that the causal complexity among factors spurring emigration makes that the marginal effect of policy reforms addressing one or more of the multiple determinants of emigration may be sufficient to retain some proportion of health professionals, even when other determinants of emigration are present. The situation observed is also indicative of the need of programs for social integration of these professionals.

Patterns of perceptions of workplace violence in the Portuguese health care sector.

This article characterizes the problem of violence against health professionals in the workplace (VAHPITWP) in selected settings in Portugal. It addresses the questions of what types of violence are most frequent and who are the most affected health professionals.Three methodological approaches were followed: (i) documentary studies, (ii) a questionnaire-based hospital and health centre (HC) complex case study and (iii) semi-structured interviews with stakeholders.Of the different types of violence, all our study approaches confirm that verbal violence is the most frequent. Discrimination, not infrequent in the hospital, seems to be underestimated by the stakeholders interviewed. Violence seems much more frequent in the HC than in the hospital. In the HC, all types of violence are also most frequently directed against female health workers and, in the hospital, against male workers.These studies allow us to conclude that violence is frequent but underreported.