Integración laboral en el sector salud de la población venezolana en la República Argentina / Labor integration in the health sector of the Venezuelan population in the Argentine Republic

En este estudio se presenta una caracterización del reciente flujo de profesionales de la Salud provenientes de la República Bolivariana de Venezuela con el objetivo de producir información confiable respecto de las calificaciones laborales de los/as trabajadores/as sanitarios de origen venezolano que residen en la República Argentina y sobre las que demanda el mercado del trabajo local. Una intención que se mantiene a lo largo de este estudio es la de proveer en relativamente corto plazo, una serie de insumos para la toma de decisiones por parte de las autoridades migratorias, sanitarias y educacionales frente a la considerable magnitud de personas migrantes y refugiadas llegadas desde la República Bolivariana de Venezuela. La realización de este estudio inicial abarcó: una revisión bibliográfica; una caracterización de la población venezolana en la República Argentina a partir de los datos provenientes de la DNM y de los colectados por las organizaciones de profesionales venezolanos; la identificación de las áreas geográficas en las que existe mayor demanda de profesionales con calificaciones laborales afines a las de la población venezolana arribada y una descripción de las motivaciones y expectativas de la misma. La recolección de datos, su procesamiento y análisis, implicaron el diseño de algunos instrumentos, tales como guiones de entrevistas individuales y grupales. Tanto OIM como la DNM y las asociaciones de profesionales venezolanos en la República Argentina, facilitaron esos contactos y el acceso a fuentes documentales propias. (AU)

[Realities and professional expectations of medical students attending Guinea Bissau's medical school in 2007 school year]. / Realidades e expectativas dos alunos da licenciatura de medicina da Guiné-Bissau no ano lectivo 2007.

In Guinea Bissau, the majority of university level professionals are still being trained abroad and most of them do not return to their country. This was a major incentive for creating Guinea Bissau's Medical School. An observational, cross-sectional, analytic study was conducted on the second trimester of 2007 to characterize the socio-demographic, familial and educational profile of medical students, their satisfaction levels, difficulties and expectations concerning the medicine course. A questionnaire was used and a response rate of 63% achieved (81 students). Data was analyzed using SPSS v.17 for descriptive statistics. Students are very committed to their education. They tend to decide to take the medicine course early in their lives and are influenced by their relatives. They choose to be medical doctors because they like it but also for altruistic reasons and the desire to save lives. Although many face financial and material difficulties, they tend to have success in their academic live. They live with their parents, do not have children and some have side jobs to provide for extra income to help with their education. They expect their education to make them good doctors in any part of the world and want to work simultaneously in the public (to serve their country and pay their debt to the State) and in the private sector (to enhance their income). The large majority wants to work in a hospital, in Bissau, and to be a pediatrician or obstetrician. They have unreasonably high expectations concerning their future income as medical doctors.

The training and professional expectations of medical students in Angola, Guinea-Bissau and Mozambique.

BACKGROUND: The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future. METHODS: Data were collected through a standardised questionnaire applied to all medical students registered during the 2007-2008 academic year. RESULTS: Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor.The degree of feminization of the student population differs among the different countries.Although most medical students are from outside the capital cities, expectations of getting into medical school are already associated with migration from the periphery to the capital city, even before entering medical education.Academic performance is poor. This seems to be related to difficulties in accessing materials, finances and insufficient high school preparation.Medical students recognize the public sector demand but their expectations are to combine public sector practice with private work, in order to improve their earnings. Salary expectations of students vary between the three countries.Approximately 75% want to train as hospital specialists and to follow a hospital-based career. A significant proportion is unsure about their future area of specialization, which for many students is equated with migration to study abroad. CONCLUSIONS: Medical education is an important national investment, but the returns obtained are not as efficient as expected. Investments in high-school preparation, tutoring, and infrastructure are likely to have a significant impact on the success rate of medical schools. Special attention should be given to the socialization of students and the role model status of their teachers.In countries with scarce medical resources, the hospital orientation of students' expectations is understandable, although it should be associated with the development of skills to coordinate hospital work with the network of peripheral facilities. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country.

The WHO UNESCO FIP Pharmacy Education Taskforce.

Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services. Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls "pharmaceutical care interventions"; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles. Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008-2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope.

The health worker shortage in Africa: are enough physicians and nurses being trained?

OBJECTIVE: To estimate systematically the inflow and outflow of health workers in Africa and examine whether current levels of pre-service training in the region suffice to address this serious problem, taking into account population increases and attrition of health workers due to premature death, retirement, resignation and dismissal. METHODS: Data on the current numbers and types of health workers and outputs from training programmes are from the 2005 WHO health workforce and training institutions' surveys. Supplementary information on population estimates and mortality is from the United Nations Population Division and WHO databases, respectively, and information on worker attrition was obtained from the published literature. Because of shortages of data in some settings, the study was restricted to 12 countries in sub-Saharan Africa. FINDINGS: Our results suggest that the health workforce shortage in Africa is even more critical than previously estimated. In 10 of the 12 countries studied, current pre-service training is insufficient to maintain the existing density of health workers once all causes of attrition are taken into account. Even if attrition were limited to involuntary factors such as premature mortality, with current workforce training patterns it would take 36 years for physicians and 29 years for nurses and midwives to reach WHO's recent target of 2.28 professionals per 1000 population for the countries taken as a whole--and some countries would never reach it. CONCLUSION: Pre-service training needs to be expanded as well as combined with other measures to increase health worker inflow and reduce the rate of outflow.

Actualización de la gestión y de la administración de personal en una obra social de la industria metalúrgica en Argentina / Update on personnel management and administration in a union health service the metal industries in Argentina

El autor expone el trabajo de consultoría que realizó un grupo de profesionales en la Obra Social de la Industria Metalúrgica (OSPIM), la cual presta servicios de salud, vinculada al sindicato de esta rama de actividad. Los autores plantean que las modificaciones en el mercado de salud en general y en Argentina en particular, están llevando el asunto al tema de la demanda. Los empelados de la industria metalúrgica no será en lo sucesivo los "clientes cautivos" de la OSPIM, lo que le plantea a esta entidad la necesidad de mantener e incrementar la demanda de sus servicios. En este marco de referencia es que se produce la consultoría que realizan los autores, la cual estuvo encaminada a generar una nueva reglamentación para el personal y sus políticas de administración, hacer una propuesta de escala salarial nueva y uniforme y dar asesoría legal para los contratos de externalización de servicios. En este último sentido la consultoría no se quedó únicamente en el plano legal, sino que se valoraron alternativas para redefinr la estructura de los servicios de la OSPIM, considerando: contratos de concesión, inserción de los servicios en redes de prestadores, fortalecimiento de la red de servicios propia. En términos de la estructura salarial y las remuneraciones se propuso una nueva estructura de categorías, por grupos funcionales y nivel de responsabilidad, lo cual se complementa con franjas salariales que permiten desarrollar una carrera horizontalmente a partir de los resultados de la evaluación del desempeño. En el artículo se detallan las consideraciones tomadas en cuenta en el diseño de la estructura salarial. A partir de la estructura de categorías ya mencionada, se actualizó la descripción de puestos y se reencuadraron los agrupamientos funcionales. Tomando este proceso como base se planteó un sistema de cobertura de vacantes. Se introdujo la evaluación del desempeño para lo que se propuso utilizar dos metodologías: evaluación por objetivos para el personal de dirección y por factores y grados para el resto del personal. la capacitación se consideró de vital importancia como herramienta para el cambio organizacional. Se propusieron además, mecanismos vinculados con la calidad de servicios (autitorías médicas, encuestas de pacientes y afiliados, buzones de sugerencias y otras). En lo sucesivo el artículo detalla la forma y los escollos que fue necesario superar para lograr poner en práctica la propuesta: