Provimento e fixação de médicos na atenção primária à saúde no estado da Bahia / Provisión y mantenimiento de médicos de atención primaria de salud en el estado de Bahía / Hiring and retaining physicians to work in primary health care in the state of Bahia

Resumo Este artigo analisa as estratégias de gestão do trabalho da Fundação Estatal Saúde da Família (FESF-SUS), criada para suprir a necessidade de médicos no Estado da Bahia. Objetiva contribuir com o debate acerca das dificuldades de provimento e fixação de médicos na Estratégia Saúde da Família (ESF). A pesquisa consistiu em um estudo de caso, por meio de diversas estratégias metodológicas, destacando-se a análise documental. Os achados apontam como solução a criação de uma carreira intermunicipal. A proposta de gestão do trabalho da Fundação Estatal Saúde da Família (FESF-SUS, n.d.) incluiu os seguintes aspectos: remuneração variável, mobilidade do trabalhador entre os municípios e fatores associados ao suprimento de médicos. A complexidade dessa proposta se depara com a ausência de experiência na gestão desse modelo e também com as questões estruturais e institucionais que marcaram historicamente a gestão do trabalho nos municípios.

Resumen El artículo analiza las estrategias de gestión del trabajo de la Fundación Estatal de Salud Familiar (FESF-SUS), creada para satisfacer la necesidad de los médicos en el estado de Bahía. Tiene como objetivo contribuir al debate sobre las dificultades en el suministro y mantenimiento de los médicos en el programa Estrategia Salud de la Familia. La investigación consistió en un estudio de caso mediante diversas estrategias metodológicas, entre las que se destaca el análisis documental. Los resultados apuntan como solución la creación de una carrera intermunicipal. La propuesta de gestión del trabajo de la Fundación Estatal Salud de Familia (FESF-SUS, n.d.) incluye aspectos tales como compensación variable, movilidad de los trabajadores entre los municipios y factores asociados con el suministro de los médicos. La complejidad de esta propuesta se depara con la falta de experiencia en el manejo de este modelo y también con las cuestiones estructurales e institucionales que históricamente han marcado la gestión del trabajo en los municipios.

Abstract This article analyzes the strategies of work management adopted at the Fundação Estatal Saúde da Família (State Health Family Foundation) (FESF-SUS), which was created to hire and allocate physicians in the Brazilian state of Bahia. The research aims to contribute to the debate about the difficulties of hiring and retaining physicians to work in the public policy promoting family health "Estratégia Saúde da Família" (ESF). The research consisted of a case study adopting several methodological strategies, with emphasis on documentary analysis. The findings show that one solution to hire and retain physicians is the creation of an inter-municipal career. The proposed work management of the Foundation included aspects such as variable compensation, worker mobility between municipalities, and factors associated with the provision of physicians to work in public health. The complexity of this proposal is faced with the lack of experience in operating this form of work management, as well as with the structural and institutional issues that historically marked the work management in the municipalities.

[Work and education in health in Brazil: trends in scientific output between 1990-2010]. / Trabalho e educação em saúde no Brasil: tendências da produção científica entre 1990-2010.

The scope of this article is to analyze the characteristics of scientific literature on work and education in health in Brazil from 1990 to 2010. A synthetic study was conducted from abstracts published in Brazilian journal articles selected from the SCIELO and LILACS databases. Five hundred and thirty-two articles were selected, categorized according to their origin, year of publication, theme, and type of study. The publication of these scientific articles increased during the period analyzed, particularly from 2007 onwards. The main areas researched were education and training of health professionals, and the majority of works in these areas examine curriculum reform, methods of learning and teaching, and teaching in-service experiences. Besides these issues, others questions were addressed such as the labor market configuration and trends in health, and characteristics of the work process in several areas, like primary healthcare units. It was also observed that there are only a small number of studies related to policy, planning and management of work in public and private health institutions, as well as a scarcity of studies presenting reflections on theoretical and conceptual aspects of this theme.