The federal government announced this Monday (20) the resumption of the Mais Médicos program, with the opening of 15,000 new vacancies. Renamed Mais Médicos para o Brasil, the program, created in 2013 and marked by the hiring of Cuban doctors, now includes other health areas, such as dentists, nurses and social workers, and promises to prioritize Brazilian professionals.
Of the total number of new vacancies for this year, 5,000 will be opened through public notices this March. The other 10,000 will be offered in a format that provides for a counterpart from municipalities, which, according to the federal government, guarantees municipalities lower costs, greater agility in replacing professionals and conditions for permanence in these locations. The investment is BRL 712 million by the Union in 2023 alone.
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During a ceremony at the Planalto Palace, the Minister of Health, Nísia Teixeira, highlighted that the government is committed to strengthening the program, classified by her as essential for the Unified Health System (SUS) and for Brazilian society.
“More Doctors has returned to respond to the challenge of guaranteeing the presence of doctors to citizens of municipalities that are farther from the big centers and that suffer from lack of access”.
“Without primary care, we will not have resolution and we will not advance in the policy we need, in high and medium complexity care”, he said, citing consolidated evidence that the program, in its first moment, was able to provide professionals in more vulnerable areas, reducing rates such as infant mortality.
President Luiz Inacio Lula da Silva said the program was “an exceptional success”. “Rarely have poor people received the treatment they received after we put Mais Médicos to work,” he said. During the ceremony, Lula recalled the criticisms related to the arrival of Cuban doctors in the country at the time and even apologized to the professionals.
“Most poor people in this country still die without being attended to by the specialist, which could be the most common thing, but it is not”, he highlighted. “Only those who live on the outskirts of big cities, in small towns in the interior, know what the absence of a doctor is like, a person starting with a small headache and dying because there was no one to make an appointment”.
The forecast is that, until December, around 28 thousand professionals will be fixed in the country, mainly in areas of extreme poverty. It is estimated that 96 million people are guaranteed medical care in primary care, considered the gateway to the SUS. This first service, in basic health units, allows the monitoring, prevention and reduction of health problems.
Brazilian professionals and exchange students, Brazilians trained abroad or foreigners, who will continue to work registered with the Ministry of Health, can participate in the notices of the More Doctors for Brazil program. Brazilian physicians trained in Brazil will have preference in the selection.
Incentives and training
One of the challenges in providing services to regions with difficult access, already identified at the time of the launch of the program, is the permanence of professionals in these locations. Data from the ministry itself show that 41% of participants give up in search of training and qualification.
With the aim of reducing this turnover and ensuring continuity of care, physicians participating in the program will be able to do specialization and master’s degrees for a period of up to four years. Professionals will also start to receive benefits, proportional to the monthly amount of the scholarship, to work in peripheries and remote regions.
Maternity and paternity leave
In the case of doctors, compensation will also be made to reach the same scholarship amount during the period of six months of maternity leave, complementing the aid paid by the National Institute of Social Security (INSS). For program participants who become parents, a 20-day maintenance leave will be guaranteed.
faithful
Professionals trained through Higher Education Student Financing (Fies) and who participate in the program will also be able to receive incentives to help pay off debt. Approved physicians who complete the residency program in remote areas will also receive incentives.
Another challenge, according to the federal government, is expanding the training of family and community physicians, professionals dedicated to providing care in basic health units. Physicians approved and who complete the residency program in remote areas will also receive incentives.
According to the Minister of Education, Camilo Santana, who participated in the program’s resumption ceremony, the bonus for professionals who studied medicine and who were hired by Fies could reach 80% of the value of scholarships paid by Mais Médicos in Brazil. “It is a stimulus because a high turnover was detected”, he reinforced.
Analysis
The president of the Brazilian Society of Family and Community Medicine, Zeliete Linhares, celebrated the resumption of the program.
“We are specialists in people and we know where they live, how they live, what influences their health, what influences their daily lives, where they work, what they earn, what their social problem is and what violence they are subjected to. All of this makes a difference in solving problems.”
“It is primary care that does this. That’s where the people are and that’s where family and community medicine should be. Quality medicine, with training and specialists in primary health care”, he added.
The vice-president of the National Council of Health Secretaries (Conass), Fábio Baccheretti, said that the new format of Mais Médicos should bring more universal and integral health. “A very important moment, in such a heterogeneous country, where assistance opportunities are often different. We have to face, in more than 30 years of SUS, this problem, which is to provide the population with health prevention at the end.
For the president of the National Council of Municipal Health Secretariats (Conasems), Wilames Freire, the Mais Médicos por Brasil program “comes at a good time” and with a bolder format, taking care to what he referred to as corners of the country. “We have a responsibility to take that population that does not have access to this professional who is so valuable to our society”.
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