observatório de recursos humanos em saúde no...

MINISTÉRIO DA SAÚDEORGANIZAÇÃO PAN-AMERICANA DA SAÚD�

Observatório de Recursos Humanosem Saúde no Brasil

Estudos e Análises

Volume 2

Brasília – DF2004

MINISTÉRIO DA SAÚDEORGANIZAÇÃO PAN-AMERICANA DA SAÚD�

Observatório de Recursos Humanosem Saúde no Brasil

Estudos e Análises

Volume 2

Série B. Textos Básicos de Saúde

Brasília – DF2004

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21

Apresentação

Pedro Miguel dos Santos Neto, José Paranaguá de Santana

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22

Observatório de Recursos Humanos em Saúde no Brasil. Estudos e Análises – Volume 2

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23

Apresentação

$#(-$-/.$*#&$( ,'%$&#-' 0'%'( )*+-&%&( A&0& * %'('#)*+)$,'#-* ' & %$?/(G*%' .*#4'.$,'#-* (*30' & ($-/&:G* %' 0'./0(*( 4/,&#*( %' (&E%'H �((&$#$.$&-$)& '#.*#-0*/ 3*& 8/&0$%& #*( �(-&%*(�,',30*( %& �08&#$9&:G*1 IF$#.+/$#%* & A&0-$.$A&:G* %' �� A&Y('(H

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Pedro Miguel dos Santos Neto

José Paranaguá de Santana

25

Observatório de Recursos Humanos em Saúde nasAméricas – 1999-2004: lições aprendidas e

expectativas para o futuro

Unidade de Desenvolvimento de Recursos Humanos, OPAS/OMS

Introdução�, 0'(A*(-& & #'.'(($%&%'( %*( A&Y('( #*( &#*( ��1 & �� $#$.$*/

/, A0*80&,& $#-'80&+ %' &:G* A&0& ?*0-&+'.'0 & ?/#:G* .**0%'#&%*0& %&(&/-*0$%&%'( (&#$-F0$&( & ?$, %' A0*%/9$0 ' %$?/#%$0 .*#4'.$,'#-* '$#(-0/,'#-*( O/' .*#%/9$((', & ,'+4*0'( A*+Y-$.&(1 0'8/+&,'#-*(1&%,$#$(-0&:G* ' '%/.&:G* %' 0'./0(*( 4/,&#*( #& F0'& %& (&E%'H �,&$#$.$&-$)& .4&)' ?*$ & .0$&:G* %* �3('0)&-P0$* %' �'./0(*( �/,&#*( ',�&E%'1 +&#:&%* ', ��H �, ��1 * �J� �*#('+4* �$0'-*0 %& �� &A0*)*/& �'(*+/:G* ��JH�M1 $#(-&#%* *( �(-&%*(�,',30*( & ̂ A&0-$.$A&0 &-$)&,'#-'%& $#$.$&-$)& �3('0)&-P0$* %' �'./0(*( �/,&#*(1 ?&.$+$-&#%* & .0$&:G* %'80/A*( $#-'0('-*0$&$( ' $#-'0$#(-$-/.$*#&$( ', .&%& A&Y( A&0& &#&+$(&0 &($-/&:G*1 8'0&0 $#?*0,&:Z'( '(('#.$&$( ' ?*0,/+&0 A0*A*(-&( (*30' A*+Y-$.& %'0'./0(*( 4/,&#*(1 0'8/+&,'#-&:G* ' &%,$#$(-0&:G*^H

�'(-' .&AY-/+*1 ?&9�(' /, '(?*0:* A&0& &-/&+$9&0 ' %'(.0')'0 &(0'&+$9&:Z'( ' &( +$:Z'( &A0'#%$%&( A'+*( 80/A*( %* �3('0)&-P0$* #*( A&Y('(13', .*,* & .**A'0&:G* %& �� #'((' ('#-$%*H * ,'(,* -',A*1 A0*./0&+')&0 & &-'#:G* %*( &-*0'( ('-*0$&$( A&0& & #'.'(($%&%' %' A*+Y-$.&( (P+$%&(%' 0'./0(*( 4/,&#*( .*,* /, ,'$* .0/.$&+ A&0& &+.&#:&0 &( ,'-&( %' �&E%'A&0& *%*( ' '#?0'#-&0 *( %'(&?$*( ?*0,/+&%*( #&( �'-&( %' �'('#)*+)$,'#-*%* �$+Q#$* ', #*((& �'8$G*H

Desenvolvimento de recursos humanos em saúde: problemas e desafiosem um ambiente complexo e em mutação rápida�, (70$* %'(&?$* '#?0'#-&%* A'+& ,&$*0$& %*( A&Y('( ', #*((& �'8$G* 7

& (/A'0A*($:G* %' A0*3+',&( A'0($(-'#-'( ' %'(&?$*( ','08'#-'(H .*,3$�#&:G* %' &,3*( +')& & .'#F0$*( ', O/' A0*3+',&( &./,/+&%*( %' ($(-',&(

Introdutório

26


-0&%$.$*#&$( .*#-$#/&, (', (*+/:G*1 '#O/&#-* (/08', #*)*( %'(&?$*( .*,*0'(/+-&%* %' 0'?*0,&( ('-*0$&$(1 ('#%* &,3*( &?'-&%*( A'+& %$#N,$.& %' /,.*#-'@-* 8+*3&+ ', ,/-&:G* WL/&%0* �XH

Quadro 1 – Problemas e desafios superpostos

Problemas persistentes

Desequilíbrios na disponibilidade,na composição e na distribuiçãoda força de trabalho

Administração e avaliação insufi-cientes do desempenho da forçade trabalho

Falta de sistemas de incentivo paraqualidade e produtividade

Fragmentação de processos detrabalho

Treinamento inadequado, centra-lizado e de impacto duvidoso

Motivação deficiente, absenteísmoe baixa taxa de participação detrabalhadores em postos de tomadade decisão

Regulamentos e normas inflexíveise retrógrados

Persistência de desigualdades pormotivo de gênero

Falta de coordenação no plane-jamento entre saúde e setoreseducacionais

Desafios emergentes

Mudanças gerenciais – descentralização,administração pública e importância dosprocessos administrativos

Maior flexibilidade nas condições detrabalho e ênfase no enfoque de equipe

Preocupações com competências,produtividade, qualidade e creden-ciamento

Melhor recrutamento e práticas deretenção

Complexidade da coexistência deregimes de trabalho diversos paracategorias ocupacionais semelhantes

Atenção ao estado de saúde, direitose obrigações dos trabalhadores desaúde

Migrações internacionais e maiormobilidade dos trabalhadores

Demandas sociais de condições detrabalho mais eqüitativas

Aumentos descontrolados das ofertaseducacionais pelo setor privado

Novacombinação

27

Observatório de Recursos Humanos em Saúde nas Américas – 1999-2004: lições aprendidas e expectativas para o futuro

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28


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34


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35


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37

História, saúde e recursos humanos:análises e perspectivas

Gilberto Hochman, Paula Xavier dos Santos e Fernando Pires-Alves

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Introdutório

38


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39

História, saúde e recursos humanos: análises e perspectivas

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�$$��$�� *�+M�7,-S3��)/� %$��/'/�%�&�'� �� )+� ��6� �� 6��:�$/��/�7 ��H�8�+��>��:��FLLQ/

�#9�$,T�� /��/�%-��/'/�(�� )�� +��.�� 1�� B �� /�� H�$�� &#�� -6�� DCCC/

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50


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51

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Célia Regina Pierantoni, Thereza Christina Varella e Tania França

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52


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53

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Figura 1 – Recursos humanos em saúde: aspectos estruturais

Fonte: MERCER et al. (2003). Adaptação livre.

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60


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62


Gráfico 1 – Avaliação da experiência/qualificação do gestor de RH. Brasil, 2004

Fonte: Rorehs/IMS-Uerj/Nescon-UFMG. Capacidade Gestora de Recursos Humanos em Instâncias Locais de Saúde em Municípioscom População Superior a 100 mil Habitantes. Brasil, 2004.

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63


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Gráfico 2 – Plano de cargos, carreira e salários específico para os trabalhadores da SMS.Brasil, 2004


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64


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Gráfico 3 – Mesa de negociação coletiva instalada na SMS. Brasil, 2004


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65


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Gráfico 4 – Ano de realização do último concurso público segundo a região do país. Brasil, 2004


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66


Gráfico 5 – Grau de autonomia do gestor de RH das SMS. Brasil, 2004


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7 1

Assistência domiciliar – instrumento parapotencializar processos de trabalho na

assistência e na formação

Maria José Bistafa Pereira, Silvana Martins Mishima, Cinira Magali Fortuna,

Silvia Matumoto, Rafaela Azenha Teixeira, Clarice Aparecida Ferraz,

Janete Rodrigues da Silva Nakao, Marcia Regina Antonietto da Costa Melo e Maria Luiza Anselmi

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Quadro 1 – Vantagens da internação domiciliar

Pacientes e suas famílias

Melhor atenção, participaçãoe responsabilidade

Melhor qualidade de vida,intimidade e bem-estar

Assistência personalizadaemais humanizada

Educação para a saúde

Prevenção de desinserçãosocial e hospitalismopsíquico

Menor risco de iatrogenia

Hospital

Melhor rentabilidade deseus recursos disponíveis

Aumento em rotação edisponibilidade de camas

Redução de permanênciasdesnecessárias

Redução dos períodos deinternações

Pressuposição de reduçãode custos

Possibilidade de melhoraros Serviços

Sistema de saúde

Incremento da eficácia e daefetividade mediante umaassistência mais humanizada

Uso mais eficiente dos recursossanitários

Possibilidade de integrar emelhorar as relações entreosdiversos níveis assistenciais

Possibilidade de atenção:continuada, integral e multidis-ciplinar entre os profissionaisda atenção primária

Fonte: COTTA, R. M. M.; VARELA-SUÁREZ, M. M.; GONZÁLEZ, A. L.; COTTA FILHO, J. S.; REAL, E. R.; RICÓS, A. D. La hospitalizacióndomiciliaria: antecedentes, situación actual y perspectivas. Rev. Panam Salud Public, v. 10, n. 1, p. 45-55, 2001.

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�$,$#,��/�8/�7/�<��)��#�� 1�� %�'�� <�� 6�� /�,�*��DCCF/�DIE�/�)�� /�$�� $6�� ,�*�� /

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Roberto Passos Nogueira,1 Solange Baraldi e Valdemar de Almeida Rodrigues

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85


Quadro 1 – Grau de vulnerabilidade social dos trabalhadores segundo suas condiçõesno mercado de trabalho

Vulnerabilidade Relação de trabalho Empresa Qualificação

Baixa Patrão Todas TodosAssalariado Grande (> 5 trab.) TodosAssalariado Pública TodosConta própria – Nível superior

Alta Assalariado Pequena (< 6 trab.) TodosConta própria – Sem nível superiorSem salário ou desocupado – Todos

Fonte: OIT, Panorama Laboral da América Latina, 2003.

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Referências bibliográficas�P�#3-�� S�� /� 3��:��0�� )�� .�� D�� )�� ) .��)��*� ��,�� )� * �+�� FG �,�� ;* /��;��e+��H&&444/��FG/��/*�&�� &E ��/+��f/��CK� ��/DCCJ/

7,��#B/�-�� 0��"��)��5��#�� I��*��FLKK&�*� �� $�� *�� A��B��5��)��<�� ? 5�� S��B;�� DL/�/� �� /�� /�� H�� DCCD/

7,��#B/�B��I/QEJ�W�FE��5/�FLQF/��7��/��;��-��# �� '�� E��/�� #� ��.�� #�� ;��e+��H&&444D/� ��/��/*�&�6&�� &�� &f/��CL� *�/�DCCJ/

7,��#B/�B��K/QJI�W�CL��5/�FLLG/�� )��0��4�� .��D�� )�� ,F��G@��-�� 0��5�� .�� #�� ;��e+��H&&444D/� ��/��/*�&�6&�� &�� &f/��CL� *�/�DCCJ/

$3�3�#��-��GGF��GEG/� #H�7,��#B/�� B��)� * �+�&�*� �� $�� *�� A��B��5��)��<�� ? 5�� S��B;�� DL/��/� �� /� ��/�� H�� DCCD/

�$,3�3�$�� <�� <��/�� '�� #�� )�� BH�� E��/�� 8��3 �� )�� /�D��/�DF��/�FLLQ/��;��e+��H&&444F/!��/��/*�&�� &�2��/ ��O��gGKKf/��FD� *�/�DCCJ/

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B#�� + �� /�-��0��'�� #�� .�� 8�� 3 �� )�� /� I�� /� JK�� 5/� DCCC/� ��;�� e+��H&&444F/!��/��/*�&�� &�2��/ ��O��gGLGf/��FD� *�/�DCCJ/

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105

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Janete Lima de Castro, Rosana Lúcia Alves de Vilar e Vicente de Paula Fernandes

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107

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Apresentando a área do estudo

VI Regional de Saúde

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112


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Quadro 1 – Distribuição dos agentes comunitários de saúde por município, segundo a escolaridade.VI Ursap-RN. Natal-RN/janeiro, 2004

Município No Ens. fund. % Ens.fund. % Ensino % Ensino %

ACS* incomp. compl. médio superior

P. dos Ferros 63 12 19 13 21 34 54 04 06São Miguel 46 09 20 13 28 24 52 – –Alexandria 34 – – 12 35 22 65 – –Umarizal 28 02 07 04 14 22 79 – –Patu 25 03 12 04 16 17 68 01 04Luis Gomes 23 05 22 05 22 13 56 – –T. Ananias 22 01 04 01 04 18 83 02 09M.Vieira 19 01 05 07 37 11 58 – –Portalegre 17 02 12 05 29 10 59 – –S. Melo 17 – – 05 29 12 71 – –A. Martins 16 05 31 07 44 04 25 – –José da Penha 15 – – 05 33 10 67 – –D. Severiano 14 04 29 06 42 04 29 – –Martins 13 01 08 04 31 08 61 – –A. Afonso 12 02 17 02 17 08 66 – –Itaú 08 04 50 – – 04 50 – –Total 372 51 14 93 25 220 59 07 2

Fonte: Gerência Estadual dos Programas Agentes Comunitários de Saúde e Saúde da Família, Secretaria Estadual de Saúde/RN.

* No levantamento feito nesta pesquisa, constata-se que alguns municípios, em decorrência do aumento da cobertura do PSF,ampliaram o no de ACS (S. Melo = 27 ACS, São Miguel = 50 ACS, Itaú = 19 ACS e Itaú = 13 ACS). Os demais municípiospermaneceram com o mesmo quantitativo.

113


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� �0*80&,& %' 8'#-'( �*,/#$-F0$*( %' �&E%' ?*$ $,A+&#-&%* #& 0'8$G*$#$.$&+,'#-' #*( ,/#$.YA$*( %' �&-&+1 �'&0F��$0$, ' �&.&Y3&1 #* &#* %'��1 .*, /, #E,'0* ,/$-* 0'%/9$%* %' &8'#-'(H �*,'#-' & A&0-$0 %' ��D.*,':*/ & ('0 &,A+$&%* #*( ,/#$.YA$*( %' �&-&+ ' �&.&Y3&H �* &#* %'��1 ?*$ $,A+&#-&%* ', �&0#&,$0$,] ', ��1 ', �G* 2*#:&+* %* ,&0&#-']' ', ��1 ', �@-0',*9 ' 0'$,A+&#-&%* ', �'&0F��$0$,H

0'8$G* A*((/$ &-/&+,'#-' �H�M= &8'#-'( .*,/#$-F0$*( %' (&E%'1 )$#./�+&%*(1 #& (/& ,&$*0$&1 [ '(-0&-78$& �&E%' %& !&,Y+$&1 .*,* $#?*0,& * L/&%0* �H

Quadro 2 – Distribuição dos ACS dos municípios da região da Grande Natal, segundo a vinculaçãoao PSF e ao PACS. Natal-RN/maio, 2004

Município % ACS vinculados ao PSF % de ACS vinculados ao PACS

Natal 65 35Parnamirim 100 00Ceará-Mirim 100 00São Gonçalo 80 00Macaíba 59 41Extremoz 63 37

� L/&%0* J &A0'('#-& & ($-/&:G* %& '(.*+&0$%&%' %'(('( &8'#-'( '.*#(-&-& O/' =�` -Q, * '#($#* ,7%$*H �*,A&0&#%*�(' .*, & �� '8$*#&+1A'0.'3'�(' /,& A'O/'#& '+')&:G* %* #Y)'+ %' '(.*+&0$%&%' %*( &8'#-'(H �O/' -&,37, #G* 7 (/0A0''#%'#-'1 .*#($%'0&#%* & .*#.'#-0&:G* %' '(.*+&(', �&-&+ ' & '(.&(('9 %' *?'0-& %' -0&3&+4*1 O/' 7 /,& .&0&.-'0Y(-$.& -&,37,%'((& 0'8$G*H

114


Quadro 3 – Distribuição dos agentes comunitários de saúde por município, segundo escolaridade.Grande Natal- RN. Natal-RN/janeiro, 2004

Município No Ens. fund. % Ens.fund. % Ensino % Ensino %

ACS* incomp. compl. médio superior

Natal 592 15 04 113 18 460 77 04 1Parnamirim 172 12 07 55 32 105 61 – –Ceará-Mirim 117 06 05 39 33 72 62 – –São Gonçalo 116 08 07 27 23 81 70 – –Macaíba 91 04 04 28 30 59 66 – –Extremoz 46 06 13 16 27 24 60 – –Total 1134 51 04 278 25 796 70 04 01

Fonte: Gerência Estadual dos Programas Agentes Comunitários de Saúde e Saúde da Família, Secretaria Estadual de Saúde/RN.

* No levantamento feito nesta pesquisa em maio/2004, verificou-se que o município de Natal, em razão do aumento da coberturado PSF, ampliou o no de ACS para 687. Os demais municípios permaneceram com o mesmo quantitativo.

Discutindo os resultados $#)'(-$8&:G* %&( ?*0,&( %' )$#./+&:G* %*( &8'#-'( .*,/#$-F0$*( #*(

('0)$:*( %' (&E%' %&( ('.0'-&0$&( %*( ,/#$.YA$*( ('+'.$*#&%*( .*#?$0,*/ &($-/&:G* %* A&#*0&,& #&.$*#&+ IF .*#4'.$%*� 80&#%' A&0-' %&( $#(-$-/$:Z'(AE3+$.&( %' (&E%' +&#:& ,G* %' .*#-0&-*( %' .&0F-'0 A0'.F0$*1 & ,&$*0$& (',8&0&#-$&( %*( %$0'$-*( -0&3&+4$(-&(H �'(-' '(-/%*1 ?*0&, $%'#-$?$.&%*( &A'#&(O/&-0* ,/#$.YA$*( O/' &((/,', *( '#.&08*( (*.$&$(� �&-&+ ' �G* 2*#:&+*1%& 0'8$G* %& 20&#%' �&-&+] ' �,&0$9&+ ' '#'#-' #&#$&(1 %& �� '8$*#&+ %'�&E%'H

� '(-/%* .*#(-&-*/ O/' "�` %*( ,/#$.YA$*( $#)'(-$8&%*( /-$+$9&,.*#-0&-*( $#?*0,&$(1 ' &A'#&( ��` +&#:&, ,G* %' .*#-0&-*( -',A*0F0$*(H�

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115


A*0 A&0-' %* �$#$(-70$* %& �&E%'1 ?*$ /, %'-'0,$#&#-' 0'?'0$%* A*0 "�` %*('#-0')$(-&%*(H �((& 0'(A*(-& %',*#(-0& O/' 3*& A&0-' %& 8'(-G* %&( ('.0'-&0$&(,/#$.$A&$( %' (&E%' &$#%& #G* .*#.'3' * &8'#-' .*,/#$-F0$* %' (&E%' .*,*/,& .&-'8*0$& A'0,&#'#-'H �',*#(-0& -&,37, & $#'@$(-Q#.$& %' /,& A*+Y-$.&,/#$.$A&+ %' 0'./0(*( 4/,&#*( ', (&E%'H �/-0*( ?&-*0'( .$-&%*( -&,37,.*#-0$3/', A&0& '((& &#F+$('� �"` %*( '#-0')$(-&%*( ?$9'0&, 0'?'0Q#.$& [$,A*(($3$+$%&%' %& 0'&+$9&:G* %' .*#./0(* AE3+$.*] �"` %$(('0&, A0*(('8/$0.*, & ?*0,& %' .*#-0&-&:G* &%*-&%& A'+& 8'(-G* &#-'0$*0] "` 0'((&+-&0&,O/' * �0*80&,& �&E%' %& !&,Y+$& #G* -', /, .&0F-'0 %'?$#$-$)* ' "` .$-&0&,& #G* 0'8/+&,'#-&:G* %& .&-'8*0$&H

L/'(-$*#&%*( (*30' &( )&#-&8'#( %&( ,*%&+$%&%'( %' .*#-0&-&:G*&%*-&%&( #&( (/&( $#(-$-/$:Z'(1 *( '#-0')$(-&%*( %'(-&.&0&, & A*(($3$+$%&%'%' .*#-0&-&0 A'((*&( %* A0PA0$* ,/#$.YA$* ' %'(+$8F�+&( %* A0*80&,& O/&#%*#'.'((F0$*H �( %'A*$,'#-*( &3&$@* $+/(-0&, '((&( &?$0,&:Z'(�

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-��;�� 6�� 6�� +�� )��*� �� $�� /�� 6 �� 6� � �(�� (�� * �+��(��+�� <�� 6�� /3�� * �+�� /

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116


%* O/&%0*] $#('8/0&#:& A'+* -$A* %' .*#-0&-*] ' * %'(.*#-* %* �,A*(-* �*30'�'0)$:*( � ��H

�((&( $#(&-$(?&:Z'( 0')'+&,�(' %' %$)'0(&( ,&#'$0&(1 .*#?*0,' &(%'.+&0&:Z'( %*( '#-0')$(-&%*(�

3�� 6�� "�� /�� "�� (��1�� /� �6�� "�� 6 �� +��/�� "�� *� � �� 5 �� /�� "�� + �� /

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�� (�� * �+�� /�� *��(�� * �+ ��(�� /��+�� <� ��*�� !�� i///j�-�� 6�� <�� /

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117


$�� 6��6 5�� * �+�� /

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Quadro 4 – Distribuição dos gestores quanto à opinião sobre modalidade de contrato mais adequadapara os ACS. VI Regional de Saúde e região da Grande Natal. Natal-RN / maio, 2004

Modalidade de contrato/vínculo Gestores %

Concurso público /regime celetista *administração direta 77Concurso público /estatutário 09Via cooperativa 04Via ONG 04Via consórcio intermunicipal – associações dos municípios. Regime celetista 04Não especificou 02Total 100

*Dois municípios mencionaram a realização de concurso interno para regularização da situação de agentes que já estão no serviço.

+8/,&( &?$0,&:Z'( %*( '#-0')$(-&%*( (*30' '((& O/'(-G* ,'0'.', ('00'((&+-&%&(�

P�� 6��6�� 6��<��6�� /��-39�� /�� *�� (�� "�� =��5��5 � �� %� ��&��'�� /P�� 6�� +�� 6�� (� �(�� 6��/��*��(�� 1�� /

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118


%' O/' &( ('.0'-&0$&( ,/#$.$A&$( %' (&E%' %* �$* 20&#%' %* �*0-' )$)',/,& 0'&+$%&%' A&0&%*@&+ O/' %',*#(-0& & %$(-N#.$& '#-0' & $#-'#:G* ' *8'(-*H

Considerações finais� A0'('#-' '(-/%* A0*./0*/ %$(./-$0 & A0'.&0$9&:G* %* -0&3&+4* %* &8'#-'

.*,/#$-F0$* %' (&E%' A*0 ,'$* %& $%'#-$?$.&:G* %&( ?*0,&( %' )$#./+&:G*%'(('( -0&3&+4&%*0'( &*( ('0)$:*( %' (&E%' ' (/& 0'+&:G* .*, *( %$0'$-*(-0&3&+4$(-&(H �0*./0*/ -&,37, %'()'#%&0 A*0 ,'$* %* 8'(-*0 %' (&E%'1 */ %'/, A0*?$(($*#&+ &/-*0$9&%* A*0 '+' A&0& 0'(A*#%'0 [( O/'(-Z'(1 O/&$( &($,A+$.&:Z'( O/' &( ,*%&+$%&%'( %' .*#-0&-&:G* /-$+$9&%&( -0&9', */-0*/@'0&, A&0& &( ('.0'-&0$&( ,/#$.$A&$( %' (&E%'H �((&( $,A+$.&:Z'( ?*0&,$%'#-$?$.&%&( A*0 ,'$* %&( )&#-&8'#( ' %&( %'()&#-&8'#( 0'?'0$%&(1 &(($,.*,* -&,37, A'+&( O/'(-Z'( 0'?'0'#-'( [( $#(&-$(?&:Z'( %*( &8'#-'(H

%$(./((G* %& .*#-0&-&:G* %* &8'#-' .*,/#$-F0$* 7 ,&$( .*,A+'@& %*O/' &A&0'#-&1 A*$( '+& #G* 7 0'(/+-&%* %' /,& ($,A+'( %'.$(G* %* ('-*0 (&E%'', .*#-0&-&0 %'(-& */ %' */-0& ?*0,&] '+& %'.*00' %' $,A*0-&#-'( ,/%&#:&(*.*00$%&(1 &* +*#8* %& %7.&%& %' ��1 #& '.*#*,$& #&.$*#&+1 #&&%,$#$(-0&:G* AE3+$.& ' #&( ?*0,&( (*.$&$( %' -0&3&+4*H �(A'.$?$.&,'#-'A&0& '(-' -0&3&+4*1 '((&( ,/%&#:&( '(-G* 0'A0'('#-&%&( A'+* -0&3&+4* ?+'@Y)'+*/ $#?*0,&+H *%&)$&1 .*,* IF ?*$ %$-* #& �#-0*%/:G*1 #G* ?&+-&, %$&8#P(-$.*(' &#F+$('( %& A0*+$?'0&:G* %*( .*#-0&-*( $#?*0,&$( */1 .*#?*0,' ?*$ &%*-&%*#'(-' '(-/%*1 %' .*#-0&-*( A0'.F0$*(H � O/' A&0'.' ?&+-&0 7 & %'.$(G* %*(8'(-*0'( ', &((/,$0 * A0*3+',& A&0& ($ ', .&%& '(?'0& %' 8*)'0#*H

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119


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121

Configurações do mercado de trabalho dosassalariados em saúde no Brasil

Sábado Nicolau Girardi, Cristiana Leite Carvalho, João Batista Girardi Jr. e Jackson Freire Araújo

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123

Configurações do mercado de trabalho dos assalariados em saúde no Brasil

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Tabela 1 – Indicadores gerais dos mercados de trabalho de profissionais de saúde empregados nomercado formal (todas as atividades e setores). Brasil, 1995

Categoria profissional No % Idade Salários Horas Índice de Tempo

vínculos Particip. média médios semanais remuneração médio de

ativos feminina (sal. min.) contratadas média emprego,

ajustado* em meses

Biologistas 6.536 66,9 36 11,0 38 68,2 79Bacteriologistas 9.203 65,8 35 7,3 36 47,5 63

Médicos 146.141 37,7 40 11,7 27 100,0 84

Cir. dentistas 39.023 53,9 38 8,8 28 73,5 96Méd. veterinários 7.294 20,4 38 13,2 38 80,4 102

Farmacêuticos 30.447 65,8 37 5,7 38 35,3 59

Nutricionistas 11.242 93,6 34 8,0 39 48,2 60Enfermeiros 71.097 88,2 36 8,4 38 51,9 74

Assist. sociais 32.740 90,0 37 8,4 38 51,9 82Psicólogos 14.032 88,2 36 9,3 34 63,6 74

Ortoptistas e óticos 1.634 32,4 32 3,5 43 19,3 48

Terapeutas 11.170 80,8 33 6,1 34 42,4 51Op. eq. med. e odont. 19.311 44,5 37 5,7 32 41,8 75

Méd. outros 15.677 78,4 34 5,6 36 36,2 63

Pessoal de enfermagem 401.282 84,2 36 4,1 38 24,7 72Auxiliar de enferm. em geral 199.899 86,1 36 4,7 38 28,6 64

Auxiliar de enf. do trabalho 2.304 77,0 37 4,6 37 28,9 64

Atendente de enfermagem 126.616 86,5 38 3,3 39 19,5 82Visitador sanitário 4.214 51,0 34 2,5 39 14,9 69

Auxiliar de banco de sangue 1.590 75,3 33 5,0 37 31,0 53

Instrumentador de cirurgia 1.352 90,0 37 4,8 38 29,4 84Parteira prática 1.052 96,0 44 2,6 35 17,5 133

Aux. de lab. análises clínicas 9.846 74,1 31 3,5 39 20,7 55

Aux. lab. análises físico-Q 2.879 38,0 30 5,1 42 28,2 70Outro pess. enferm. 51.530 79,1 36 3,8 38 23,2 80

Total pessoal de saúde 816.838 72,4 37 6,7 35 44,0 75

Fonte: Rais/TEM.

*Calculado por meio do ajuste da remuneração média ao número de horas contratadas; a remuneração do médico foi tomada comoigual a 100, a partir da qual se constituíram os índices das outras categorias.

131


Tabela 2 – Indicadores gerais dos mercados de trabalho de profissionais de saúde empregados nomercado formal (todas as atividades e setores). Brasil, 2000

Categoria profissional N o % Idade Salários Horas Índice de Tempo

vínculos Particip. média médios semanais remuneração médio de

ativos feminina (sal. min.) contratadas média emprego,

ajustado* em meses

Biologistas 7.374 73,2 37 10,9 37 68,4 94

Bacteriologistas 9.890 66,2 36 7,5 37 47,4 71

Médicos 152.119 39,6 42 12,2 29 100,0 100Cir. dentistas 38.533 57,4 40 8,6 28 71,4 113

Méd. veterinários 8.005 25,0 40 11,8 37 73,5 118

Farmacêuticos 40.040 67,3 37 6,3 39 37,6 49Nutricionistas 12.167 94,3 35 7,6 39 45,7 67

Enfermeiros 69.774 89,7 37 9,3 37 58,0 82

Assist. sociais 30.956 93,0 40 8,1 37 50,8 100Psicólogos 16.292 89,5 38 8,6 34 59,2 84

Ortoptistas e óticos 1.573 30,5 34 3,8 43 20,9 55

Terapeutas 13.348 81,0 34 6,4 33 45,6 64Op. eq. med. e odont. 21.574 44,3 38 5,2 32 38,4 79

Méd. outros 18.673 78,3 35 5,2 37 33,3 68

Pessoal de enfermagem 489.871 82,8 37 3,9 39 23,8 80Auxiliar de enferm. em geral 314.233 84,9 37 4,2 38 25,7 75

Auxiliar de enf. do trabalho 3.827 76,7 38 4,1 39 24,6 67

Atendente de enfermagem 68.609 86,5 41 3,3 39 19,8 109Visitador sanitário 10.150 54,0 34 2,3 40 13,5 58

Auxiliar de banco de sangue 1.888 74,0 – 4,7 38 0,0 58Instrumentador de cirurgia 1.307 87,5 37 4,3 39 25,9 82

Parteira prática 765 96,7 47 2,4 34 16,4 182

Aux. de lab. análises clínic. 13.747 75,8 32 2,9 40 17,0 58Aux. lab. análises físico-Q 3.526 47,8 30 3,7 43 20,3 52

Outro pess. enferm. 71.819 77,3 36 3,7 39 22,2 81

Total pessoal de saúde 930.189 73,3 38 6,5 36 42,1 84

Fonte: Rais/TEM.

*Calculado por meio do ajuste da remuneração média ao número de horas contratadas; a remuneração do médico foi tomada comoigual a 100, a partir da qual se constituíram os índices das outras categorias.

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O médico e o mercado de trabalho em saúde no Brasil:revendo conceitos e mudanças1

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Tabela 1 – Índice de participação do PSF em relação ao número de médicos em atividade,de postos de trabalho médicos ocupados em serviços de saúde e de vínculos formaisde emprego médico na economia

No de Total de PSF/ Postos de PSF/ Vínculos PSF/

médicos no médicos em oferta trabalho médico postos de de emprego emprego

PSF (1) atividade de médicos nos serviços trabalho médico médico

(oferta) (2) de saúde (3) médico (4) formal

14.513 262.891 5,5 % 431.282 3,4 % 152.119 9,5 %

(1) Estimativa Pesquisa Nescon.(2) CFM.(3) Em estabelecimentos com e sem internação e de apoio diagnóstico.(4) Ministério do Trabalho.Fonte: Girardi e Carvalho (2003).

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163


Precarização do trabalho de nível técnicoem saúde no Nordeste: um enfoque nos

auxiliares e nos técnicos de enfermagem

João Bosco Feitosa dos Santos, José de Freitas Uchoa e José Meneleu Neto

Introdução: as mudanças no mercado de trabalho de saúde no Brasil 0''(-0/-/0&:G* %* ,/#%* %* -0&3&+4*1 $#$.$&%& #* �0&($+ #& %7.&%&

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164


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Metodologia do trabalho '(-0&-78$& $#)'(-$8&-$)& ?*$ .*,A*(-& %' /, '(-/%* 3$3+$*80F?$.*U

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165

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��1 %* �$(-',& �&$(U�&8'%1 %* �$#$(-70$* %* 0&3&+4* ' �,A0'8*1 0'+&-$)*(&* A'0Y*%* ��H

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Categorias profissionais selecionadas( .&-'8*0$&( &/@$+$&0 ' -7.#$.* %' '#?'0,&8', -Q, &/,'#-&%* ('/

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171


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179


Gráfico 1 – Condições de trabalho –- auxiliar de enfermagem

Fonte: elaboração própria, 2003.

Gráfico 2 – Condições de trabalho – técnico de enfermagem

Fonte: elaboração própria, 2003.

180


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183

Tendências do sistema educativo no Brasil:medicina, enfermagem e odontologia1

Ana Luiza Stiebler Vieira, Ana Claudia Pinheiro Garcia, Antenor Amâncio Filho, Célia Regina Pierantoni,

Clarice Aparecida Ferraz, Eliane dos Santos Oliveira, Janete Rodrigues da Silva Nakao, Sérgio Pacheco de Oliveira,

Silvana Martins Mishima, Tania França e Thereza Christina Varella

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As tendências das graduações em medicina, enfermagem e odontologia

O crescimento da oferta

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186


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A concentração geográfica da oferta

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187


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Tabela 1 – Cursos, vagas e egressos da graduação em medicina por regiões, segundo unidadesfederadas. Brasil, 1995-2001

Graduação Medicina

Cursos Vagas Egressos

Região/UF 1995 2001 1995 2001 1995 2001

Brasil 85 106 8247 11282 7622 8004

Norte 4 4 360 310 319 241

Acre 0 0 0 0 0 0Amapá 1 1 80 80 75 48Amazonas 0 0 0 0 0 0Pará 2 2 250 210 244 179Rondônia 0 0 0 0 0 0Roraima 1 1 30 20 0 14Tocantins 0 0 0 0 0 0

Nordeste 14 18 1574 1493 1281 1376Alagoas 2 2 150 130 128 133Bahia 2 3 560 400 310 391Ceará 1 4 140 330 136 169Maranhão 1 1 70 63 121 61Paraíba 2 2 164 290 158 118Pernambuco 3 2 290 0 219 284Piauí 1 2 50 110 52 58Rio G. do Norte 1 1 80 90 83 80Sergipe 1 1 70 80 74 82

Sudeste 46 53 4757 7258 4550 4838Espírito Santo 2 2 200 200 216 232Minas Gerais 10 11 1054 1190 1039 1079Rio de Janeiro 15 16 1930 3685 1700 1719São Paulo 19 24 1573 2183 1595 1808

Sul 17 23 1298 1711 1222 1261Paraná 5 6 406 516 395 372Rio G. do Sul 10 11 752 816 729 754Santa Catarina 2 6 140 379 98 135

Centro-Oeste 4 8 258 510 250 288Distrito Federal 1 2 60 95 46 82Goiás 1 1 110 110 105 110Mato Grosso 1 2 40 140 44 52Mato G. do Sul 1 3 48 165 55 44

Fonte: Inep/ME, adaptado pela Rorehs em 2004.

188


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189


Tabela 2 – Cursos, vagas e egressos da graduação em enfermagem por regiões, segundo unidadesfederadas. Brasil, 1995-2001

Graduação Enfermagem


Região/UF 1995 2001 1995 2001 1995 2001

Brasil 108 215 8068 22133 4373 6355

Norte 7 13 270 753 280 245

Acre 1 1 30 30 16 14Amapá 1 1 30 35 0 19Amazonas 1 2 40 200 37 16Pará 3 6 140 258 214 177Rondônia 1 2 30 130 13 19Roraima 0 0 0 0 0 0Tocantins 0 1 0 100 0 0

Nordeste 22 29 1615 2314 1023 1244Alagoas 1 2 40 280 31 26Bahia 5 6 370 560 240 412Ceará 4 5 290 440 167 233Maranhão 2 2 140 67 77 103Paraíba 3 3 280 240 214 141Pernambuco 3 3 320 350 165 179Piauí 1 4 50 240 43 41Rio G. do Norte 2 2 85 97 68 57Sergipe 1 2 40 40 18 52

Sudeste 51 105 4384 13565 2135 3485Espírito Santo 1 4 60 520 12 54Minas Gerais 8 19 580 1463 338 480Rio de Janeiro 12 25 1104 3386 743 637São Paulo 30 57 2640 8196 1042 2314

Sul 23 54 1485 4429 782 1048Paraná 7 21 345 1749 268 312Rio G. do Sul 12 21 880 2026 395 559Santa Catarina 4 12 260 654 119 177

Cento-Oeste 5 14 314 1072 153 333Distrito Federal 1 3 56 212 30 60Goiás 2 4 168 510 74 183Mato Grosso 1 3 50 170 29 40Mato G. do Sul 1 4 40 180 20 50


190


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191


A&0& & 0'8$G*H �'8/#%* %&%*( %$(A*#Y)'$( %* �!�1 4F /, ,*)$,'#-* .0'(.'#-'%' (&Y%& %' A0*?$(($*#&$( %' ('/( '(-&%*( %' *0$8', A&0& & 0'8$G* �/%'(-'1&(($, .*#?$8/0&%*� %* �/+ ,$80&, ��1"`] %* �'#-0*��'(-'1 "�1M`] %*�*0%'(-'1 M1�` ' %* �*0-'1 �D1=` W�!�1 ��JXH

Tabela 3 – Cursos, vagas e egressos da graduação em odontologia por regiões, segundo unidadesfederadas. Brasil, 1995-2001

Graduação Odontologia


Região/UF 1995 2001 1995 2001 1995 2001

Brasil 89 150 8351 13672 6741 7698Norte 2 9 150 614 72 84Acre 0 0 0 0 0 0Amapá 0 0 0 0 0 0Amazonas 1 5 60 334 31 31Pará 1 2 90 170 41 53Rondônia 0 1 0 60 0 0Roraima 0 0 0 0 0 0Tocantins 0 1 0 50 0 0Nordeste 14 22 978 1787 765 894Alagoas 1 2 60 180 41 60Bahia 2 3 180 300 128 155Ceará 2 2 180 190 92 169Maranhão 1 3 48 245 41 34Paraíba 2 2 130 140 124 123Pernambuco 3 3 240 250 185 216Piauí 1 3 40 190 47 42Rio G. do Norte 1 2 60 152 68 58Sergipe 1 2 40 140 39 37Sudeste 50 80 5672 8093 4641 5109Espírito Santo 1 2 60 130 70 60Minas Gerais 12 15 1520 1640 1247 1180Rio de Janeiro 11 18 964 1841 763 1179São Paulo 26 45 3128 4482 2561 2690Sul 17 30 1219 2456 957 1283Paraná 9 14 576 1072 400 621Rio G. do Sul 6 9 483 864 434 504Santa Catarina 2 7 160 520 123 158Centro-Oeste 6 9 332 722 306 328Distrito Federal 2 3 100 212 95 105Goiás 2 2 120 180 124 119Mato Grosso 1 2 80 220 58 74Mato G. do Sul 1 2 32 110 29 30Fonte: Inep/ME, adaptado pela Rorehs em 2004.

192


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A privatização do ensino A*+Y-$.& A&0& & '%/.&:G* (/A'0$*0 #& %7.&%& %' �� &((/,$/ O/' *

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193


Gráfico 1 – Cursos privados de medicina, enfermagem e odontologia. Brasil, 1995 e 2001


Gráfico 2 – Cursos públicos de medicina, enfermagem e odontologia. Brasil, 1995 e 2001


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194


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Gráfico 3 – Cursos de medicina por regiões segundo entidade mantenedora. Brasil, 2001


Gráfico 4 – Vagas de medicina por regiões segundo entidade mantenedora. Brasil, 2001


195


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Gráfico 5 – Cursos de enfermagem por regiões segundo entidade mantenedora. Brasil, 2001


196


Gráfico 6 – Vagas de enfermagem por regiões segundo entidade mantenedora. Brasil, 2001


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197


Gráfico 7 – Cursos de odontologia por regiões, segundo entidade mantenedora. Brasil, 2001


Gráfico 8 – Vagas de odontologia por regiões segundo entidade mantenedora. Brasil, 2001


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�-3�$B�-��$�$,�B��$�-�-3)-B-9#�/�7��'0�>�� ,� �.�� (�� #�� 7� �� $�� (�� A�� W�#*� �� *��DCCG/

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��9�B�`$��B�� )+�� /�<�� '�� 6�� 6�� /�� DCCC/�FCK�/�)��%�� '��$�� $6�� /

�#$,�3)-3#�� ,�� /��6�� $�� +�� H��*�� /�-��-��#��/�E��/�D��/�GJF�GEC/�,��8 ��H�*� ��DCCF/

�#$,�3)-3#�� ,�� M� �,�3_��)@� M�?�,$BB��)+�5 ��+�� /$�� 6�� 6��7� ��H��*�� 6�� /�#H��3)-��3$)-��M��-�)�� %-��/'/�<) ��#��+�� "�� $�� <��/�,��8 ��H��5��DCCG/��/�DQL�DLD/

202


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203

Educação profissional em saúde: uma análise a partirdo censo escolar 20021

Júlio César França Lima , Luciane Velasque, Mônica Vieira,

Renata Reis, Rita Elisabeth da Rocha Sório e Valdemar de Almeida Rodrigues

Apresentação� A0'('#-' '(-/%* ?*$ A+&#'I&%* & A&0-$0 %& %',&#%& %& �'.0'-&0$& %'

2'(-G* %* 0&3&+4* ' %& �%/.&:G* #& �&E%' %* �$#$(-70$* %& �&E%'1 A*0,'$* %& �'%' %' �3('0)&-P0$*( %' �'./0(*( �/,&#*( ', �&E%' W�*0'4(XH� *3I'-$)* 8'0&+ ?*$ (/3($%$&0 &( %$(./((Z'( '#-G* -0&)&%&( %/0&#-' & ��&�*#?'0Q#.$& �&.$*#&+ %' �&E%'1 *.*00$%& ', %'9',30* %' ��J1 3', .*,*&( $#(-N#.$&( 8'(-*0&( %* �$(-',& �#$.* %' �&E%' W��X A&0& & ?*0,/+&:G* '& $,A+','#-&:G* %' A*+Y-$.&( %' ?*0,&:G* ', (&E%'H

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�(-' '(-/%*1 A*0-&#-*1 7 %' #&-/0'9& O/&#-$-&-$)&1 .*#($%'0&#%* *('(-&3'+'.$,'#-*( %' '#($#*1 *( ./0(*( *?'0'.$%*( ' *( &+/#*( ,&-0$./+&%*( '.*#.+/$#-'(H ( $#(-$-/$:Z'( (G* &A0'('#-&%&( ('8/#%* * )Y#./+* $#(-$-/.$*#&+� AE3+$.* ' A0$)&%*H �( ./0(*( (G* *08&#$9&%*( A*0 (/3F0'&( %' ?*0,&:G* %*('-*0 (&E%'1 -'#%* .*,* A&0N,'-0* *( �'?'0'#.$&$( �/00$./+&0'( �&.$*#&$(%& �%/.&:G* �0*?$(($*#&+ %' �Y)'+ 7.#$.* W�0&($+U��1 ��X1 ('#%* *(&+/#*( %$(-0$3/Y%*( ('8/#%* * ('@*1 * -/0#* '(.*+&0 ' & ?&$@& '-F0$&H

� �'#(* �(.*+&0 7 /,& 3&(' %' %&%*( O/' &80'8& $#?*0,&:Z'( '(-&-Y(-$.*�'%/.&.$*#&$( %' N,3$-* #&.$*#&+1 &30&#8'#%* & '%/.&:G* 3F($.& ', ('/(%$?'0'#-'( #Y)'$(� '%/.&:G* $#?&#-$+1 '#($#* ?/#%&,'#-&+ ' '#($#* ,7%$*H

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Formação

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205

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Análise da educação profissional em saúde

a) A grande concentração regional e o caráter privado do ensino técnico em saúde

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�-3�$B�-��$�$,�B��$�$3�$,��9$�/�,�� FLQ&LQ/� $�� *�� +�� &�� (� ��6�� 6�� 6�� /�� ). �� K/��/�3 � �H��6��FLLQ/��/FJJ/

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223

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Adriana Rosa Linhares Carro, Aniara Nascimento Corrêa Araújo,

Nosor Orlando de Oliveira Filho e Paulo Henrique D`Ângelo Seixas

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229


Quadro 1

Especialidades Custo das vagas ocupadas (R$) %

Clínica médica 8.351.179,32 12,95Pediatria 7.226.711,76 11,21Cirurgia geral 6.322.935,48 9,81Obst. e ginec. 5.850.029,64 9,07Ortopedia e traum. 3.860.318,04 5,99Anestesiologia 2.497.646,16 3,87Oftalmologia 2.595.730,68 4,03Rad. e diag. imag. 2.466.119,76 3,83Cardiologia 2.136.837,48 3,31Infectologia 1.800.550,70 2,79Psiquiatria 1.954.680,12 3,03Dermatologia 1.590.367,20 2,47Otorrinolaringologia 1.331.143,80 2,06Neurocirurgia 1.324.138,08 2,05Neurologia 1.208.538,48 1,87Cirurgia plástica 1.047.400,56 1,62Patologia 938.806,80 1,46Angiol.e cir. vasc. 984.346,32 1,53Nefrologia 788.177,40 1,22Urologia 879.255,72 1,36Hematologia 711.111,12 1,10Endoc. e metab. 858.237,72 1,33Pneumologia 641.050,92 0,99Gastroenterologia 521.948,52 0,81Cancerologia 574.493,64 0,89Reumatologia 469.403,40 0,73Med. fam. comunid. 462.397,32 0,72Cir. apar. digest. 669.075,00 1,04Med. prev. e soc. 462.397,32 0,72Cir. pediátrica 374.822,16 0,58Medicina nuclear 378.325,08 0,59Pat. clín.e med. lab. 336.288,96 0,52Cir. torácica 287.246,88 0,45Cir. cardiovascular 311.768,16 0,48Cir. cab. e pescoço 304.761,96 0,47Geriatria 280.240,80 0,43Cir. oncológica 266.228,76 0,41Neuropediatria 294.252,84 0,46Radioterapia 266.228,76 0,41Coloproctologia 245.210,88 0,38Med. intensiva 126.108,36 0,20Alergia e imunol. 126.108,36 0,20Genética médica 126.108,36 0,20Cir. do trauma 98.084,28 0,15Med. fís. e reab. 70.060,20 0,11Nutrologia 56.048,16 0,09Total 64.472.921,42 100,00

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232


Quadro 2

Especialidades Concedidas

Nefrologia 08Medicina da família e comunidade 13Neurologia 04Cancerologia 04Neonatologia 13Medicina intensiva 10Clínica médica 30Anestesiologia 10UTI pediátrica 06Neurocirurgia 00Nefrologia pediátrica 01Cirurgia pediátrica 01Cirurgia do trauma 00Cancerologia pediátrica 07Total 107

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Quadro 3

Natureza jurídica No de vagas recebidas

Instituições filantrópicas 6Hospitais de administração direta 5Faculdades de medicina não estaduais 24Faculdades de medicina estaduais 56Organizações sociais de saúde 7Autarquias 9Total 107

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233


Quadro 4

Especialidades Concedidas Ocupadas

Nefrologia 08 00Med. família e comunidade 13 07Neurologia 04 01Cancerologia 04 01Neonatologia 13 11Medicina intensiva 10 08Clínica médica 30 29Anestesiologia 10 09UTI pediátrica 06 06Neurocirurgia 00 00Nefrologia pediátrica 01 01Cirurgia pediátrica 01 01Cirurgia do trauma 00 00Cancerologia pediátrica 07 07Total 107 81

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Referências bibliográficasF/��#�Z7$N3��/�� 0��7�� ;�� DCCC/�%)�� W�� *�� W�� <�� *�� '/

D/�,$�#�h3�#��d�#��&9�#��DCCC/�,�� 1�� /�� H�2��%��1�� DCCC/

G/�$B#��$�/�"� �� 5 �� *�� 1�� /�� FLKQ/�%)�� W�� W�� '/

J/��-9�$�W��H�444/��/��/�� CK&CJ/

I/��#-��/�� 1�� ;�� H(� �� +��.�� /�"� ��%��$�� /�� FLKJ/

E/��3��3/� �/�� 1�� H� �� ;�� +��.�� 6�� 6�� /�"� ��$�� /�� FLKJ/

Q/�7$?#B��P��,/�9/�,��1�� H�� /�"� ��$�� /�� FLKJ/

K/��3,��W��H�444/��/��/*�&��&�� /�� CK&CJ/

L/��-3�$��/��/M��$#R��/��/��/��/�� 3 �� ,�� /�#H�3$9,#��7/�� /�"�� 7��/�� #��#��)�� H�� #��$�� DCCD/

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237

Rede de recursos humanos em saúde: os nósconstituintes da integralidade em saúde

Maria Ysabel Barros Bellini, Décio Ignácio Angnes e Suzane de Mendonça e Silva

Introdução $,A+','#-&:G* %&( -'.#*+*8$&( $#-'+'.-/&$( $,AZ' #'(-' ,*,'#-*

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Formação

238


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247


Quadro 1

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Redes/ NTICs

Entendemos redes no atualcontexto de comunicação einformação como: entrela-çamento de sistemas e/ouconjuntos constituídos porrelações horizontalizadas, dinâ-micas e inter-relacionadas. Viasde comunicação e informaçãoflexíveis, descentralizadas, queatuam na articulação social,instrumentalizando práticas pormeio do espaço virtual.

Observatório de RecursosHumanos em Saúde

Entendido como organizaçãosociogovernamental com vistasà produção e à difusão deconhecimentos referentes àtemática de recursos humanosem saúde. Ocupa-se com oacompanhamento e o desen-volvimento de articulações sobreos processos complexos quecircundam a formação e autilização dos recursos humanosem saúde. Favorece a criação deespaços e de redes sinérgicasde gestão e pesquisa na área derecursos humanos em saúde.

Recursos Humanos em Saúde

Visto como o sujeito prota-gonista dos processos deorganização, planejamento,gestão e práticas em saúde.Agente profissionalizado e/ouespecializado em saúde,comprometido com a cons-trução e a garantia de práticasuniversalistas, integralizantese eqüitativas. Capacitado aatuar na defesa e na conso-lidação do SUS.

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252


Anexo

Buscamos a constituição de uma rede virtual de comunicação e articulação entreos diferentes envolvidos na área da saúde, a fim de garantir fluxos deinformações com perspectivas de socialização e otimização das característicasprofissionais do panorama de recursos humanos em saúde da SecretariaEstadual de Saúde através da utilização de uma banco de dados, tendo emmãos, dados da realidade da qualificação profissional podendo assim,identificar expressivamente as características desses agentes no momento atual.

REDE RECURSOS HUMANOS DA SAÚDE

OBJETIVOS DA PESQUISA:

• MAPEAR A REDE DOS RECURSOS HUMANOS DA SECRETARIA DA SAÚDE DO RIO

GRANDE DO SUL EM NÍVEL DE ESPECIALIZAÇÃO, MESTRADO E DOUTORADO ECRIAÇÃO DE UM BANCO DE DADOS.

• IDENTIFICAR OS RECURSOS HUMANOS EXISTENTES NA SES COMFORMAÇÃO EM NÍVEL DE ESPECIALIZAÇÃO, MESTRADO E DOUTORADO.

• IDENTIFICAR OS RECURSOS HUMANOS QUALIFICADOS PELA ESP NOSDIFERENTES NÍVEIS.

• CRIAR UM BANCO DE DADOS DA SES QUE IDENTIFIQUE ESSES RECURSOS

HUMANOS E PERMITA A ATUALIZAÇÃO DOS DADOS PELOS PRÓPRIOS

PROFISSIONAIS.

• ARTICULAR ESSES RECURSOS HUMANOS E POTENCIALIZAR A PARTICIPAÇÃO

NAS ATIVIDADES DA ESP E NAS ATIVIDADES DA SES EM GERAL.

253


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