Abstract
Doctor shortage is a constant problem in smaller cities and towns, which tend to be more vulnerable from a social and economic point of view, and located in geographically isolated areas. The goal of this study was to establish the share and characteristics of the small cities and towns in the macro-region of northern Paraná that subscribed to the Mais Médicos para o Brasil (PMMB) program. This is a quantitative study of 82 cities and towns using primary and secondary data. Results show that only a few of them (6.1%) had any adherence criteria, which was not an impediment for other cities and towns (75%) to adhere to the project. Cities and towns with over five thousand inhabitants, lower municipal HDI (Human Development Index), some adherence criteria and more geographically isolated, either from the main city in the region or the closest large or mid-sized city, tended to adhere to the PMMB. It is undeniable that the PMMB significantly reduced the uneven distribution of doctors in Brazil and the study region. However, the sustainability of this policy is linked to addressing other remaining challenges in the SUS system.
Highlights
Uneven distribution of doctors is an issue in several regions and countries
Despite the fact that most of the municipalities do not meet the criteria in the law, over half of the small municipalities (62 or 75.6%) in the region adhered to PMMB (Figure 2)
A study by the EPSM (Market Signal Survey Station) of the Observatory of Healthcare Human Resources shows that in the state of Paraná, 89% of the municipalities have fewer than 0.66 primary care doctors per 1,000 inhabitants
Summary
Uneven distribution of doctors is an issue in several regions and countries. In Australia for example, the ratio of doctors per thousand inhabitants is only 0.9 in rural areas. If we look at economically distressed regions, this shortage becomes even more critical, such as in certain countries in Africa and Southeast Asia[2]. The shortage of doctors in Brazil is not a new problem. Over 20% of the municipalities in Brazil have some sort of doctor shortage[5]. In Brazil, the problem is associated with uneven geographic distribution. In 2015, the doctor : inhabitant ratio in Brazil was 1.9:1,0006. This is lower than in the UK (2.7), Portugal (3.8), Spain (3.9) and Argentina (3.2)[7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
