Abstract
ABSTRACTOBJECTIVE To characterize the workforce in the pharmaceutical services in the primary care of the Brazilian Unified Health System (SUS). METHODS This is a cross-sectional and quantitative study, with data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). For the analysis, we considered the data stratification into geographical regions. We analyzed the data on workers in the municipal pharmaceutical services management and in the medicine dispensing units, according to the country’s regions. For the statistical association analysis, we carried out a Pearson correlation test for the categorical variables.RESULTS We analyzed 1,175 pharmacies/dispensing units, 507 phone interviews (495 pharmaceutical services coordinators), and 1,139 professionals responsible for medicine delivery. The workforce in pharmaceutical services was mostly constituted by women, aged from 18 to 39 years, with higher education (90.7% in coordination and 45.5% in dispensing units), having permanent employment bonds (public tender), being for more than one year in the position or duty, and with weekly work hours above 30h, working both in municipal management and in medicine dispensing units. We observed regional differences in the workforce composition in dispensing units, with higher percentage of pharmacists in the Southeast and Midwest regions.CONCLUSIONS The professionalization of municipal management posts in primary health care is an achievement in the organization of the workforce in pharmaceutical services. However, significant deficiencies exist in the workforce composition in medicine dispensing units, which may compromise the medicine use quality and its results in population health.
Highlights
Since its implementation in the late 1980s, the Brazilian Unified Health System (SUS) expanded the number of work posts in all health care levels, especially in primary health care (PHC)
The workforce in pharmaceutical services was mostly constituted by women, aged from 18 to 39 years, with higher education (90.7% in coordination and 45.5% in dispensing units), having permanent employment bonds, being for more than one year in the position or duty, and with weekly work hours above 30h, working both in municipal management and in medicine dispensing units
The professionalization of municipal management posts in primary health care is an achievement in the organization of the workforce in pharmaceutical services
Summary
Since its implementation in the late 1980s, the Brazilian Unified Health System (SUS) expanded the number of work posts in all health care levels, especially in primary health care (PHC). The expansion and diversification of health workforce occurred with an increase in the number of doctors and nurses and the inclusion of new professional categories, such as physical therapists, pharmacists, nutritionists, speech and language therapists, physical education professionals, among others[6]. With the objective of reorganizing SUS and meeting the principles of integrality, equity, and universality of health care, and having PHC as an organizer of the health services network, the Brazilian Ministry of Health implemented the Programa Saúde da Família (PSF – Brazilian Family Health Program) in 1994, oriented to the reduction of maternal and infant mortality, especially in the North and Northeast of the country. In 2006, the government published the Política Nacional de Atenção Básica (PNAB – National Primary Health Care Policy), which transformed the PSF into the Estratégia Saúde da Família (ESF – Brazilian Family Health Strategy), reaffirming its major role in the reorganization of PHC14
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