Incentive policies in the rural zone: PROVAB experience in Ceará

Resumo

Introdução: In 2012, a new proposal at the Brazilian primary care scenario arises: Enhancement Program for Professionals in Primary Care – PROVAB. Expecting a better support and incentive to work in the field of Primary Health Care, I decide to join the program. Here I make a report, trying to add values such as Management, Policy and Health Education, and Permanent Education.

Objetivos: The paper aims at illustrate a camp experience, lived in the city of General Sampaio /CE, and enable a theoretical and practical basis for case reports and new paper from this experience. In preparation, field diary and participant observation were used.

Metodologia ou descrição da experiência: The work took place in rural area of Brazilian northeast from January 2012 to February 2013. The health team developed a daily work through several small communities that surrounded the city. There was a car to bring physician, nurse, and nursing assistant, as well as all materials including medications. In April 2013, doctors enrolled in the program began to attend monthly meetings with topics of relevance to primary care. Then scheduling visits were made to the cities in order to discuss about territory recognition, problems identification, improvement of health actions, pipelines in service attendance and the beginning of the program evaluation process.

Resultados: It was evident that the monitoring and supervision offered by PROVAB contributed to my work in the territory. There was contact with other realities of nearby cities, exchange of experiences, shimmering of the health situation and what influences and determines it in different scenarios. The participants had the opportunity to discuss ordinary topics such as Leprosy, Tuberculosis, common skin lesions, and some others. However, much was lost due to limited articulation with the management of the cities. And the still present policy lobbying, which permeates the election period, brought direct negative impacts on the organization of local health systems.

Conclusões ou hipóteses: While pioneering experience, the PROVAB finds challenges, however, encouraging the establishment of worker in Primary Care makes the Program an important tool to support both physician and the city management. But from now on, the program shall focus on the management monitoring, since that, in this experience, it was more a hindrance than an ally.