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INTRODUCTION: The COVID-19 pandemic challenged the scientific community to find and develop a vaccine to fight the disease. However, problems with achieving high vaccine coverage have emerged, even among high-risk groups such as healthcare workers (HCWs). OBJECTIVE: The objective of this study is to examine factors that influence HCW's and the general population's adherence to COVID-19 vaccination and national policies to vaccinate HCWs and other target groups. METHODS: This study implemented a systematic review. The eligibility criterion for inclusion was being a HCW, target population for COVID-19 vaccination, or general population. Vaccination was the target intervention, and the COVID-19 pandemic was the context. We selected publications published between 1 January 2020 and 31 March 2022. Qualitative synthesis used a meta-aggregation approach. RESULTS: Nineteen articles were included in the review, with study samples varying from 48 to 5708 participants. Most of the evidence came from cross-sectional and qualitative studies. The main findings were related to vaccine hesitancy rather than acceptance. Factors associated with HCW vaccine hesitancy included subjective feelings such as safety concerns, rapid vaccine development, and insufficient testing. Countries have adopted few public policies to address this problem, and the main concern is whether to enforce vaccination and the extent to which measures are legal. CONCLUSION: The quality of the evidence base remains weak. Skepticism, mistrust, and hesitancy toward vaccination are global issues that can jeopardize vaccination coverage.

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Objective: To create and validate criteria for prioritizing problems related to policies and management of the health workforce. Methods: This methodological study was divided into three stages. First, the criteria were elaborated by means of a systematized literature review. Second, the criteria were evaluated online by a committee of judges comprised of eight specialists. In the third stage, an evaluation was carried out by the target audience in a hybrid workshop. The participants evaluated the material using the Suitability Assessment of Materials instrument, adapted for the research. Results: Three prioritization criteria (relevance, window of opportunity and acceptability) and a scoring scale were developed based on the literature review. In the evaluation by the committee of judges, the approval percentage of the criteria and prioritization method was 84%. Modifications were made based on suggestions in relation to the material presented to the specialists. In the pre-test stage, the approval percentage varied by item, with six of them reaching a maximum approval of 100% (corresponding to approximately 46% of the items), four reaching 92% and three achieving 83% each, indicating positive results. Conclusions: The developed criteria were considered valid for use in the context of policies and management in the area of human resources for health.

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ABSTRACT Objective. To create and validate criteria for prioritizing problems related to policies and management of the health workforce. Methods. This methodological study was divided into three stages. First, the criteria were elaborated by means of a systematized literature review. Second, the criteria were evaluated online by a committee of judges comprised of eight specialists. In the third stage, an evaluation was carried out by the target audience in a hybrid workshop. The participants evaluated the material using the Suitability Assessment of Materials instrument, adapted for the research. Results. Three prioritization criteria (relevance, window of opportunity and acceptability) and a scoring scale were developed based on the literature review. In the evaluation by the committee of judges, the approval percentage of the criteria and prioritization method was 84%. Modifications were made based on suggestions in relation to the material presented to the specialists. In the pre-test stage, the approval percentage varied by item, with six of them reaching a maximum approval of 100% (corresponding to approximately 46% of the items), four reaching 92% and three achieving 83% each, indicating positive results. Conclusions. The developed criteria were considered valid for use in the context of policies and management in the area of human resources for health.

RESUMEN Objetivo. Crear y validar criterios para priorizar los problemas relacionados con las políticas y la gestión de los recursos humanos para la salud. Métodos. Este estudio metodológico se dividió en tres etapas. En la primera se elaboraron los criterios mediante una revisión sistematizada de la bibliografía. En la segunda un comité de ocho especialistas evaluó en línea los criterios. Y la tercera consistió en una evaluación por parte del público destinatario en un taller híbrido. Los participantes evaluaron el material utilizando el instrumento de evaluación de la idoneidad de los materiales, que fue adaptado para la investigación. Resultados. Sobre la base de la revisión de la bibliografía, se elaboraron tres criterios para la asignación de prioridades (relevancia, ventana de oportunidad y aceptabilidad) y una escala de puntuación. En la evaluación realizada por el comité de especialistas, el porcentaje de aprobación de los criterios y del método de asignación de prioridades fue del 84%. Se realizaron modificaciones basadas en sugerencias planteadas con respecto al material presentado a los especialistas. En la etapa posterior de prueba preliminar, el porcentaje de aprobación varió en los distintos puntos, de tal manera que en seis puntos (es decir, en aproximadamente el 46% de los puntos) se alcanzó una aprobación máxima del 100%, en cuatro una aprobación del 92% y en tres una aprobación del 83% en cada uno, lo que indica unos resultados positivos. Conclusiones. Se consideró que los criterios elaborados son válidos para su uso en el contexto de las políticas y la gestión en el ámbito de los recursos humanos para la salud.

RESUMO Objetivo. Criar e validar critérios para priorizar problemas relacionados a políticas e gerenciamento da força de trabalho em saúde. Métodos. O presente estudo metodológico foi dividido em três fases. Primeiro, foram elaborados critérios por meio de revisão sistematizada da literatura. A seguir, os critérios foram avaliados on-line por uma comissão de juízes composta por oito especialistas. Na terceira fase, o público-alvo fez uma avaliação dos critérios em uma oficina de formato híbrido. Os participantes avaliaram o material usando o instrumento Suitability Assessment of Materials, adaptado para esta pesquisa. Resultados. Com base na revisão da literatura, foram elaborados três critérios de priorização (relevância, janela de oportunidade e aceitabilidade) e uma escala de pontuação. Na avaliação da comissão de juízes, a porcentagem de aprovação dos critérios e do método de priorização foi de 84%. Foram feitas alterações com base em sugestões relacionadas ao material apresentado aos especialistas. Na fase de pré-teste, a porcentagem de aprovação variou de acordo com o item. Seis deles (aproximadamente 46% dos itens) atingiram aprovação máxima de 100%, quatro atingiram 92% e três atingiram 83%, indicando resultados positivos. Conclusões. Os critérios desenvolvidos foram considerados válidos para uso no contexto de políticas e gerenciamento na área de recursos humanos em saúde.

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[ABSTRACT]. Objective. To create and validate criteria for prioritizing problems related to policies and management of the health workforce. Methods. This methodological study was divided into three stages. First, the criteria were elaborated by means of a systematized literature review. Second, the criteria were evaluated online by a committee of judges comprised of eight specialists. In the third stage, an evaluation was carried out by the target audience in a hybrid workshop. The participants evaluated the material using the Suitability Assessment of Materials instrument, adapted for the research. Results. Three prioritization criteria (relevance, window of opportunity and acceptability) and a scoring scale were developed based on the literature review. In the evaluation by the committee of judges, the approval percentage of the criteria and prioritization method was 84%. Modifications were made based on suggestions in relation to the material presented to the specialists. In the pre-test stage, the approval percentage varied by item, with six of them reaching a maximum approval of 100% (corresponding to approximately 46% of the items), four reaching 92% and three achieving 83% each, indicating positive results. Conclusions. The developed criteria were considered valid for use in the context of policies and management in the area of human resources for health.

[RESUMEN]. Objetivo. Crear y validar criterios para priorizar los problemas relacionados con las políticas y la gestión de los recursos humanos para la salud. Métodos. Este estudio metodológico se dividió en tres etapas. En la primera se elaboraron los criterios mediante una revisión sistematizada de la bibliografía. En la segunda un comité de ocho especialistas evaluó en línea los criterios. Y la tercera consistió en una evaluación por parte del público destinatario en un taller híbrido. Los participantes evaluaron el material utilizando el instrumento de evaluación de la idoneidad de los materiales, que fue adaptado para la investigación. Resultados. Sobre la base de la revisión de la bibliografía, se elaboraron tres criterios para la asignación de prioridades (relevancia, ventana de oportunidad y aceptabilidad) y una escala de puntuación. En la evaluación realizada por el comité de especialistas, el porcentaje de aprobación de los criterios y del método de asignación de prioridades fue del 84%. Se realizaron modificaciones basadas en sugerencias planteadas con respecto al material presentado a los especialistas. En la etapa posterior de prueba preliminar, el porcentaje de aprobación varió en los distintos puntos, de tal manera que en seis puntos (es decir, en aproximadamente el 46% de los puntos) se alcanzó una aprobación máxima del 100%, en cuatro una aprobación del 92% y en tres una aprobación del 83% en cada uno, lo que indica unos resultados positivos. Conclusiones. Se consideró que los criterios elaborados son válidos para su uso en el contexto de las políticas y la gestión en el ámbito de los recursos humanos para la salud.

[RESUMO]. Objetivo. Criar e validar critérios para priorizar problemas relacionados a políticas e gerenciamento da força de trabalho em saúde. Métodos. O presente estudo metodológico foi dividido em três fases. Primeiro, foram elaborados critérios por meio de revisão sistematizada da literatura. A seguir, os critérios foram avaliados on-line por uma comissão de juízes composta por oito especialistas. Na terceira fase, o público-alvo fez uma avaliação dos critérios em uma oficina de formato híbrido. Os participantes avaliaram o material usando o instrumento Suitability Assessment of Materials, adaptado para esta pesquisa. Resultados. Com base na revisão da literatura, foram elaborados três critérios de priorização (relevância, janela de oportunidade e aceitabilidade) e uma escala de pontuação. Na avaliação da comissão de juízes, a porcentagem de aprovação dos critérios e do método de priorização foi de 84%. Foram feitas alterações com base em sugestões relacionadas ao material apresentado aos especialistas. Na fase de pré-teste, a porcentagem de aprovação variou de acordo com o item. Seis deles (aproximadamente 46% dos itens) atingiram aprovação máxima de 100%, quatro atingiram 92% e três atingiram 83%, indicando resultados positivos. Conclusões. Os critérios desenvolvidos foram considerados válidos para uso no contexto de políticas e ger- enciamento na área de recursos humanos em saúde.

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Abstract This study investigated how comprehensive and integrated care is expressed in the legislation of the Portuguese National Health Service and the Brazilian Unified Health System, especially in healthy aging policies. This qualitative and exploratory study was based on documentary research and included laws, decrees, ordinances, and plans, published until 2020. Twenty-four documents were selected, 12 from Portugal and 12 from Brazil. The data was subjected to content analysis. The findings indicated that Primary Health Care is the level of care responsible for integrating care in both countries. Both invested in the formation of care networks, intersectoral coordination, and the adoption of information and communication technologies to facilitate integration. Healthy aging policies have emphasized the importance of care at the community level, integrating users, their families, health equipment, and other sectors, promoting autonomy, and preventing chronic diseases and violence. The transformations in both countries follow scientific evidence published by the World Health Organization and research centers focused on healthy aging that contributes to making their systems more efficient and problem-solving. It is hoped that the aspects discussed will contribute to the development of successful ways of overcoming current challenges, such as those imposed by the COVID-19 pandemic.

Resumo Este estudo investigou como o cuidado integral e integrado expressa-se na legislação do Sistema Nacional de Saúde português e do Sistema Único de Saúde brasileiro, especialmente nas políticas de envelhecimento saudável. A análise de conteúdo foi realizada através de pesquisa documental envolvendo 24 documentos, 12 de cada país, publicados até 2020. Os achados indicaram que a atenção primária é o nível de atenção responsável pela integração do cuidado nos dois países. Ambos apostaram na formação de redes de atenção, articulação intersetorial e adoção de tecnologias de informação e comunicação para facilitar a integração. As políticas de envelhecimento saudável enfatizaram a importância do cuidado comunitário, integrando usuários, seus familiares, equipamentos de saúde e outros setores, promovendo a autonomia e prevenindo doenças crônicas e situações de violência. As transformações nos dois países acompanham as evidências científicas divulgadas pela Organização Mundial da Saúde e por centros de pesquisa voltados para o envelhecimento saudável e contribuem para tornar seus sistemas mais eficientes e resolutivos. Apesar dos avanços, o risco de descaso e os impactos do isolamento social provocados pela Doença do Coronavírus 2019 desafiam a efetividade da integralidade. Espera-se que os aspectos discutidos contribuam para a construção de formas exitosas de superação deste desafio.

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BACKGROUND: Countries and health systems have had to make challenging resource allocation and capacity-building decisions to promote proper patient care and ensure health and care workers' safety and well-being, so that they can effectively address the present COVID-19 pandemic as well as upcoming public health problems and natural catastrophes. As innovations are already in place and updated evidence is published daily, more information is required to inform the development and implementation of policies and interventions to improve health and care workforce capacity to address the COVID-19 pandemic response. OBJECTIVE: The objective of this protocol review is to identify countries' range of experiences with policies and management interventions that can improve health and care workers' capacity to address the COVID-19 pandemic response and synthesize evidence on the effectiveness of the interventions. METHODS: We will conduct a living systematic review of quantitative, qualitative, and mixed methods studies and gray literature (technical and political documents) published in English, French, Hindi, Portuguese, Italian, and Spanish between January 1, 2000, and March 1, 2022. The databases to be searched are MEDLINE (PubMed), Embase, SCOPUS, and Latin American and Caribbean Health Sciences Literature. In addition, the World Health Organization's COVID-19 Research Database and the websites of international organizations (International Labour Organization, Economic Co-operation and Development, and The Health System Response Monitor) will be searched for unpublished studies and gray literature. Data will be extracted from the selected documents using an electronic form adapted from the Joanna Briggs Institute quantitative and qualitative tools for data extraction. A convergent integrated approach to synthesis and integration will be used. The risk of bias will be assessed with Joanna Briggs Institute critical appraisal tools, and the certainty of the evidence in the presented outcomes will be assessed with the Grading of Recommendations, Assessment, Development and Evaluation. RESULTS: The database and gray literature search retrieved 3378 documents. Data are being analyzed by 2 independent reviewers. The study is expected to be published by the end of 2023 in a peer-reviewed journal. CONCLUSIONS: This review will allow us to identify and describe the policies and strategies implemented by countries and their effectiveness, as well as identify gaps in the evidence. TRIAL REGISTRATION: PROSPERO CRD42022327041; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327041. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/50306.

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BACKGROUND: The COVID-19 pandemic highlighted pre-existing weaknesses in health and care systems and services and shortages of health and care workers (HCWs). As a result, policymakers needed to adopt measures to improve the health and care workforce (HCWF) capacity. This review aims to identify countries' range of policies and management interventions implemented to improve HCWs' capacity to address the COVID-19 pandemic response, synthesize their evidence on effectiveness, and identify gaps in the evidence. METHODS: The literature was searched in PubMed, Embase, Scopus, LILACS-BVS, WHO's COVID-19 Research Database and the ILO, OECD and HSRM websites for literature and documents published between January 2020 and March 2022. Eligibility criteria were HCWs as participants and policy and management interventions aiming to improve HCWF capacity to address the COVID-19 pandemic response. Risk of bias was assessed with Joanna Briggs Institute (JBI) Critical Appraisal Tools (CAT) and certainty of the evidence in presented outcomes with GRADE. RESULTS: The searches retrieved 3378 documents. A total of 69 were included, but only 8 presented outcomes of interventions implemented. Most of the selected documents described at least one intervention implemented by countries at the organizational environment level to increase the flexibility and capacity of the HCWF to respond to the pandemic, followed by interventions to attract and retain HCWs in safe and decent working environments. There was a lack of studies addressing social protection, human resources for health information systems, and regarding the role of community health workers and other community-based providers. Regarding the risk of bias, most of documents were rated as medium or high quality (JBI's CAT), while the evidence presented for the outcomes of interventions was classified as mostly low-certainty evidence (GRADE). CONCLUSIONS: Countries have implemented various interventions, some innovative, in response to the pandemic, and others had their processes started earlier and accelerated by the pandemic. The evidence regarding the impact and efficacy of the strategies used by countries during the pandemic still requires further research.

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RESUMO Nas últimas décadas, o tema da participação pública em processos de decisão tem estado presente nas agendas políticas, com mais ou menos centralidade, em vários contextos democráticos do mundo. No campo da saúde, a participação pública apresenta-se como estratégia política com potencialidades para garantir maior corresponsabilização entre os atores envolvidos e para incrementar a transparência dos serviços, sendo enfatizada como boa prática que deve ser implementada em prol da qualidade das decisões, mas também de decisões que sejam orientadas para os reais problemas das populações. A pandemia da Covid-19 trouxe pressões adicionais aos sistemas de saúde, constituindo-se como contexto propício à análise da participação cidadã nos processos de decisão que enquadram problemas de saúde na sua relação com a pandemia. Este ensaio apresenta uma análise exploratória sobre a evolução das práticas de participação cidadã nas políticas de saúde em Portugal, destacando alguns dos seus desafios atuais e futuros. Procura-se, assim, compreender como a pandemia teve ressonância na forma como a participação em saúde vinha decorrendo no País, aferindo se, em um período global de crise com características singulares, a pandemia, enquanto problema coletivo, distendeu ou contraiu essas práticas participativas.

ABSTRACT In the last decades, public participation in decision-making processes has been an ongoing theme, assuming more or less centrality, within the political agendas in several democratic contexts around the world. In the health domain, public participation has been considered a political strategy with the potential of ensuring greater co-responsibility among the actors involved, as well as to increase health services' transparency, thus being emphasized as one of the best practices that should be implemented towards the quality of decisions, especially those oriented to the real health problems of the populations. The COVID-19 pandemic brought additional pressures to health systems, constituting itself as a conducive context to the analysis of citizen participation in health decision-making processes. This essay presents an exploratory analysis on the evolution of citizen participation practices in health policies in Portugal, highlighting some of its current and future challenges. The present analysis aims to understand how the pandemic resonated in the way in which participation in the health domain had been carried out in the country, assessing whether, in a singular global period of crisis, the pandemic as a collective problem expanded or contracted these participatory practices.

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ABSTRACT Objective: to analyze the emotions and coping strategies of men living in Brazil to the Covid-19 pandemic. Method: a qualitative socio-historical study, carried out with 200 men residing in Brazil. A semi-structured form was applied, made available on an online platform between March and May 2020. The data were analyzed by the Collective Subject Discourse method and sustained in the theoretical reference of Coping. Results: the strategies most used by the men were the following: compliance with preventive measures, strengthening of family/social ties, promotion of psychological well-being, self-care, emotional suppression, externalization of negative feelings, emotional control, positive reassessment, intellectual investment/professional qualification, maintenance of daily routines, adaptation to home office work, physical activity, control of marital conflicts, acceptance, and strengthening of belief and faith. Conclusion: the coping strategies adopted by the men are focused on following a pandemic coping protocol, and on the meaning and channeling of emotion and sense.

RESUMEN Objetivo: analizar las emociones y las estrategias de coping en hombres que viven en Brasil frente a la pandemia del Covid-19. Método: estudio socio-histórico y cualitativo, realizado con 200 hombres que viven en Brasil. Se aplicó un formulario semiestructurado, puesto a disposición en una plataforma on-line entre marzo y mayo de 2020. Los datos se analizaron con el método del Discurso del Sujeto Colectivo y se sustentaron en el referencial teórico del Coping. Resultados: las estrategias más utilizadas por los hombres fueron las siguientes: cumplimiento de las medidas de prevención, fortalecimiento del vínculo familiar/social, promoción del bienestar psicológico, autocuidado, supresión emocional, externalización de sentimientos negativos, control emocional, reevaluación positiva, inversión intelectual/calificación profesional, mantenimiento de rutinas diarias, adaptación al trabajo en modalidad home office, práctica de actividad física, control de conflictos conyugales, aceptación y fortalecimiento de las creencias y de la fe. Conclusión: las estrategias de coping adoptadas por los hombres se enfocan en respetar un protocolo de afrontamiento a la pandemia, en la significación y la canalización de la emoción y del sentido.

RESUMO Objetivo: analisar as emoções e as estratégias de coping de homens residentes no Brasil à pandemia da Covid-19. Método: estudo sócio-histórico, qualitativo, realizado com 200 homens residentes no Brasil. Realizou-se a aplicação de um formulário semiestruturado, disponibilizado em uma plataforma on-line entre março e maio de 2020. Os dados foram analisados pelo método do Discurso do Sujeito Coletivo e sustentados no referencial teórico de Coping. Resultados: as estratégias mais utilizadas pelos homens foram: cumprimento das medidas de prevenção, fortalecimento do vínculo familiar/social, promoção do bem-estar psicológico, autocuidado, supressão emocional, externalização de sentimentos negativos, controle emocional, reavaliação positiva, investimento intelectual/qualificação profissional, manutenção de rotinas diárias, adaptação ao trabalho home office, prática de atividade física, controle de conflitos conjugais, aceitação e fortalecimento da crença e da fé. Conclusão: as estratégias de coping adotadas pelos homens estão focadas no seguimento de um protocolo de enfrentamento à pandemia, na significação e canalização da emoção e do sentido.

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OBJECTIVE: To identify in the literature the tools used to measure self-efficacy of health professionals in hand hygiene. METHODS: Integrative literature review carried out by consulting the databases PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Europe PubMed Central, and Science Direct using the descriptors Self Efficacy, Hand Hygiene, and Health Personnel. RESULTS: Six articles, all of which with observational design, were selected. It was possible to infer that four studies used validated instruments to measure self-efficacy of health professionals in the conformity with the recommendations for hand hygiene. The other studies used questionnaires that were not validated. FINAL CONSIDERATIONS: Despite the extensive literature on hand hygiene, there is a lack of scientific evidence regarding the use of validated instruments to measure self-efficacy of health professionals in the procedure. The use of properly validated psychometric instruments is useful to guarantee the quality of results in studies.

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ABSTRACT Objective: To identify in the literature the tools used to measure self-efficacy of health professionals in hand hygiene. Methods: Integrative literature review carried out by consulting the databases PubMed, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Europe PubMed Central, and Science Direct using the descriptors Self Efficacy, Hand Hygiene, and Health Personnel. Results: Six articles, all of which with observational design, were selected. It was possible to infer that four studies used validated instruments to measure self-efficacy of health professionals in the conformity with the recommendations for hand hygiene. The other studies used questionnaires that were not validated. Final considerations: Despite the extensive literature on hand hygiene, there is a lack of scientific evidence regarding the use of validated instruments to measure self-efficacy of health professionals in the procedure. The use of properly validated psychometric instruments is useful to guarantee the quality of results in studies.

RESUMEN Objetivo: Identificar, a partir de la literatura, las herramientas utilizadas para medir la autoeficacia de profesionales de salud en la higienización de las manos. Métodos: Revisión integrativa de literatura, en bases de datos Pubmed, Scopus, Web ofScience, CINAHL, Europe PMC y Science Direct, con los descriptores SelfEfficacy, Hand Hygiene y Health Personnel. Resultados: Fueron seleccionados seis artículos, todos de tipo observacional. Pudo inferirse que cuatro estudios utilizaron instrumentos validados para medir la autoeficacia de los profesionales de salud conforme las recomendaciones para higiene de las manos. Los otros estudios usaron cuestionarios que no estaban validados. Consideraciones finales: Incluso ante la vasta literatura sobre higiene de las manos, se carece de evidencia científica relativa al uso de instrumentos validados para medir la autoeficacia de los profesionales de salud en el procedimiento; el uso de instrumentos psicométricos debidamente validados permite garantizar la calidad de los resultados de los estudios.

RESUMO Objetivo: Identificar, a partir da literatura, as ferramentas utilizadas para mensurar a autoeficácia dos profissionais de saúde na higienização das mãos. Método: Revisão integrativa de literatura, nas bases de dados Pubmed, Scopus, Web of Science, CINAHL, Europe PMC e Science Direct, com os descritores Self Efficacy, HandHygiene e Health Personnel. Resultados: Selecionaram-se seis artigos, todos do tipo observacional. É possível inferir que quatro estudos utilizaram instrumentos validados para mensurar a autoeficácia dos profissionais de saúde em conformidade com as recomendações para a higiene das mãos. Os outros estudos utilizaram questionários, porém não validados. Considerações finais: Mesmo diante da vasta literatura sobre higiene das mãos, há carência de evidências científicas no que concerne à utilização de instrumentos validados para mensuração da autoeficácia dos profissionais de saúde em relação ao procedimento, pois o uso de instrumentos psicométricos devidamente validados é útil para assegurar a qualidade dos resultados dos estudos.

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This paper analyzes capacity building in practice, addressing the expectations, imaginaries and experiences of health researchers from Mozambique and Angola. The empirical data stems from the Erasmus+ funded project "University Development and Innovation - Africa (UDI-A)", a consortium established between European and African institutions to promote the mobility and empowerment of African academics, the establishment of North/South research partnerships and the strengthening of African institutions. Through qualitative research methods - semi-structured interviews and a focus group with African participants, and participant observation - this article analyzes the experiences of African academics working in the health field, their perceptions of capacity building and aspirations during their stay in Portugal in 2018. By addressing some of their concerns and achievements, this paper reflects on the performativity of capacity building methodologies, exploring a wide range of issues that emerge within the framework of North/South partnerships, inquiring whether it would be possible to decolonize capacity-building methodologies.

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Abstract This paper analyzes capacity building in practice, addressing the expectations, imaginaries and experiences of health researchers from Mozambique and Angola. The empirical data stems from the Erasmus+ funded project "University Development and Innovation - Africa (UDI-A)", a consortium established between European and African institutions to promote the mobility and empowerment of African academics, the establishment of North/South research partnerships and the strengthening of African institutions. Through qualitative research methods - semi-structured interviews and a focus group with African participants, and participant observation - this article analyzes the experiences of African academics working in the health field, their perceptions of capacity building and aspirations during their stay in Portugal in 2018. By addressing some of their concerns and achievements, this paper reflects on the performativity of capacity building methodologies, exploring a wide range of issues that emerge within the framework of North/South partnerships, inquiring whether it would be possible to decolonize capacity-building methodologies.

Resumo Este artigo analisa dispositivos de capacitação na prática, explorando as expetativas, os imaginários e as experiências de pesquisadores de saúde de Moçambique e Angola. Os dados empíricos resultam do projeto "University Development and Innovation - Africa (UDI-A)", financiado pelo programa Erasmus+, um consórcio estabelecido entre instituições europeias e africanas para promover a mobilidade e a capacitação de académicos africanos, o estabelecimento de parcerias de investigação Norte/Sul e o fortalecimento das instituições africanas. Através de metodologias qualitativas - entrevistas semiestruturadas e grupos de discussão com participantes africanos, e observação participante - este artigo analisa as experiências de académicos africanos trabalhando no setor da saúde, as suas perceções da capacitação e as suas ambições durante a estadia em Portugal em 2018. Através da análise das suas preocupações e sucessos, este artigo reflete acerca da performatividade das metodologias de capacitação, explorando um vasto leque de tópicos que emergem no contexto das parcerias Norte/Sul, questionando a possibilidade de uma descolonização das metodologias de capacitação.

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INTRODUCTION: The judicialization of health arose following the possibility of judicially demanding the right to health before national and international courts. In the case of Colombia, health litigation is done through a constitutional tool called the tutela action, which allows for the immediate protection of fundamental rights. METHODS: A retrospective cross-sectional study using a probabilistic stratified sample of 1031 users of the tutela actions, in Medellín, Colombia, between 2011 and 2014. Bivariate and multivariate analyses were performed, using statistical tests and multiple logistic regression models. RESULTS: According to the respondents, 95.9% of the tutela actions succeeded in favour of the applicant. On average, the judicial process took 10.96 days (SD = 8.09). After the favourable decision of the tutela action, access to health care followed in 76.2% of cases, partial access was found for 14.0% (median, 10 d), and in 9.8% of cases, claimants had not received access to the health care they sought. CONCLUSION: The tutela action is an essential constitutional mechanism that guarantees the access to health services. However, it must be strengthened from the legal point of view through the implementation of monitoring and control actions and by imposing the sanctioning measures and deadlines established in existing legislation.

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This study aims to analyze whether the process by which policies for human resources for health that aim to improve the geographic distribution of physicians have been informed by scientific evidence in Brazil and Portugal. This was a multiple case study on a decision-making process for human resources for health in Brazil and Portugal. The respective case studies were based on Brazil's More Doctors Program (Programa Mais Médicos - PMM) and Portugal's strategy of hiring foreign physicians through bilateral agreements, to work in the country's National Health Service (SNS). We interviewed 27 key actors in the policy-making process on the following topics: factors that influenced the policy decisions, actors that were expected to win or lose from the policy, and the scientific evidence and available data used in the policy-making, among others. The most evident factors appearing in the interviews as having influenced the PMM were: institutions; external factors (Presidential elections); group interests (e.g. physicians' professional associations), governments (Brazil and Cuba), international organizations, and civil society; and ideas (scientific evidence). The most frequently cited factors in Portugal were: institutions and interests of government (from Portugal and the countries involved in the bilateral agreements), civil society, and groups (physicians' professional associations). Contrary to the case study in Brazil, where the evidence was reported to having played an important role in the policy decisions, in Portugal, scientific evidence was not identified as contributing to the specific policy process.

O estudo objetiva analisar o processo em que as políticas de recursos humanos em saúde (RHS), que visam melhorar a distribuição geográfica dos médicos, são (ou não) informadas por evidência científica no Brasil e em Portugal. Foi realizado um estudo de caso-múltiplo sobre o processo de decisão das políticas de RHS no Brasil e em Portugal. Para compor os estudos de caso, as políticas escolhidas foram o Programa Mais Médicos (PMM) e a estratégia de contratação de médicos estrangeiros por acordos bilaterais para o trabalho no Serviço Nacional de Saúde (SNS) português. Foram entrevistados 27 atores-chave no processo de formulação das políticas em análise nos seguintes tópicos: fatores que influenciaram a formulação, atores que eram esperados ganhar ou perder, evidências científicas e os dados disponíveis utilizados para a formulação, entre outros. Os fatores mais evidentes identificados nas entrevistas como sendo influenciadores do PMM foram: Instituições; Fatores Externos (eleições presidenciais); Interesses de grupos (por exemplo, associações de profissionais médicos), governos (brasileiro e cubano), organização internacional e sociedade civil; e Ideias (evidência científica). Os fatores mais listados em Portugal foram: Instituições e Interesses dos governos (português e envolvidos nos acordos bilaterais), sociedade civil e grupos (associações de profissionais médicos). Ao contrário do que se verificou no estudo de caso do Brasil, em que reconhecidamente a evidência teve um papel importante na formulação da política em análise, em Portugal a evidência científica não foi identificada como contributo para a formulação da intervenção em estudo.

El estudio tiene por objetivo analizar el proceso en el que las políticas de recursos humanos en salud (RHS), que tienen como fin la mejora de la distribución geográfica de los médicos, son (o no) informadas por evidencias científicas en Brasil y en Portugal. Se trata de un estudio de caso-múltiple sobre el proceso de decisión de las políticas de RHS en Brasil y en Portugal. Para configurar los estudios de caso, las políticas elegidas fueron el Programa Más Médicos (PMM) y la estrategia de contratación de médicos extranjeros mediante acuerdos bilaterales para el trabajo en el Servicio Nacional de Salud (SNS) portugués. Se entrevistaron a 27 actores-clave en el proceso de formulación de las políticas en el análisis en los siguientes asuntos: factores que influenciaron la formulación, actores que se esperaba ganar o perder, evidencias científicas y datos disponibles utilizados para la formulación, entre otros. Los factores más evidentes, identificados en las entrevistas como de influencia en el PMM, fueron: instituciones; factores externos (elecciones presidenciales); intereses de grupos (por ejemplo, asociaciones de profesionales médicos), gobiernos (brasileño y cubano), organización internacional y sociedad civil; e ideas (evidencia científica). Los factores más registrados en Portugal fueron: instituciones e intereses de los gobiernos (como el portugués y los involucrados en los acuerdos bilaterales), sociedad civil y grupos (asociaciones de profesionales médicos). Al contrario de lo que se verificó en el estudio de caso de Brasil, donde se reconoció que la evidencia tuvo un papel importante en la formulación de la política en análisis, en Portugal la evidencia científica no fue identificada como una contribución para la formulación de la intervención en estudio.

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Background: The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. Methods: We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Results: Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal's. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. Conclusions: In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

Asunto(s)

RESUMEN

Background: The production of knowledge on Human Resources for Health (HRH) issues has increased exponentially since 2000 but integration of the research in the policy-making process is often lagging. We looked at how research on HRH contributes or not to inform policy decisions and interventions affecting the health workforce in Portugal and Brazil. Methods: We designed a comparative case study of semi-structured interviews with present and past national decision-makers, policy advisors and researchers. Issues explored included the existence of a national HRH policy and the use, or non-use, of research evidence by policy makers and reasons to do so. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Results: Policy-makers in Brazil recognize a greater use of evidence in the process of defining HRH policy when compared to Portugal’s. But the existence of formal instruments to support policy development is not sufficient to ensure that policies are informed by evidence. Conclusions: In both countries the importance of the use of evidence in the formulation of policies was recognized by policy-makers. However, the influence of other factors, such as political pressures from various lobby groups and from the media and the policy short timeframe which requires rapid responses, is predominant.

Asunto(s)

RESUMEN

O estudo objetiva analisar o processo em que as políticas de recursos humanos em saúde (RHS), que visam melhorar a distribuição geográfica dos médicos, são (ou não) informadas por evidência científica no Brasil e em Portugal. Foi realizado um estudo de caso-múltiplo sobre o processo de decisão das políticas de RHS no Brasil e em Portugal. Para compor os estudos de caso, as políticas escolhidas foram o Programa Mais Médicos (PMM) e a estratégia de contratação de médicos estrangeiros por acordos bilaterais para o trabalho no Serviço Nacional de Saúde (SNS) português. Foram entrevistados 27 atores-chave no processo de formulação das políticas em análise nos seguintes tópicos: fatores que influenciaram a formulação, atores que eram esperados ganhar ou perder, evidências científicas e os dados disponíveis utilizados para a formulação, entre outros. Os fatores mais evidentes identificados nas entrevistas como sendo influenciadores do PMM foram: Instituições; Fatores Externos (eleições presidenciais); Interesses de grupos (por exemplo, associações de profissionais médicos), governos (brasileiro e cubano), organização internacional e sociedade civil; e Ideias (evidência científica). Os fatores mais listados em Portugal foram: Instituições e Interesses dos governos (português e envolvidos nos acordos bilaterais), sociedade civil e grupos (associações de profissionais médicos). Ao contrário do que se verificou no estudo de caso do Brasil, em que reconhecidamente a evidência teve um papel importante na formulação da política em análise, em Portugal a evidência científica não foi identificada como contributo para a formulação da intervenção em estudo.(AU)

El estudio tiene por objetivo analizar el proceso en el que las políticas de recursos humanos en salud (RHS), que tienen como fin la mejora de la distribución geográfica de los médicos, son (o no) informadas por evidencias científicas en Brasil y en Portugal. Se trata de un estudio de caso-múltiple sobre el proceso de decisión de las políticas de RHS en Brasil y en Portugal. Para configurar los estudios de caso, las políticas elegidas fueron el Programa Más Médicos (PMM) y la estrategia de contratación de médicos extranjeros mediante acuerdos bilaterales para el trabajo en el Servicio Nacional de Salud (SNS) portugués. Se entrevistaron a 27 actores-clave en el proceso de formulación de las políticas en el análisis en los siguientes asuntos: factores que influenciaron la formulación, actores que se esperaba ganar o perder, evidencias científicas y datos disponibles utilizados para la formulación, entre otros. Los factores más evidentes, identificados en las entrevistas como de influencia en el PMM, fueron: instituciones; factores externos (elecciones presidenciales); intereses de grupos (por ejemplo, asociaciones de profesionales médicos), gobiernos (brasileño y cubano), organización internacional y sociedad civil; e ideas (evidencia científica). Los factores más registrados en Portugal fueron: instituciones e intereses de los gobiernos (como el portugués y los involucrados en los acuerdos bilaterales), sociedad civil y grupos (asociaciones de profesionales médicos). Al contrario de lo que se verificó en el estudio de caso de Brasil, donde se reconoció que la evidencia tuvo un papel importante en la formulación de la política en análisis, en Portugal la evidencia científica no fue identificada como una contribución para la formulación de la intervención en estudio.(AU)

This study aims to analyze whether the process by which policies for human resources for health that aim to improve the geographic distribution of physicians have been informed by scientific evidence in Brazil and Portugal. This was a multiple case study on a decision-making process for human resources for health in Brazil and Portugal. The respective case studies were based on Brazil's More Doctors Program (Programa Mais Médicos - PMM) and Portugal's strategy of hiring foreign physicians through bilateral agreements, to work in the country's National Health Service (SNS). We interviewed 27 key actors in the policy-making process on the following topics: factors that influenced the policy decisions, actors that were expected to win or lose from the policy, and the scientific evidence and available data used in the policy-making, among others. The most evident factors appearing in the interviews as having influenced the PMM were: institutions; external factors (Presidential elections); group interests (e.g. physicians' professional associations), governments (Brazil and Cuba), international organizations, and civil society; and ideas (scientific evidence). The most frequently cited factors in Portugal were: institutions and interests of government (from Portugal and the countries involved in the bilateral agreements), civil society, and groups (physicians' professional associations). Contrary to the case study in Brazil, where the evidence was reported to having played an important role in the policy decisions, in Portugal, scientific evidence was not identified as contributing to the specific policy process.(AU)

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This study analyzes the production of scientific knowledge on Health Inequalities (HI) and its use in policies of education of dentists, nurses and physicians in Brazil and Portugal. Documents published between January 2000 and December 2001, in Portuguese, French, English and Spanish, were identified by means of a combination of a manual and intentional electronic database survey of the grey literature. Fifty-three documents were selected from a total of 1,652. The findings revealed that there is still little knowledge available to enable an assessment of policies for human resource training in healthcare in general and for those related to physicians, nurses and dentists in particular. In Brazil, few studies have thus far been made to understand how such training can contribute towards reducing these inequalities and, in the case of Portugal, no studies were found that established a direct relationship between human resource training and the future role that these could play in combating inequality. Despite a vast increase in scientific production, many lacunae still exist in this field. Knowledge production and its relationship with decision-making still seem to be separate processes in these two countries.

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ResumoO estudo analisa a produção do conhecimento científico sobre desigualdades sociais em saúde e discute sua relação com as políticas de formação de dentistas, enfermeiros e médicos no Brasil e em Portugal. Foram identificados documentos publicados em Português, Francês, Inglês e Espanhol, entre janeiro de 2000 e dezembro de 2012, por meio da combinação de levantamento em bases de dados eletrônicas, manual e intencional da literatura cinzenta. Foram selecionados 53 documentos de um total de 1652. Os resultados mostram escassez de conhecimento para permitir a avaliação das políticas de formação de recursos humanos em saúde em geral e aquelas relativas a médicos, enfermeiros e dentistas, em particular. No Brasil, ainda são poucos os estudos que procuram entender como essa formação pode contribuir para a diminuição das desigualdades e, para Portugal, não encontramos estudos que estabeleçam uma relação direta entre a formação de recursos humanos e um eventual papel que esses poderão desempenhar no combate às desigualdades. Apesar de um grande aumento na produção científica, muitas lacunas persistem nesse campo. A produção de conhecimento e sua relação com a tomada de decisão parecem ainda ser processos separados nos dois países.

AbstractThis study analyzes the production of scientific knowledge on Health Inequalities (HI) and its use in policies of education of dentists, nurses and physicians in Brazil and Portugal. Documents published between January 2000 and December 2001, in Portuguese, French, English and Spanish, were identified by means of a combination of a manual and intentional electronic database survey of the grey literature. Fifty-three documents were selected from a total of 1,652. The findings revealed that there is still little knowledge available to enable an assessment of policies for human resource training in healthcare in general and for those related to physicians, nurses and dentists in particular. In Brazil, few studies have thus far been made to understand how such training can contribute towards reducing these inequalities and, in the case of Portugal, no studies were found that established a direct relationship between human resource training and the future role that these could play in combating inequality. Despite a vast increase in scientific production, many lacunae still exist in this field. Knowledge production and its relationship with decision-making still seem to be separate processes in these two countries.

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