RESUMEN
Residents of long-term care (LTC) facilities have a significantly higher risk of poor oral health status compared with those living independently; moreover, the provision of oral health services to LTC residents is often limited. This study identifies and classifies state-level policies and funding sources for dental services that are available to LTC residents. The research details variability in coverage levels, payment sources, workforce capacity, and care delivery configuration, finding little coherence between policy and the needs of patients or providers. Reforms to address the oral health care needs of vulnerable populations in LTC settings should start with defining a clearer standard of oral care required for this population. This will allow best practices in policy, practice, and accountability to be structured around care that improves patients' oral health.
Asunto(s)
Atención Odontológica/organización & administración , Hogares para Ancianos/organización & administración , Cuidados a Largo Plazo/organización & administración , Casas de Salud/organización & administración , Políticas , Atención Odontológica/normas , Personal de Odontología/provisión & distribución , Fuerza Laboral en Salud , Hogares para Ancianos/normas , Humanos , Reembolso de Seguro de Salud/normas , Cuidados a Largo Plazo/normas , Medicaid/organización & administración , Medicare/organización & administración , Casas de Salud/normas , Estados UnidosRESUMEN
OBJECTIVES: There is considerable variation in dental services utilization across Appalachian counties, and a plausible explanation is that individuals in some geographical areas do not utilize dental care due to dental workforce shortage. We conducted an ecological study on dental workforce availability and dental services utilization in Appalachia. METHODS: We derived county-level (n = 364) data on demographic and socioeconomic characteristics and dental services utilization in Appalachia from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) using person-level data. We obtained county-level dental workforce availability and physician-to-population ratio estimates from Area Health Resources File and linked them to the county-level BRFSS data. The dependent variable was the proportion using dental services within the last year in each county (ranging from 16.6% to 91.0%). We described the association between dental workforce availability and dental services utilization using ordinary least squares regression and spatial regression techniques. Spatial analyses consisted of bivariate local indicators of spatial association (LISA) and geographically weighted regression (GWR). RESULTS: Bivariate LISA showed that counties in the central and southern Appalachian regions had significant (P < 0.05) low-low spatial clusters (low dental workforce availability, low percent dental services utilization). GWR revealed considerable local variations in the association between dental utilization and dental workforce availability. In the multivariate GWR models, 8.5% (t-statistics > 1.96) and 13.45% (t-statistics > 1.96) of counties showed positive and statistically significant relationships between the dental services utilization and workforce availability of dentists and dental hygienists, respectively. CONCLUSIONS: Dental workforce availability was associated with dental services utilization in the Appalachian region; however, this association was not statistically significant in all counties. The findings suggest that program and policy efforts to improve dental services utilization need to focus on factors other than increasing the dental workforce availability for many counties in Appalachia.
Asunto(s)
Atención Odontológica , Personal de Odontología/provisión & distribución , Región de los Apalaches , Sistema de Vigilancia de Factor de Riesgo Conductual , Demografía , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Factores Socioeconómicos , Recursos HumanosRESUMEN
Este artigo tem como objetivo principal discutir a necessidade de demanda por cirurgiões-dentistas no Brasil a partir do indicador que expressa a proporção identificada como adequada entre o número de profissionais por uma quantidade determinada de população. Deste modo, serão observados dois indicadores: o primeiro é o indicador clássico preconizado pela Organização Mundial de Saúde (OMS); o segundo é o proposto pelo Ministério da Saúde (MS) para a reorganização da Atenção Básica em Saúde no país, através da Estratégia de Saúde da Família (ESF). Com vistas a alcançar os objetivos traçados, optou-se por utilizar a Pesquisa Bibliográfica e a Pesquisa Documental. Destaca-se, neste sentido, a utilização de Fontes para Estudos e Pesquisas de Recursos Humanos em Saúde. Os resultados apontam para, tomando-se por base o indicador da OMS, um excesso e uma má distribuição dos cirurgiões-dentistas no país. Por outro lado, ao levar em consideração o indicador preconizado pelo Ministério da Saúde, evidencia-se a necessidade de um grande número de novos postos de trabalho em saúde pública, de modo a garantir a universalidade de acesso aos serviços odontológicos. Por fim, salienta-se que o tema precisa ser problematizado no interior da classe odontológica, pois a incoerência entre as necessidades de mercado e a oferta crescente de cirurgiões-dentistas pode trazer consequências indesejáveis, tanto para os profissionais quanto para os usuários das ações e serviços de saúde prestados.
This article has the main goal of discussing the demand for dental surgeons in Brazil starting from the indicator that expresses the proportion between the number of professionals and a determined amount of the population identified as adequate. Therefore, two indicators were observed: the first is the classic indicator advocated by the World Health Organization (OMS); the second is the one proposed by the Ministry of Health (MS) for there-organization of the Basic Health Attention in the country, through the Family Health Strategy (ESF). To achieve the proposed goals, the Bibliographical Research and the Documental Research were used. In this regard, the use of Health Human Resources Study and Research Sources is highlighted. If the supporting indicator is the OMS, the results point to an excess and a bad distribution of the dental surgeons in the country. In the other hand, if the indicator advocated by the Ministry of Health is taken into consideration, the need of a high number of new work posts in public health is evident, to assure the universality of access to dental services. Lastly, it is brought up that the theme needs to be problematized inside the dental class, because the incoherence between the market demands and the rising offer of dental surgeons might bring undesired consequences, for both professionals and users of the provided actions and services.
Asunto(s)
Personal de Odontología/provisión & distribución , Atención Primaria de SaludRESUMEN
OBJECTIVE: To identify reasons for the development of dental auxiliaries across six developed countries and to explore attitudes towards them. DESIGN: Literature review; semistructured interviews with key informants. SETTING: Interviews in each selected country; Belgium, Greece, Finland, U.K., Canada and New Zealand. MATERIALS AND METHODS: For each country, representatives of key informants were interviewed. RESULTS: The introduction of dental auxiliaries in many countries was as a result of workforce shortages. There has been no development of dental auxiliaries in Belgium or Greece largely because of perceived lack of need by the representative respondents. In Canada, Finland, New Zealand and the U.K. the introduction of clinical dental auxiliaries was a result of shortages of workforce and high levels of disease. Concerns amongst dentists were about the pace of the increased scope of practice for auxiliaries and by auxiliaries about lack of career development. CONCLUSIONS: Two distinct professional attitudes towards dental auxiliaries were found--in Belgium and Greece, there is little or no support compared with the other countries, where, in general, professional attitudes support the use of dental hygienists but are less supportive of therapists and denturists.
Asunto(s)
Actitud del Personal de Salud , Actitud , Auxiliares Dentales/estadística & datos numéricos , Países Desarrollados , Bélgica , Canadá , Movilidad Laboral , Análisis Costo-Beneficio , Atención a la Salud , Atención Odontológica , Personal de Odontología/provisión & distribución , Finlandia , Predicción , Grecia , Humanos , Evaluación de Necesidades , Nueva Zelanda , Práctica Profesional , Desarrollo de Personal , Reino UnidoRESUMEN
BACKGROUND: Workforce development is acritical factor allowing delivery on government health priorities. Against a backdrop of increasingdemand for dental therapists being significantly higher than the levels of recruitment, it is widely acknowledged that rural and remote areas (having greater recruitment and retention issues) will face significant shortfall in therapist numbers as the workforce shortages take hold in dentistry. This study analysed the reasons for dental therapists leaving the profession, and factors that would promote the recruitment and retention of dental therapists, especially in rural and remote areas. METHODS: A postal survey was undertaken amongst all registered dental therapists in Western Australia between the years 1999-2003. RESULTS: Of all respondents, 28 per cent indicated that they do not work as dental therapists anymore. A number of reasons for leaving the profession were highlighted, including family reasons, careerchange, poor salaries, relocation, illness and injury, and stress. To increase retention and recruitment of dental therapists to rural areas, a number of opportunities were highlighted by respondents, including increased salaries, living support, travel assistance, access to continuing education, recruitment of more rural students and more flexibility (including job sharing). CONCLUSION: This survey has highlighted various opportunities to recruit and retain dental therapists in their profession and to increase the numbers of rural dental therapists. A broad integrated rural retention strategy is necessary to address these issues among the dental therapy workforce.
Asunto(s)
Personal de Odontología/provisión & distribución , Selección de Personal , Reorganización del Personal , Adulto , Personal de Odontología/economía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Selección de Personal/estadística & datos numéricos , Reorganización del Personal/estadística & datos numéricos , Salud Rural/estadística & datos numéricos , Población Rural , Encuestas y Cuestionarios , Australia OccidentalRESUMEN
The requirements for dentists in Lebanon for the year 2015 were estimated using the World Health Organization/World Dental Federation planning model. The aim was to help decision- and policy-makers in Lebanon to plan strategically for the supply of dental personnel in line with the recommendations of the Oral Health National Plan guidelines from 1995. Assumptions based on previous research in selected populations were taken to support the simulation. The number of dentists required for Lebanon in the year 2015 was estimated to be 2715 while the projected supply will be 6176. Urgent measures are needed to reduce the potential oversupply of dentists in this country.
Asunto(s)
Servicios de Salud Dental , Personal de Odontología/provisión & distribución , Odontólogos/provisión & distribución , Planificación en Salud/organización & administración , Evaluación de Necesidades/organización & administración , Adolescente , Adulto , Anciano , Niño , Preescolar , Toma de Decisiones en la Organización , Servicios de Salud Dental/tendencias , Encuestas de Salud Bucal , Personal de Odontología/tendencias , Odontólogos/tendencias , Predicción , Adhesión a Directriz , Guías como Asunto , Política de Salud , Investigación sobre Servicios de Salud , Humanos , Lactante , Líbano , Persona de Mediana Edad , Admisión y Programación de Personal/organización & administración , Formulación de Políticas , Recursos Humanos , Carga de TrabajoRESUMEN
OBJECTIVES: To evaluate different measurements of prevalence and inequality in the distribution of dental caries as to their partial collinearity, and ability in expressing associations with the supply of fluoridated tap water, indices of socioeconomic status and provision of dental services. METHODS: The DMFT, the Significant Caries (SiC) Index, the proportions of children with high- (DMFT > or = 4) and rampant- (DMFT > or = 7) caries experience, caries-free children (DMFT = 0), the Gini coefficient and the Dental Health Inequality Index (DHII) were the dental outcomes appraised in a sample comprising 18 718 oral examination records for 11- and 12-year-old schoolchildren in 131 towns of the state of São Paulo, Brazil. Spatial data analysis assessed the association between aggregate figures of dental indices and several covariates. RESULTS: The DMFT, the SiC Index and the proportions of children with high- and rampant-caries experience presented strong linear associations (Pearson r near or higher than 0.95), and an analogous profile of correlation with indicators of socioeconomic status, dental services and access to fluoride tap water. The same was observed for the DHII, the Gini coefficient and the proportion of caries-free children. These observations involve the perception of variables in each set as interchangeable tools for ecological studies assessing factors influencing, respectively, prevalence levels and inequality in the distribution of dental disease. CONCLUSION: An improved characterization of the skewed distribution of caries experience demands the concurrent estimation of figures of prevalence and inequality in dental outcomes. This strategy may contribute to the design of socially appropriate programmes of oral health promotion.
Asunto(s)
Caries Dental/epidemiología , Brasil/epidemiología , Niño , Índice CPO , Caries Dental/economía , Personal de Odontología/provisión & distribución , Fluoruración , Accesibilidad a los Servicios de Salud , Humanos , Análisis de los Mínimos Cuadrados , Pobreza , Prevalencia , Análisis de Área Pequeña , Clase Social , Estadísticas no Paramétricas , Salud UrbanaRESUMEN
Oral health and general health status depend on a dynamic interplay of many factors, including the individual's personal characteristics, behaviors, and perceptions. There are differences and disparities among different racial and ethnic groups in terms of oral health status, and in the physical, socioeconomic, cultural, and political environment. Furthermore, response to the environment may vary among individuals and populations. Access to care and patient-provider interactions are key issues to consider. This article presents a conceptual model of the variable influences on behaviors and perceptions that determine oral health status in minority and other populations.
Asunto(s)
Conductas Relacionadas con la Salud/etnología , Conocimientos, Actitudes y Práctica en Salud , Indicadores de Salud , Grupos Minoritarios/psicología , Salud Bucal , Atención a la Salud/estadística & datos numéricos , Personal de Odontología/educación , Personal de Odontología/provisión & distribución , Estado de Salud , Humanos , Modelos Logísticos , Grupos Minoritarios/estadística & datos numéricos , Evaluación de Necesidades/estadística & datos numéricos , Educación del Paciente como Asunto , Relaciones Profesional-Paciente , Estados Unidos/epidemiologíaRESUMEN
PURPOSE: The objective of this study was to survey pediatric dentistry program directors on perceived resource needs and changes over the last 5 years in the characteristics of their patient population and on waiting times for dental treatment with sedation or general anesthesia (GA) for children with complex dental and medical histories in hospital- and dental school-based training programs. METHODS: A 47-question survey was sent electronically to all pediatric dentistry program directors in the United States using the University of Washington's Catalyst Tools program. Two reminder messages were sent. After 3 months, the data was downloaded and descriptive statistics were performed using the SPSS for Windows version 8.0. RESULTS: Twenty-eight of 54 program directors responded with 26 usable survey responses (48%). Thirty-one percent reported outpatient clinics located in a dental school, 31% reported that their clinics were in a hospital, and 38% had clinics in both settings. Program directors perceive that the number of new, recall and emergency patients and the number of pre-school aged children and children with special health care needs had increased in their programs in the last 5 years. Payment by Medicaid was the most common insurance for children cared for in these settings. The mean waiting time for scheduling treatment with GA for a child in pain is 28 days; without pain 71 days. The mean waiting time for scheduling treatment with sedation is 36 days. The majority of program directors reported they had an adequate number of faculty and residents (61% and 66%, respectively) even though 52% of the directors were presently actively recruiting faculty. CONCLUSIONS: 1. Dental school and hospital-based training programs are an important source for an increasing number of children with complex dental needs; 2. The majority of patients treated in the programs are Medicaid beneficiaries; 3. Average waiting times for complex dental care for children in pain is 28 days with GA; without pain and need for GA 71 days; 4. There was an average 36-day wait for treatment with sedation.
Asunto(s)
Anestesia Dental/estadística & datos numéricos , Atención Dental para Niños/estadística & datos numéricos , Clínicas Odontológicas/estadística & datos numéricos , Servicio Odontológico Hospitalario/estadística & datos numéricos , Listas de Espera , Anestesia Dental/economía , Niño , Preescolar , Atención Dental para Niños/economía , Atención Dental para Niños/organización & administración , Clínicas Odontológicas/organización & administración , Servicio Odontológico Hospitalario/organización & administración , Personal de Odontología/provisión & distribución , Humanos , Medicaid , Facultades de Odontología , Encuestas y Cuestionarios , Estados UnidosRESUMEN
The dental clinic is an environment where disease transmission occurs easily. Prevention of cross infection in the dental clinic is therefore a crucial aspect of dental practice and dental clinic workers must adopt certain basic routines while practising. This study evaluates basic routines in prevention of cross-infection in the dental clinic, University College Hospital Ibadan. The sample comprised 77 dental clinic workers, who completed closed-ended questionnaires. The questionnaires enquired into practices of the workers in the clinic as well as in the laboratories Physical inspection of dental equipment, instruments and materials was also carried out. The results highlight poor compliance of workers, especially the dental surgeons and students, with the hepatitis B vaccination programme of the Hospital. History to identify high risk individuals was often overlooked and was practised by less than 50% of the clinic workers. Barrier technique with the exception of the use of eye shield, was well practised by all the clinic workers. Aseptic technique was well practised in the dental clinic. Inadequate number of dental surgery assistants, faulty sterilizing equipment, poor monitoring of sterilization, coupled with inadequate number of instruments contributed to the poor success of prevention of contamination and instrument processing procedures. Less than 30% of dental surgeons and fewer than 50% of students discarded sharp materials into the yellow/sharp bin. Liquid waste was well disposed off through the drain for onward flow into the sewer, whilst the disposal of solid contaminated waste did not conform to stipulated international standard. The study found that successful infection control in the dental clinic was highly dependent on the dental surgery assistants, because highly technological equipment were lacking. The management/administration also plays an important role in the number of physical and human resources available and in the overall surveillance of nosocomial infections.
Asunto(s)
Infección Hospitalaria/prevención & control , Clínicas Odontológicas/normas , Servicio Odontológico Hospitalario/normas , Hospitales Universitarios/normas , Control de Infección Dental/normas , Asepsia/métodos , Asepsia/normas , Actitud del Personal de Salud , Auxiliares Dentales/educación , Auxiliares Dentales/psicología , Auxiliares Dentales/provisión & distribución , Equipo Dental/microbiología , Personal de Odontología/educación , Personal de Odontología/psicología , Personal de Odontología/provisión & distribución , Odontólogos/psicología , Odontólogos/provisión & distribución , Contaminación de Equipos/prevención & control , Adhesión a Directriz/normas , Conocimientos, Actitudes y Práctica en Salud , Hepatitis B/prevención & control , Humanos , Control de Infección Dental/métodos , Eliminación de Residuos Sanitarios/métodos , Eliminación de Residuos Sanitarios/normas , Evaluación de Necesidades , Nigeria , Guías de Práctica Clínica como Asunto , Factores de Riesgo , Encuestas y Cuestionarios , Vacunación/normasAsunto(s)
Personal de Odontología/provisión & distribución , Cuerpo Médico/provisión & distribución , Admisión y Programación de Personal/estadística & datos numéricos , Medicina Estatal/organización & administración , Adulto , Anciano , Investigación sobre Servicios de Salud , Humanos , Persona de Mediana Edad , EscociaAsunto(s)
Personal de Odontología/provisión & distribución , Cuerpo Médico/provisión & distribución , Admisión y Programación de Personal/estadística & datos numéricos , Medicina Estatal/organización & administración , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , EscociaRESUMEN
The implications in terms of dental manpower and costs of applying the Scandinavian system of dental care in Brazil are specified and analysed. Two societies were chosen for study: those of Sweden, in Scandinavia and Santa Catarina, State in southern Brazil. The theoretical analysis of the implications was undertaken on the basis of an estimate of dental and auxiliary manpower required to deal with the high levels of oral disease and needs (caries, teeth needing extraction, periodontal diseases and the need for full dentures) in Santa Catarina. This estimate was undertaken by means of the World Health Organization-Fédération Dentaire Internationale (WHO-FDI) Model "Health Through Oral Health" (1989). The implications in costs, taking the total Swedish expenditure per dentist as a basis, were calculated and applied to the manpower calls for by the WHO-FDI model. The high costs resulting showed that the application of the Swedish model of dental care to Santa Catarina would be unrealistic. The implications in terms of manpower were calculated by applying the manpower ratios considered desirable in Sweden to Santa Catarina. In order to achieve the Swedish dentist: population ration, Santa Catarina would need 85% more dentists that it had in 1990. Regarding auxiliary personnel, the Brazilian State of Santa Catarina would need to train a large number of new personnel in order to attain the Swedish auxiliary: dentist ratio. In the light of the findings of this study, the adoption of the Swedish model of providing dental care by Santa Catarina in terms of costs and manpower is not feasible. Therefore, alternative approaches for the improvement of oral health in Santa Catarina and in the rest to Brazil should be sought. These approaches should take consider political, cultural and socio-economic aspects of Brazilian society into consideration.
Asunto(s)
Atención Odontológica/economía , Personal de Odontología/economía , Adulto , Brasil , Niño , Índice CPO , Atención Odontológica/estadística & datos numéricos , Personal de Odontología/estadística & datos numéricos , Personal de Odontología/provisión & distribución , Humanos , Persona de Mediana Edad , Salud Bucal , Suecia , Recursos HumanosRESUMEN
Objetivou-se detectar e analisar as implicaçöes em custos e recursos humanos em odontologia de uma hipotética aplicaçäo dos conceitos escandinavos de atençäo odontológica no Brasil. Duas sociedades foram escolhidas para serem estudadas: Suécia, país da Escandinávia, e Santa Catarina, Estado da regiäo Sul do Brasil. A análise teórica dessas implicaçöes foi realizada a partir da determinaçäo das necessidades de recursos humanos em odontologia, considerando-se os altos índices de doenças bucais no Estado brasileiro. Utilizou-se o programa de software "Health Throught Oral Health" da Organizaçäo Mundial da Saúde - Federaçäo Dentária Internacional (1989). Os resultados mostraram alto custo financeiro e a necessidade de se aumentar em até 85 por cento o recurso humano disponível para atuar em saúde bucal no Estado de Santa Catarina. Concluiu-se que os princípios de alta provisäo de recursos humanos e financeiros, característicos do modelo escandinavo, näo serviriam para serem adotados por Santa Catarina e, extensivamente, pelo Brasil
Asunto(s)
Humanos , Personal de Odontología/provisión & distribución , Odontología en Salud Pública/economía , Servicios de Salud Dental/organización & administración , Diagnóstico de la Situación de Salud , Economía en Odontología , Atención Odontológica/organización & administración , Evaluación de Programas y Proyectos de Salud , Necesidades y Demandas de Servicios de Salud , Odontología en Salud PúblicaAsunto(s)
Personal de Odontología/provisión & distribución , Personal de Odontología/estadística & datos numéricos , Administración de la Práctica Odontológica/estadística & datos numéricos , Salarios y Beneficios/estadística & datos numéricos , Asistentes Dentales/estadística & datos numéricos , Asistentes Dentales/provisión & distribución , Auxiliares Dentales/estadística & datos numéricos , Auxiliares Dentales/provisión & distribución , Higienistas Dentales/estadística & datos numéricos , Higienistas Dentales/provisión & distribución , Humanos , Estados UnidosAsunto(s)
Citas y Horarios , Agotamiento Profesional/prevención & control , Personal de Odontología/provisión & distribución , Admisión y Programación de Personal/organización & administración , Administración de la Práctica Odontológica/organización & administración , Personal de Odontología/psicología , Eficiencia Organizacional , HumanosRESUMEN
As a public health agency, the Indian Health Service (IHS) must plan for the needs of the entire American Indian and Alaskan Native (AI/AN) population and distribute resources as equitably as possible. To facilitate this process, the IHS has developed a manpower planning model to provide for the distribution of dental providers based upon the dental needs of the AI/AN population and within the limits of annual appropriations of funds. This paper briefly describes the original IHS Dental Program manpower planning model and the development of modifications over time. The need-based approach to manpower planning developed by the IHS Dental Program has exhibited utility and flexibility over time. It allows a determination of clinic size (number of operatories) and dental staffing requirements, and may be generalizable to other public health programs if an accurate assessment of utilization rate and treatment need can be made for the defined population. Nonetheless, the availability of resources in public programs is subject to the compromises inherent in the political process; thus, the use of a manpower planning model alone may not be sufficient to ensure the equitable distribution of dental resources and dental providers.
Asunto(s)
Servicios de Salud Dental , Planificación en Salud , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Odontología en Salud Pública , United States Indian Health Service/organización & administración , Servicios de Salud Dental/organización & administración , Personal de Odontología/provisión & distribución , Humanos , Estados Unidos , Recursos HumanosAsunto(s)
Asistentes Dentales/educación , Asistentes Dentales/provisión & distribución , Personal de Odontología/provisión & distribución , Odontólogos/estadística & datos numéricos , Actitud del Personal de Salud , Asistentes Dentales/estadística & datos numéricos , Personal de Odontología/estadística & datos numéricos , Educación Continua , Educación Continua en Odontología , Humanos , Nebraska , Encuestas y CuestionariosRESUMEN
Dedica-se, inicialmente, ao estudo das condiçöes de desenvolvimento brasileiro nas áreas econômica e social, retratando a forte crise que caracterizou os anos oitenta. Após examinar o sistema geral de atençäo à saúde, analisa o aparelho prestador de serviços odontológicos e os gastos em saúde geral e em saúde bucal para o ano de 1989. A questäo epidemiológica é vista sob a ótica de cinco indicadores principais: ataque pela cárie dental, doenças periondontais, necessidade e uso de próteses totais, edentulismo e procura de atendimento, estimando-se médias, percentuais e valores totais idade por idade para a populaçäo de 5 a 79 anos. O estudo dos programas e políticas setoriais engloba as iniciativas de nível central e regional, as açöes preventivas e dois temas relacionados à saúde oral: o consumo e produçäo de açúcar e o modelo de ensino elementar. Apresentaram-se sugestöes para estruturaçäo geral do sistema de atendimento odontológico com ênfase em sub-sistemas de prevençäo, educaçäo em saúde, atençäo a crianças e adolescentes, cuidados a outros grupos e problemas, vigilância sanitária e epidemiológica, além de propor medidas relacionadas à preparaçäo de recursos humanos, ao financiamento setorial e às linhas de estudos e pesquisas