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BACKGROUND: The number of oral health technicians (OHT) in the public health service in Brazil is lower than the number of training school graduates. Thus, the objective of this study was to investigate possible factors associated with the inclusion of OHT in the public health service in Minas Gerais, Brazil, and its implications on oral health indicators. METHODS: This cross-sectional ecological study used a database (Excel) composed of 122 municipalities that participated in an OHT training course that took place between 2012 and 2013. Municipal contextual variables, including oral health indicators and sociodemographic indicators, related to the organization of health services were incorporated before and after the course. The dependent variable was the entry of graduates into the public health service according to a self-report survey conducted in 2015. A descriptive analysis of the variables was carried out, followed by bivariate analyses between the independent variables and the dependent variable using Pearson's chi-square test. The independent variables selected for multivariate logistic regression were statistically significant at p <  0.20. In the final model, significant effects were identified for variables with p <  0.05. The statistical software SPSS 18.0 for Windows was used. RESULTS: After the course, the variable of the public service organization and the two variables of oral health indicators were associated with the outcome. The organization services variable "presence of oral health team modality II" and the variable "indicator of coverage of first dental programmatic consultation" presented an association tendency with the entry of OHT in the multivariate logistic regression model, but these associations were not statistically significant because they had significance levels of p = 0.075 and p = 0.191, respectively. The variable "collective action indicator supervised dental brushing" was associated with the entry of egress (p = 0.045) remaining in the final model. CONCLUSION: The model of organization of the oral health service formed through the implementation of modality II oral health teams positively influenced the inclusion of OHT in the public health service in Minas Gerais, with improvement in the oral health indicators of the municipalities.

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RESUMO

Para atender às demandas de formação técnica dos trabalhadores dos serviços de saúde, foram criadas no ano 2000 as Escolas Técnicas e Centros Formadores do Sistema Único de Saúde. A literatura revela que o número de Técnicos em Saúde Bucal inseridos no serviço público é menor que o de egressos das escolas formadoras. Objetivou-se avaliar o impacto da formação do Técnico em Saúde Bucal realizada pela Escola de Saúde Pública do Estado Minas Gerais, no âmbito de egressos de 19 turmas formadas entre 2012-2013. Foram realizados dois estudos: o primeiro foi transversal, ecológico, e avaliou 122 municípios participantes do Curso. Objetivou-se investigar os fatores associados à inserção do Técnico em Saúde Bucal no Sistema Único de Saúde em Minas Gerais, e suas implicações nos indicadores de saúde bucal. As variáveis municipais selecionadas foram referentes à organização dos serviços de saúde, aos indicadores de saúde bucal e aos indicadores sociodemográficos, antes e após o curso. A variável dependente foi a inserção do egresso no serviço público, conforme autorrelato para uma pesquisa realizada em 2015/2016. Realizou-se análise descritiva, seguida de análises bivariadas e multivariada entre as variáveis independentes e a variável dependente, utilizando-se o teste qui-quadrado de Pearson. Utilizou-se o software SPSS® 18.0. A variável "indicador de ação coletiva escovação dental supervisionada" apresentou associação com a inserção, permanecendo no modelo final. Concluiu-se que a implantação de Equipe de Saúde Bucal modalidade II, influenciou positivamente na inserção do Técnico em Saúde Bucal no Sistema Único de Saúde em Minas Gerais, com melhora nos indicadores de saúde bucal municipais. O segundo estudo foi transversal, descritivo, quali-quantitativo, realizado com os docentes do Curso. Avaliou-se a percepção dos docentes em relação à formação, inserção, atuação e contribuição do egresso para o serviço. Utilizou-se questionário semiestruturado enviado por e-mail, que possuía quatro dimensões: perfil sociodemográfico, formação docente, formação do Técnico em Saúde Bucal e inserção e atuação do egresso no Sistema Único de Saúde. A taxa de resposta foi de 74% e 58% para os dois grupos de docentes avaliados (Concentração e Dispersão). O perfil encontrado foi de uma maioria de mulheres, com média de idade de 40,2 anos (DP±7,38) para a Concentração e de 37,8 anos (DP±8,26) para a Dispersão, que concluiu a graduação em instituição de ensino privada e possui pós-graduação de nível Especialização na área da Saúde Coletiva ou Saúde Pública. Os participantes em sua maioria avaliaram que a formação do Técnico em Saúde Bucal foi condizente com os objetivos propostos. Em relação à baixa inserção dos egressos no serviço público, acreditam que seja por falta de interesse da gestão municipal. Relataram que a atuação do egresso é maior em atividades coletivas do que em clínicas e que a inserção contribuiu na qualidade e produtividade dos serviços de saúde bucal. Percebe-se com esses estudos uma necessidade de reformulação da política de educação permanente no estado, visando à otimização dos recursos investidos na formação do Técnico em Saúde Bucal.(AU)

In order to meet the technical training demands of health service workers, the Technical Schools and Training Centers of the Unified Health System were created. The literature reveals that the number of Oral Health Technicians included in the public service is lower than that of training schools. The objective of this study was to evaluate the impact of the Oral Health Technician training conducted by the School of Public Health of the State of Minas Gerais, in the scope of graduates from 19 groups formed between 2012-2013. Two studies were carried out: the first one was transversal, ecological, and evaluated 122 municipalities participating. The objective was to investigate the possible factors associated with the insertion of the Oral Health Technician in the Unified Health System in Minas Gerais, and its implications on oral health indicators. The municipal variables selected were related to the organization of health services, oral health indicators and sociodemographic indicators, before and after the course. The dependent variable was the inclusion of egress in the public service, according to self-report for a research conducted in 2015/2016. A descriptive analysis was carried out, followed by bivariate and multivariate analyzes between the independent variables and the dependent variable, using the chi-square test by Pearson. The software SPSS® 18.0 was used. The variable "collective action indicator supervised dental brushing" showed association with the insertion, remaining in the final model. It was concluded that the implantation of the Oral Health Team modality II, positively influenced the insertion of the Oral Health Technician in the Unified Health System in Minas Gerais, with improvement in the municipal oral health indicators. The second study was transversal, descriptive, qualitative and quantitative, carried out with the teachers of the Course. The perception of the teachers in relation to the formation, insertion, actuation and contribution of the egress for the service was evaluated. A semistructured questionnaire sent by e-mail was used, which had four dimensions: sociodemographic profile, teacher training, Oral Health Technician training and egress and insertion in the Unified Health System. The response rate was 74% and 58% for the two groups evaluated. The profile found was of a majority of women, with a mean age of 40.2 years (SD ± 7.38) and 37.8 years (SD ± 8.26), who completed graduation in private educational institution and has postgraduate level of Specialization in the area of Collective Health or Public Health. The majority of participants evaluated that the training of the Oral Health Technician was in line with the proposed objectives. In relation to the low insertion of the graduates in the public service, they believe that it is due to lack of interest of the municipal management. They reported that the performance of the egress is greater in collective activities than in clinics and that the insertion contributed to the quality and productivity of oral health services. These studies show a need to reformulate the policy of permanent education in the state, aiming at optimizing the resources invested in the training of the Oral Health Technician.(AU)

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