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This manuscript reviewed the state of the art about the teaching and training of human resources for genetics and genomics in Brazil. We presented the national scenario of teaching genetics in medical undergraduate and other health courses. We discussed the training of medical geneticists through medical residency and addressed the training in genetics of physicians from specialties other than genetics. We examined the training of health professionals specializing in genetics through lato sensu and stricto sensu postgraduate programs and presented the proposals for multi-professional residency in genetic counseling and genetics and genomics that are currently the subject of discussion in the country. Finally, we highlighted the importance of training primary health care professionals concerning genetics and genomics for the effective establishment of a line of care for individuals with genetic disorders in the Brazilian Unified Health System. Therefore, we provided a thorough overview of how genetics is (or is not) incorporated into professional training in a comprehensive public healthcare system such as the Brazilian.

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On the sidelines of the 75th Session of the Regional Committee of the World Health Organization for the Americas, the Republic of Ecuador hosted an event to expand on National Surgical, Obstetric, and Anaesthesia Plans (NSOAPs). NSOAPs are policy frameworks that offer governments a pathway to incorporate surgical planning into their overall health strategies. In Latin America, Ecuador became the first country to lead the development of an NSOAP and is fostering regional efforts for other Latin American countries to have sustainable surgical strengthening plans. Brazil is a prominent candidate for enrolling in an NSOAP process to enhance its public health system's functionality. An NSOAP in Brazil can help mitigate social disparities, promote greater efficiency in allocating existing resources, and optimise public health system financing. This process can also encourage the creation of resources and distinct NSOAP vocabulary in Portuguese to facilitate the development of NSOAPs in other Portuguese-speaking and low- and middle-income countries. In this viewpoint, we explore why an NSOAP can benefit Brazil's surgical system, national features that enable surgical policymaking, and how multiple stakeholder engagement can contribute to the country's planning, validation, and implementation of an NSOAP.

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Objective: To determine the participation of female dentists in the evolution of dental specialties in Peru and establish the gender distribution in each specialty. Materials and Methods: A descriptive and retrospective cross-sectional study was conducted using data from the National Registry of Specialists of the Peruvian College of Dentists in August 2023. The relative frequency of female gender and the femininity index were calculated in the total population of specialists and in each specialty to assess their respective evolution over the last 25 years. Results: Currently, 51.74% of the 3,827 specialty registrations correspond to female dentists, with a femininity index of 1.072. Nine specialties with a female predominance were identified, including Pediatric Dentistry, Family and Community Health in Dentistry, and Restorative and Esthetic Dentistry. On the other hand, areas with a higher male presence are Orthodontics and Maxillary Orthopedics, and Oral and Maxillofacial Surgery. Upon analyzing the temporal evolution, a shift from the historical male majority to the current female predominance in the last fifteen years is observed, and gender parity was reached in 2019. Conclusion: There is evidence of a change in the gender composition of Peruvian dental specialties, currently with a female predominance.

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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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BACKGROUND: Health professionals in Colombian and many parts of the world, in some cases, work in precarious conditions and intend to migrate to other countries in search of better living conditions for themselves and their families, which results in inadequate distribution worldwide and in the quality of care throughout the health system, which can ultimately influence the quality of life of patients in their health-disease processes. PURPOSE: Describe in depth what quality of life at work is like for the health workforce in adult critical care (ACC). METHODS: This is an investigation of convergent parallel mixed methods approach that are integrated by means of a matrix in terms of convergence, divergence, and complementarity. Two methods are used: a transversal analytical method in which three instruments were applied to 209 participants to study the relationship between Quality of Life at Work, exposure to psychosocial risks, compassion fatigue and the intention to rotate; other than from the experiences narrated by 10 Human Talent in Health explore organizational practices in critical care. RESULTS: The dimension of quality of work life with the greatest dissatisfied was the management of free time (77%), the most compromised psychosocial risk was the pace of work (84%). They have high compassion satisfaction (67%) and there is an intention to migrate to another country (66%). The narrative results in discrimination/harassment as normalized practices and faceless spirituality. The integration of mixed methods shows convergence between the use of the instrument that measures quality of life at work and the narratives of the participants, complementarity with the other instruments, and divergence regarding the intention to rotate to another health institution. CONCLUSION: The positive trend that converges with the two approaches is that of safety at work and well-being achieved through work, embodied in the constant updating of technology and care protocols, experience time, balance between salary and work effort, staffing and supplies, and disconnection with work.

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Aim and background: Satisfaction with the quality of work life reflects the inadequate distribution of the workforce in critical care units and is not enough; on many occasions, they work in precarious conditions and with high levels of physical, emotional, spiritual, and social demands, impacting the quality of care. Aim: To identify predictors of the quality of work life of healthcare workers in adult critical care units (ACCU). Materials and methods: Quantitative study, cross-sectional analytical design with stratified two-stage sampling; three instruments were applied to 209 healthcare professionals in adult critical care units in different sites in a region of Colombia, concerning Quality of Life at Work-GOHISALO, Copenhagen Psychosocial Questionnaire-COPSOQ and Professional Quality of Life-ProQoL V. Multiple ordinal logistic regression was performed with exposure variables from the COPSOQ and ProQoL domains; the outcome variables were the dimensions of the Quality of Work Life instrument. Ethical standards for research involving human subjects were ensured. Results: According to the results of the multiple logistic models, quality of work life is predicted by job integration and predictability (OR = 6.93; 95% CI = 3.6-13.9), leisure time management and double presence (OR = 4.5; 95% CI = 1.22-8.79). Both job satisfaction and job security are related to leadership quality (OR=3.82; 95% CI = 2.27-6.55 and OR = 3.18; 95% CI = 1.22-8.79), respectively. Conclusions: The quality of work life of healthcare workers in adult intensive care units is predicted by quantitative demands, double presence, emotional demands, work pace, predictability, vertical trust, and quality of leadership. How to cite this article: Quinones-Rozo LP, Canaval-Erazo GE, Sandoval-Moreno LM. Predictors of Quality of Work Life in Health Care Workers at Adult Critical Care Units: A Cross-sectional Study. Indian J Crit Care Med 2024;28(4):355-363.

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BACKGROUND: This study explores the impacts of attacks perpetrated in the context of armed conflict, to female health workers in three Colombian territories. METHODS: We conducted a document review of the reports and databases of the Colombian Truth Commission, 17 in-depth semi-structured interviews with experts on the national and regional armed conflict and the medical mission, and 26 female health workers who were victims of attacks. RESULTS: Experts and female health workers reported attacks to health activities, facilities, equipment, and personnel, including attacks to traditional doctors belonging to indigenous communities. The most frequent attacks were threats and retention of health personnel; theft of supplies and medicines; damage and use of infrastructure and means of transport for purposes other than health care; and hinderance of health service provision. The attacks occurred in a framework of structural violence that intersects with poverty, racism, and gender bias. The impacts of these attacks include gender-based violence, significant disruption of the lives of health workers, and physical, emotional, psychological, social, and economic effects on the victims and their families. The government response to protect victims and populations has been absent or insufficient. CONCLUSIONS: Attacks to health care were reported in all the studied territories obstructing adequate health care. Impacts of these attacks affect negatively the professional and personal life of the workers and are aggravated by structural violence and absent or little institutional response.

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La prestación de servicios para la atención integral de la salud requiere la participación de diversos profesionales con competencias específicas para brindar la mejor atención posible a la población. La inclusión del nutricionista en los diferentes niveles del sistema de salud es crucial para garantizar una atención integral en las diversas etapas de la vida. Una distribución inequitativa de nutricionistas en los niveles de atención puede conducir a una fragmentación de la atención y la pérdida de oportunidades para abordar los problemas relacionados con la alimentación y nutrición. Por ello, se desarrolló un estudio con el objetivo de describir la distribución de nutricionistas en los establecimientos de salud según el nivel de atención, y evaluar el cumplimiento de las recomendaciones de recursos humanos establecidas por la norma técnica de las UPSS de Nutrición y Dietética. Se desarrolló un estudio descriptivo y transversal, mediante el análisis de fuentes secundarias. Se utilizaron los datos de recursos humanos por IPRESS de SUSALUD, del año 2022. Se consideró la Norma técnica de UPSS de Nutrición y Dietética para evaluar el cumplimiento de las recomendaciones de recursos humanos. Entre los principales resultados, se identificó que el 7.93% de los establecimientos de salud del primer nivel de atención tienen al menos un nutricionista. En el segundo nivel de atención, el 96.35% de los establecimientos de salud no cumplen con las recomendaciones de recursos humanos de la norma técnica, y ningún establecimiento del tercer nivel de atención cumplió esta recomendación. La distribución de nutricionistas en los diversos niveles de atención del sistema de salud peruano es desigual. Es necesario mejorar la planificación de recursos humanos en el sistema de salud peruano para garantizar una atención integral de la salud a la población.

The provision of services for comprehensive healthcare requires the involvement of various professionals with specific competencies to provide the best possible care to the population. The inclusion of nutritionists at different levels of the healthcare system is crucial to ensure comprehensive care at various stages of life. An unequal distribution of nutritionists across healthcare levels can lead to fragmented care and missed opportunities to address nutrition-related issues. Therefore, a study was conducted with the aim of describing the distribution of nutritionists in healthcare facilities according to the level of care and evaluating compliance with the human resources recommendations established by the technical standard of Nutrition and Dietetics UPSS. A descriptive and cross-sectional study was conducted using the analysis of secondary sources. Human resources data from SUSALUD for the year 2022 were used. The Technical Standard of UPSS of Nutrition and Dietetics was considered to assess compliance with human resources recommendations. Among the main findings, it was identified that 7.93% of first-level healthcare facilities have at least one nutritionist. In the second level of care, 96.35% of healthcare facilities do not comply with the human resources recommendations of the technical standard, and no third-level healthcare facility met this recommendation. The distribution of nutritionists across various levels of care in the Peruvian healthcare system is unequal. It is necessary to improve human resources planning in the Peruvian healthcare system to ensure comprehensive healthcare for the population..

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The migration of health workforces tends to be economically based benefiting high-income countries, while draining lower-income countries of workers and skills However, national instability or civil conflict may also have the effect of forcing out health workers. However, few articles focus on the experiences of these types of migrants. Peru has become the second largest Latin American destination for Venezuelan forced displaced migrants, a number of which are health workers. While the exact numbers of these workers is unknown, it is estimated that 4000 and 3000 doctors and about 2500 nurses and health technicians from Venezuela reside in Peru. These workers find entry into the heath system difficult due to bureaucratic and costly registration and qualification validation procedures. However, during Covid-19 these conditions were relaxed, and a large number of these heath workers entered the heath workforce. These workers were primarily doctors and worked in urban medical facilities, though there was some distribution across the country's departments. This avenue to the health workforce allowed the mobilisation of dormant health skills and lifted workforce density numbers. Nonetheless, it is too early to see if there have been sustainable improvements, and it remains uncertain how these policies have contributed to the country's UHC goals. Peru's experiences raise the issue of how to mobilise dormant displaced health worker migrants.

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ABSTRACT The 35th Brazilian Congress of Surgery marked a turning point for surgical education in the country. For the first time, the Brazilian College of Surgeons included Global Surgery on the main congressional agenda, providing a unique opportunity to rethink how surgical skills are taught from a public health perspective. This discussion prompts us to consider why and how Global Surgery education should be expanded in Brazil. Although Brazilian researchers and institutions have contributed to the fields expansion since 2015, Global Surgery education initiatives are still incipient in our country. Relying on successful strategies can be a starting point to promote the area among national surgical practitioners. In this editorial, we discuss potential strategies to expand Global Surgery education opportunities and propose a series of recommendations at the national level.

RESUMO O 35º Congresso Brasileiro de Cirurgia foi marcado por discussões inovadoras para a educação cirúrgica no país. Pela primeira vez, o Colégio Brasileiro de Cirurgiões incluiu a Cirurgia Global na pauta principal do congresso, proporcionando uma oportunidade única de repensar como as habilidades cirúrgicas são ensinadas a partir de uma perspectiva de saúde pública. Essa discussão nos leva a considerar por que e como o ensino da Cirurgia Global deve ser expandido no Brasil. Embora pesquisadores e instituições brasileiras tenham contribuído para a expansão do campo desde 2015, as iniciativas de educação em Cirurgia Global ainda são incipientes em nosso país. Basear-se em estratégias bem-sucedidas pode ser um ponto de partida para promover a área entre os profissionais de cirurgia nacionais. Neste editorial, discutimos potenciais estratégias para expandir as oportunidades de educação em Cirurgia Global e propomos uma série de recomendações a nível nacional.

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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 analyze the availability (in terms of stock and composition) and accessibility (in terms of geographical distribution) of the nursing workforce in Brazil. Method: this is a descriptive, cross-sectional study with retrospective data collection, identified by combining databases available on institutional websites and structured according to indicators from the World Health Organization's "National Health Workforce Accounts". The study considered nursing professionals at senior level (nurses) and middle level (nursing auxiliaries and technicians). Indicators of stock, composition, distribution (by age group and gender) and the ratio of nurses to doctors were included. Results: there was an increase in the number of personnel between 2005 and 2010, mainly in middle and technical level professionals. There are more personnel aged between 36 and 55, with a predominance of women in all categories, despite the increase in men. There was an uneven distribution of personnel across the country's regions, with the Southeast having the largest number of professionals. The ratio of nurses to doctors is less than one in the South and Southeast. Conclusion: despite the large number of nurses, their distribution is uneven. The growth of nursing technicians has significantly outstripped that of nurses, indicating more intensive technical training policies than those found in higher education.

Resumo Objetivo: analisar a disponibilidade (estoque e composição) e acessibilidade (distribuição geográfica) da força de trabalho de enfermagem no Brasil. Método: estudo descritivo e transversal, com coleta retrospectiva de dados, identificados por meio da combinação de bancos de dados disponíveis em sites institucionais e estruturados de acordo com indicadores das "Contas Nacionais da Força de Trabalho em Saúde" da Organização Mundial da Saúde. Consideraram-se, para o estudo, profissionais de enfermagem de nível superior (enfermeiros) e nível médio (auxiliares e técnicos de enfermagem). Indicadores de estoque, composição, distribuição (por faixa etária e sexo) e razão de enfermeiros para médicos foram incluídos. Resultados: houve aumento no número de profissionais, entre 2005 e 2010, principalmente nos profissionais de nível médio e técnico. Há mais profissionais entre 36 e 55 anos, com predominância do sexo feminino em todas as categorias, apesar do aumento do sexo masculino. Observou-se distribuição desigual de profissionais nas regiões do país, sendo a região Sudeste a com maior número de profissionais. A razão de enfermeiros por médico é inferior a um nas regiões Sul e Sudeste. Conclusão: apesar do elevado contingente de enfermeiros, sua distribuição é desigual. O crescimento de técnicos de enfermagem superou significativamente o de enfermeiros, indicando políticas de formação técnica mais intensivas que as encontradas no ensino superior.

Resumen Objetivo: analizar la disponibilidad (en términos de número y composición) y accesibilidad (en términos de distribución geográfica) de la fuerza de trabajo de enfermería en Brasil. Método: estudio descriptivo y transversal, con recolección retrospectiva de datos, identificados a través de una combinación de bases de datos disponibles en sitios web institucionales y estructurados en función de los indicadores de las "Cuentas Nacionales del Personal de Salud" de la Organización Mundial de la Salud. La población del estudio fueron profesionales de enfermería de nivel superior (enfermeros) y nivel medio (auxiliares y técnicos en enfermería). Se incluyeron indicadores de número, composición, distribución (por franja etaria y sexo) y razón entre enfermeros y médicos. Resultados: aumentó el número de personal entre 2005 y 2010, principalmente la de nivel medio y técnico. La mayoría del personal tiene entre 36 y 55 años y predomina el sexo femenino en todas las categorías, pese a que aumentó la cantidad de trabajadores do sexo masculino. Se observó que la distribución de personal en las diferentes regiones de Brasil era desigual y la región Sudeste es la que tiene la mayor cantidad de profesionales. La proporción de enfermeros por médico es inferior a uno en las regiones Sur y Sudeste. Conclusión: a pesar de que la cantidad de enfermeros es elevada, la distribución es desigual. El aumento de la cantidad de técnicos en enfermería superó significativamente al de enfermeros, lo que indica que las políticas de formación técnica son más intensivas que las observadas en la educación superior.

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RESUMO Introdução: Em julho de 2021, o Brasil tinha 373 cursos de Medicina autorizados pelo MEC, dos quais 229 de instituições privadas, com um valor médio de mensalidade de R$ 8.242,70. O grande volume de recursos envolvidos em mensalidades, bolsas e fomentos (Prouni, Fies etc.) justifica o esforço envolvido neste trabalho. Objetivo: A revisão visou identificar as metodologias de análise de custo de formação de médicos, classificando-as segundo categorias de nível de ensino e abrangência do custo. Método: A metodologia escolhida foi a revisão de escopo, dado que a produção na área de foco é irregular e com lacunas metodológicas. Resultado: As buscas em português e inglês resultaram na seleção de 24 textos, que foram agrupados em nove grupos, elaboradas a partir do foco de seus conteúdos combinados com os interesses da pesquisa. Conclusão: A inexistência de consenso metodológico e a busca por otimizar recursos e avaliar a eficácia do ensino reforçam a necessidade do desenvolvimento de metodologias de apuração de custos da graduação em Medicina.

ABSTRACT Introduction: Brazil had 373 medical courses authorized by the Ministry of Education in July 2021, with 229 being in private institutions and an average monthly tuition rate of R$8,242.70. The vast number of resources involved in tuition, scholarships, and grants (PROUNI, FIES, and so forth) justifies the effort required for this activity. Objective: The review sought to find approaches for analyzing the cost of training doctors, categorizing them according to the level of education and cost scope. Method: Given the irregularity and methodological inadequacies around interest, the chosen methodology was a scoping review. Result: The literature search in Portuguese and English yielded 24 articles, which were divided into nine categories depending on their content focus and the study interests. Conclusion: The lack of methodological agreement, as well as the pressure to optimize resources and evaluate educational efficacy, highlight the need for the development of methods to determine the costs of undergraduate medical education.

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This article presents the experience of the health policy dialogue on nursing held in Uruguay in 2021, based on the theory of change. Four working groups were held, with the participation of 725 people. The points discussed included: the shortage of registered nurses to implement programs and cover functions at all levels of health care; the poor visibility of the healthcare impact of the activities carried out; insufficient financial resources for undergraduate and postgraduate training; and poor integration of nurses in management teams and policy decision-making spaces in the country. Participants expressed the need to implement the national nursing development plan so that the country can: reduce the shortage of professionals; invest in job creation to meet the demand for professional care; improve staffing of services at all levels of care; improve working conditions; create new spaces for nurses by expanding their role through postgraduate training, while continuously improving the quality of training. Participants emphasized the need to increase intersectoral coordination in the areas of governance, regulation, and management, and to step up efforts to increase investment in health professionals in Uruguay.

Este artigo apresenta a experiência do diálogo político-sanitário sobre enfermagem realizado no Uruguai em 2021 com base na teoria da mudança. Foram organizados quatro grupos de trabalho, dos quais participaram 725 pessoas. Entre os pontos discutidos, destacam-se: a falta de profissionais graduados em enfermagem para desenvolver programas e cobrir funções em todos os níveis de atenção à saúde; a falta de visibilidade do impacto assistencial das atividades desenvolvidas; a insuficiência de recursos financeiros para programas de graduação e pós-graduação; e a pouca integração desses profissionais às equipes de gestão e aos espaços de tomada de decisão política no país. Os participantes indicaram a necessidade de implementar o plano nacional de desenvolvimento da enfermagem para que o país reduza o déficit de profissionais; invista na criação de cargos para atender à demanda por cuidados profissionais; melhore a dotação de pessoal nos serviços em todos os níveis de atenção; melhore as condições de trabalho; crie novas oportunidades de inserção para profissionais de enfermagem, ampliando suas funções por meio da pós-graduação; e aprimore continuamente a qualidade da formação. Os participantes enfatizaram a necessidade de aumentar a coordenação intersetorial nos aspectos de governança, regulação e gestão, bem como de acelerar os esforços no sentido de aumentar o investimento em profissionais de saúde no Uruguai.

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Objetivo: Determinar la relación entre los estilos de liderazgo y el desempeño laboral del personal médico del Hospital Vitarte Lima, en 2018. Métodos: Estudio descriptivo, correlacional y transversal. Se hizo un muestreo no probabilístico intencionado y se seleccionó a 64 trabajadores. La recolección de datos se hizo mediante un cuestionario previamente validado y un análisis de consistencia interna, por el alfa de Cronbach. Resultados: La estadística descriptiva determinó un 50% en el estilo de liderazgo democrático de las dimensiones y un nivel superior a 60% para el desempeño laboral. La estadística inferencial, mediante la prueba de hipótesis por el coeficiente de correlación de Spearman (rho = 0,85), evidenció una correlación positiva alta en ambas variables. Conclusión: Existe correlación positiva entre el estilo de liderazgo democrático de las dimensiones y el desempeño laboral, por lo que se recomienda la creación de proyectos de mejora de la calidad y capacitación en los trabajadores.

Objective: To determine the relationship between leadership styles and work performance of the medical staff of Hospital Vitarte Lima in 2018. Methods: Descriptive, correlational and cross-sectional study. A non-probabilistic purposive sampling was done and was selected 64 workers. The data collection was done through a previously validated questionnaire and internal consistency by Cronbach's alpha. Results: The descriptive statistics determined a 50% in the democratic leadership style of the dimensions and a level higher than 60% for job performance, the inferential statistics through the hypothesis test by Spearman's correlation coefficient (rho = 0.85) showed a high positive correlation in both variables. Conclusion: There is a positive correlation between the dimensions Democratic Leadership Style and work performance, so it is recommended the creation of quality improvement projects and training for workers.

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O objeto de estudo desta dissertação é a formação do sanitarista no nível de graduação. Delimita-se na história dos cursos de graduação em saúde coletiva e no desenho formativo realizado para a nova profissão. Objetiva-se analisar a formação na graduação em saúde coletiva dos cursos existentes no Brasil à luz dos projetos pedagógicos dos cursos. Trata-se de um estudo qualitativo e exploratório com abordagem documental, utilizando o método da análise de conteúdo. Depois da análise de 22 projetos, os resultados demonstraram uma abertura gradual dos cursos, com concentração entre 2008 e 2009, sendo o último aberto em 2019, e que estão organizados em maior número na região Norte, com 27,3%. A maioria dos cursos segue ou se adequou às Diretrizes Curriculares Nacionais do Curso de Graduação em Saúde Coletiva (DCNsCGSC), com predominância de carga horária igual ou superior a 3.200 horas, duração de oito a nove semestres e média de quatro anos, havendo turno noturno em 45,5% dos cursos. A oferta média é de 1.864 vagas/ano, 68% dos cursos são oferecidos por universidades federais, e 77,3% deles recebem a nomenclatura de bacharelado em saúde coletiva. Dos 18 cursos avaliados pelo Ministério da Educação (MEC), 67% são avaliados com conceito 5. A formação permite uma construção do conhecimento de forma gradativa a partir das bases da saúde coletiva. Os cursos articulam-se com os serviços e os sistemas de saúde do Sistema Único de Saúde (SUS) e com a comunidade através de aulas práticas, estágios, pesquisa e projetos de extensão, fortalecendo o contato prático dos alunos com situações reais de saúde da população. Conclui-se que, embora o país esteja vivenciando uma crise na educação superior, os cursos de graduação em saúde coletiva estão na contramão dessa realidade. Apesar de as DCNsCGSC não estarem em vigor devido à não publicação pelo MEC em Diário Oficial, os cursos estão em conformidade com elas. A formação segue as bases da saúde coletiva, de modo que cumpre o objetivo de fortalecimento do SUS para a formação de recursos humanos em saúde.

The object of study of this dissertation is the training of the public health professional at the undergraduate level. It is delimited in the history of undergraduate courses in public health and in the training design carried out for the new profession. The objective is to analyze the undergraduate training in public health of the existing courses in Brazil in the light of the pedagogical projects of the courses. This is a qualitative and exploratory study with a document approach, using the method of content analysis. After analyzing 22 projects, the results showed a gradual opening of courses, with a concentration between 2008 and 2009, with the last one being in 2019, and which were organized in greater numbers in the Northern region, with 27.3%. Most courses follow or fit the National Curriculum Guidelines of the Undergraduate Course in Public Health (DCNCGSC), with a predominance of hours equal to or greater than 3,200 hours, duration of eight to nine semesters, and an average of four years, with night classes in 45.5% of the courses. The average offer is 1,864 places/year, 68% of the courses are offered by federal universities, and 77.3% of them receive the name of bachelor in public health. Of the 18 courses evaluated by the Ministry of Education (MEC), 67% are evaluated with a grade of 5. Training allows a gradual construction of knowledge based on the foundations of public health. The courses are articulated with health services and systems of the Unified Health System (SUS) and with the community with practical classes, internships, research, and extension projects, strengthening students' practical contact with real health situations in the population. Therefore, although the country is experiencing a crisis in higher education, the undergraduate courses in public health are going against this reality. Although the DCNsCGSC are not in force due to the non-publication by the MEC in the Official Gazette, the courses are in accordance with them. The training follows the basis of collective health so that it fulfills the objective of strengthening the SUS for the training of human resources in health.

El objeto de estudio de esta tesis es la formación de profesionales de la salud pública en el grado. Se hace una delimitación de la trayectoria de los cursos de grado en salud colectiva y el diseño formativo realizado para la nueva profesión. La investigación pretende analizar la formación de grado en salud colectiva en Brasil a partir de los proyectos pedagógicos de los cursos. Se trata de un estudio cualitativo y exploratorio, de enfoque documental, y con el método de análisis de contenido. Del análisis de 22 proyectos, los resultados muestran que hubo una ampliación gradual de los cursos en el período entre 2008 y 2009, la última se llevó a cabo en 2019, y que entre las regiones brasileñas donde se concentran destaca más el Norte, con un 27,3%. La mayoría de los cursos siguen o se ajustan a las Directrices Curriculares Nacionales de la Carrera de Grado en Salud Colectiva (DCNsCGSC), tienen carga horaria igual o superior a 3.200 horas, con una duración de ocho a nueve semestres y un promedio de cuatro años, con jornada nocturna en el 45,5%. La oferta promedio es de 1.864 vacantes/año, el 68% de los cursos son en universidades federales y el 77,3% llevan el nombre Licenciatura en Salud Colectiva. De los 18 cursos evaluados por el Ministerio de Educación (MEC), el 67% recibieron calificación 5. La formación permite construir paulatinamente conocimientos a partir de las bases de la salud colectiva. Los cursos se articulan con los servicios y redes de salud del Sistema Único de Salud (SUS) brasileño y con la comunidad mediante clases prácticas, pasantías, proyectos de investigación y extensión, fortaleciendo el contacto de los alumnos con situaciones reales de salud de la población. Se concluye que, aunque el país viva una crisis en la educación superior, las carreras de grado en salud colectiva van en sentido contrario a esta realidad. Si bien las DCNsCGSC no se encuentran vigentes todavía, porque hace falta que el MEC las publique en el Diario Oficial, los cursos están de acuerdo con ellas. La formación sigue las bases de la salud colectiva, de modo que cumpla el objetivo de fortalecer el SUS para la formación de recursos humanos en salud.

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BACKGROUND: This paper responds to Asante et al. (in Hum Resour Health, 2014), providing an updated picture of the impacts of Cuban medical training in the Pacific region based on research carried out in 2019-2021, which focused on the experiences of Pacific Island doctors trained in Cuba and their integration into practice in their home countries. METHODS: The research focussed on two case studies-Solomon Islands and Kiribati. Study methods for this research included multi-sited ethnographic methods and semi-structured interviews as well as qualitative analysis of policy documents, reports, and media sources. RESULTS: The Cuban health assistance programme has had a significant impact on the medical workforce in the Pacific region increasing the number of doctors employed by Pacific Ministries of Health between 2012 and 2019. Qualitatively, there have been some notable improvements in the medical workforce and health delivery over this period. However, the integration of the Cuban-trained doctors into practise has been challenging, with criticisms of their clinical, procedural and communication skills, and the need for the rapid development of bridging and internship training programmes (ITPs) which were inadequately planned for at the outset of the programme. CONCLUSIONS: The Cuban programme in the Pacific is an important model of development assistance for health in the region. While Cuba's offer of scholarships was the trigger for a range of positive outcomes, the success of the programme has relied on input from a range of actors including support from other governments and institutions, and much hard work by the graduates themselves, often in the face of considerable criticism. Key impacts of the programme to date include the raw increase in the number of doctors and the development of the ITPs and career pathways for the graduates, although this has also led to the reorientation of Cuban graduates from preventative to curative health. There is considerable potential for these graduates to contribute to improved health outcomes across the region, particularly if their primary and preventative health care skills are utilised.

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BACKGROUND: This article contributes to the health workforce planning literature by exploring the dynamics of health professions in New Zealand's Primary Care sector and deriving broad lessons for an international audience. Professions tend influence health policy and governance decisions and practices to retain their place, status and influence. Therefore, understanding their power dynamics and the positions that they have on workforce policies and issues assists workforce governance or health system reform plans. METHODS: Using the infrequently reported health workforce policy tool, actor analysis, a reanalysis of previously collected data is undertaken using an actor-based framework for the study of professionalism. Two models were developed, (1) the framework's original four-actor model and (2) a five-actor model for the comparison of the Medical and Nurse professions. Existing workforce actor data were reclassified, formatted, and entered into actor analysis software to reveal the professions' relative power, inter-relationships and strategic workforce issue positions. RESULTS: In the four-actor model, the Organised user actor is found to be most influential, while the others are found to be dependent. In the five-actor model, the Medical and Nurse professions are individually more influential than their combined position in the four-actor model. Practicing professionals and Organised user actors have strong converging inter-relationships over workforce issues in both models, though in the five-actor model, the Nurse profession has weaker coherency than the Medical profession. The Medical and Nurse professions are found to be in opposition over the workforce issues labelled divisive. CONCLUSIONS: These results reflect the professions' potential to influence New Zealand's Primary Care sector, indicating their power and influence over a range of policy and reform measures. As such, the four lessons that are derived from the case indicate to policy makers that they should be aware of situational contexts and actor power, take care when encountering divisive issues and try to achieve broad-based support for proposed policies.

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Resumo No contexto do trabalho hospitalar durante a COVID-19, é preciso reconhecer que as atividades de apoio exercidas por maqueiros, agentes de limpeza e auxiliares administrativos são imprescindíveis para o processo de trabalho. Este artigo analisou resultados de uma etapa exploratória de uma pesquisa ampla com esses trabalhadores dentro de uma unidade hospitalar referência para COVID-19 no estado da Bahia. Foram selecionadas três entrevistas semiestruturadas produzidas a partir da perspectiva do "fazer falar" sobre o trabalho, utilizando pressupostos da etnometodologia e da ergonomia. A análise incidiu sobre as atividades de trabalho de um maqueiro, um agente de limpeza e uma auxiliar administrativa, problematizadas a partir da díade essencialidade-invisibilidade. O estudo demonstrou que esses trabalhadores são invisibilizados pela desvalorização social de suas atividades e nível de escolaridade e resistem apesar das circunstâncias e do sobretrabalho; e evidenciou a essencialidade desses serviços pela interdependência entre o trabalho de apoio e o trabalho assistencial e suas contribuições para a segurança do paciente e da equipe. Conclui-se que é necessário criar estratégias para que esses trabalhadores sejam valorizados social, financeira e institucionalmente.

Abstract In the context of hospital work during the COVID-19 pandemic, it should be acknowledged that the nonclinical support activities carried out by stretcher bearers, cleaning agents and administrative assistants were essential for the work process. This article analyzed the results of an exploratory stage of broader research with these workers in a COVID-19 hospital reference unit in the state of Bahia. Three semi-structured interviews were selected, using assumptions of ethnomethodology and ergonomics, to encourage these workers to talk about their work, The analysis concentrated on the work activities of stretcher-bearers, cleaning agents and administrative assistants from a visibility perspective. The study showed that these workers were rendered invisible by the scant social respect for their activities and level of schooling that prevailed despite the circumstances and excess workload; and revealed the essential nature of these services due to the interdependence between support work and care work and their contributions to patient and team safety. The conclusion drawn is that it is necessary to establish strategies such that these workers are valued socially, financially, and institutionally.