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Community Health Workers training in Brazil

Community Health Workers training in Brazil. Francisco Eduardo Campos Secretary of Management of Work and Education in Health Ministry of Health - Brazil. Some important information about the National Health System (SUS):. Universal, equitable and holistic system included in the Constitution

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Community Health Workers training in Brazil

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  1. Community Health Workers training in Brazil Francisco Eduardo Campos Secretary of Management of Work and Education in Health Ministry of Health - Brazil

  2. Some important information about the National Health System (SUS): • Universal, equitable and holistic system included in the Constitution • Decentralized and socially controlled system • Provides comprehensive and free medical care to the entire population • Outcomes in PHC (e.g. 70 million measles vaccinations); Universal ARV; Leading public-funded transplantations and so on.

  3. Life expectancy: Improving, but differences persist JCN 10/2007

  4. Fact: Misdistribution of Health Professionals and services

  5. Technical Education Experience: From Scaling-Up and Education of Auxiliary Nurses Program to PROFAPS • 1970´s to 1990´s: Scaling Up Program tested methodologies funded by regular MOH budget. • 1990´s: PROFAE (Program of Auxiliary Nurses Education): US$400 million split between Brazilian Government and IDB • 2005: PROFAPS extends the proposal to other professional technical level categories such as pharmacists, laboratory, dental hygiene, home-care, epidemiological, sanitary and environmental surveillance, and Community Health Workers • Target 2010: To train 750 thousand professionals.

  6. Strategy to tackle the problem: Establishment of a Network of Technical Schools based on a new paradigm and validated within the National Education System. • Combines Education and Work: • In-service training, • Developed in service´s ordinary environment • Comprising regular and specialized teaching institutions

  7. Guiding Principles of the Network of Technical Schools - RETSUS • Main issues: • Integration teaching-services • Based on the National Health System’s guidelines • In-service education • Competency based Curricula • Pedagogical approach – Problembasedlearning • No differentiation: the student is an ordinary health worker and the teacher is a qualified health worker bearing pedagogicalverifiedcapability. • Teachers are trained via DistanceLearning (540 hours) • Administrativeprocesscentralized, curricular executiondecentralized

  8. Number of Students who benefited by the PROFAE until December 2008 3.108 871 13.796 9.804 4.164 22.961 15.095 18.372 12.111 8.722 20.527 7.716 4.364 7.436 7.207 31.973 4.464 37.950 9.349 6.952 6.644 15.494 7.839 20.207 36.125 321,189 students 359.238 Students Total : 13.126 12.861

  9. 90´s: Family’s Health Program - FHP • Backbone of the reorganization of NHS • Working in 84% of municipalities • 30 thousand teams (1 physician, 1 dentist, 1 nurse, 1-2 aux nurse, 6 community health workers) • Each team is responsible for 1 thousand families • Current coverage: 60% of the Brazilian population 94 million people covered!

  10. Family Health Strategy

  11. Family health teams coverage

  12. Community Health Workers • There are 250 thousand, all institutionalized (no volunteer work) • Recruited locally in the area where they work (wide range of scholar background): Liaison between NHS and the population due to cultural ties. • Health promotion: visiting households, oversee sanitation and nutritional behaviors, check vaccines card, growth of children, incentive pregnant woman to take prenatal visits, etc. • They do not prescribe medicines or perform other profession duties

  13. Community Health Workers Training • 3 tiers system: • Introductory (400 hours) – already implemented • Intermediary (800 hours) • Technical Community Health Worker(1200 hours) • Curricula based on Competencies Comprises: Health Promotion, Environment, Local culture, Vaccines follow-up, Risk Factors, • System of Certification of Competencies tied to Curricula – Skills, Attitudes and Behavioral.

  14. CHW Basic Professional Education Number of CHW funded by the Ministry of Health – per state, 2008 618 1.370 0 2.394 3.269 14.106 CHW – Community Health Workers • Pre-requisite (400 hours) – intersectorial nature of the social assistance, education and environment – activity strongly related to the health promotion and disease prevention 6.915 13.942 5.192 10.057 12.975 4.611 1.283 3.615 2.410 21.338 4.138 23.724 5.027 5.041 806 11.075 3.345 12.128 16.753 9.888 0 192.680 studants Total :

  15. OBRIGADO! THANK YOU! francisco.campos@saude.gov.br

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