Situação e capacidades institucionais em gestão do trabalho e emprego no setor saúde: uma análise comparada (Angola, Cabo Verde e Moçambique)

Abstract

Health professionals play a central and critical role in improving access and quality of health care for the population and are fundamental to policies aimed at reducing inequalities in health. The operation, performance and the health systems development are dependent on these professionals, their efforts and skills mix in the execution of daily tasks. However, issues related to labor management in this sector have been identified as obstacles to achieving most of the health and development goals. These situations are challenges for health institutions and for its protagonists, since they depend on preparation and political will to find the coping strategies of the problems that arise in daily work. It is in this context that governments are called upon to identify health problems to plan the workforce, retention, recruitment and training in order to achieve the Millennium Development Goals (MDG) for health. Management, shortage and migration issues may be seen worldwide. In African Countries of Portuguese Language (PALOP) such issues are acute especially in rural and remote areas. This study aimed to focus on the current state of working conditions and employment of health professionals from Angola, Cape Verde and Mozambique. The objectives of the study were: 1) to study the current situation of the conditions of work and employment in the health sector in Angola, Cape Verde and Mozambique, according to the indicators developed for the study; 2) to identify actions and policies developed in Brazil as part of working conditions and employment in health; 3) to compare the situations of health working conditions in those three countries under study, considering the Brazilian case. A documentary study, using databases of international institutions, electronic journals and official websites of the government and the ministry of health of each country was conducted. The search strategy focused on data from primary sources and original documents. Reports were consulted, as well as regulations, presentations, projects, articles, news and other media when accessible with clear information. The comparison of results between selected countries enabled the identification of capacities and institutional boundaries after describing the differences, similarities and relationships within the working conditions in health sector. Once restricted the national situations, it was possible to establish analogies and identify variations on the same structure based on the reference situation, Brazil. The study results suggest that Angola, Cape Verde and Mozambique share, to varying degrees, similar problems. There is a lack of information and little or no updating of data, which are of poor quality and have no standards. Among the issues were observed: insufficient and inadequate distribution of the workforce; deficiencies in the field of occupational surveillance; weak control and regulation of the private sector by the public sector. It is possible that the weaknesses identified in the working conditions of management and employment in health is interfering with the operation of services in areas known to be affected by health inequities. The Brazilian experience may be a reference to the debate and inter-actions in the future.