The Distribution of Medical Professionals in the Northern Paraná Macroregion: Inequality between Municipalities with Populations Varying in Size

ABSTRACT

Inappropriate distribution of medical professional in different areas of the country occurs in several ways: between the regions of the country; between capital and countryside; between urban and rural areas; between central and peripheral areas of metropolitan regions and between public and private assistance. Thus, even if you submit a medical/proper inhabitant ratio, the distribution of these professionals tends to concentrate in certain areas. In order to analyze the distribution of physicians in the 97 municipalities that compose the Northern Paraná Macroregion, held exploratory, descriptive study based on secondary data (Brazilian Institute of Geography and Statistics – IBGE and National Registration System of Health Establishments – SCNES), accessed in October and November 2014. The results indicate an unequal distribution of population and physicians among the 97 municipalities of the macro-region. The three largest municipalities cover 39.3% of the population and 56.1% of physicians while in the other 94 municipalities in which they reside 60.7% of the population, 43.9% of physicians work. However, when analyzing the distribution of professionals who are part of the more medical program, its distribution occurs in reverse, because half of these physicians work in small municipalities in which resides about a third of the population. These shows that the distribution of these professionals contributes to improving the health index in small municipalities. Addressing inequalities in the distribution of physicians in different regions of the country is complex, with no unique and isolated solutions, requiring interventions that coordinate federal, state and municipal management, financing strategies, training of health professionals and the regulation of health work process, policies that strengthen the vulnerabilities of smaller municipalities. Investing in reducing this inequality is fundamental to ensuring comprehensive care, especially in hard to reach locations, to ensure the right to health, especially in relation to the lack of professionals in the SUS.

Basic Health Services; Primary Healthcare; Human Resources; Physicians