Panorama dos recursos humanos em saúde bucal nos municípios de fronteira do Brasil: análise da série histórica de 2007 a 2016

Abstract

The Health Human Resources (HHR) are the basis of health system. The shortfall and poor geographical distribution of professionals are complex challenges. In the area of dentistry is not different. The remote regions are the most affected by this reality, including the Brazilian border areas. The objective of this study was to describe the human resources density in Oral Health in the 588 municipalities bordering Brazil. The categories evaluated were: dental surgeons, oral health technicians and auxiliaries and dental office assistants. Possible associations between the density of professionals and socioeconomic and demographic indicators, training indicators and distance from the municipality to the state capital were tested. The surveyed data comprised the period between 2007 and 2016, being characterized as a time series study. It is also an ecological, descriptive and analytical study, with a quantitative approach. Electronic data banks were used. The SPSS program 20.0 version was applied for statistical analysis and ANOVA 1-way e 2-way tests for repeated measures, followed by Bonferroni post-test, as well as the Pearson correlation test were applied. There was an increase in the density of dental surgeons in the border cities between the years 2007 and 2016. This increase was accompanied and may be justified by the greater offer of dentistry courses in the country. The highest densities of higher education professionals were found in Southern Arch. The density of oral health technicians and auxiliaries increased from 2007 to 2010, and after that period, it had a considerable decrease in all the Arches. The professionals of higher level had the greater representativeness among the categories analyzed in the study. The South Arch presented the greatest results for the training variables. The high/ very high human development index was associated with a greater number of dentists. The amount of oral health technicians and auxiliaries also had a direct correlation with the human development index. Positive (p < 0.001) and strong (r = 0.93) correlation were found between the amount of dental surgeons and the number of inhabitants of the municipality. The professionals at elementary level, dental office attendants, showed a significant correlation with the distance from the municipality to the capital, that is, the greater the distance, the greater the number of these professionals. Thus, it was concluded that there were quantitative advances in human resources in oral health in the municipalities of the border, for the period analyzed. However, the regional iniquities observed at the beginning of the study lasted until the last year of the study. It is suggested that there is a need to better manage the human resources in oral health in the border municipalities, with a focus on reducing regional inequalities, as well as on the need to train technical/auxiliary professionals, because it was found low density of these professionals in some regions. Based on the results, it is also important to realize that human resources policies in oral health, besides requiring direct strategic actions, should be accompanied by a policy to encourage regional development.