Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

There are few researches that address the economic and sanitary importance of the organizational model of a level of care or of the presence of certain professionals. The aim of this descriptive and transversal study is to explore and analyze the possible associations between the specialty of family medicine and economic and sanitary indicators in 16 countries of Ibero-America. The data processing was carried out through the program R, a programming language that shows “a set of functions that maintain some type of relation between them”. It seems that there is a positive association between the number of specialists in family medicine with GDP, investment in health and life expectancy and in negative with the GINI index, anemia, mortality in children under 5 years, maternal mortality ratio and in traffic accidents. The GDP per capita is negatively related to anemia, mortality in children under 5 years of age, maternal and accident mortality ratio, and less intensely with cardiovascular mortality and suicide. There are no correlations between pocket expenses or investment in healthcare. Despite the different health and social realities of the countries studied, a favorable relation is found between the availability of specialists in Family Medicine and better health results, which suggests that it can be an efficient strategy for health services. More studies are necessary to analyze the statistical scope of this association.

The VII Ibero-American Summit of Family Medicine was held in Cali, Colombia, on the 13th and 14th ofMarch 2018, with the theme FORTY YEARS OF ALMA-ATA: FAMILY MEDICINE AND FAMILY HEALTH,A PATH FOR PEACE.

The Ministers participating in the VII Ibero-American Summit of Family Medicine, held in Cali, Colombia, withthe aim of reflecting on the role of Family Medicine in Health Systems based on Primary Care, and specifically on the care of complex situations of people, families and communities as the centre of these Systems:

Objective: To present the steps taken to build a competency curriculum in family medicine residency program of the within the Medical School of the University of São Paulo; to describe fundamental characteristics and guidelines of the competency curriculum related to its three central attributes: learning tools, teaching methodologies and evaluation processes; and finally, to describe comparisons of the use of evaluation instruments by our residency program and other experiences in the literature. Methods: Review and analysis of the main international experiences in training of family physicians; conducting a series of workshops and creation of working groups with specific areas, themes and responsibilities for study, presentation and collective definition. Results: Elaboration of a competency curriculum based on a five-dimensional competence model. Conclusion: Establishing a competency-based curriculum is vital to in the organization of the residency program. The use of international and national references and the contribution of the people involved in the residence program favor the organization of competences while respecting the singularities of the residency program. Challenges are encountered in implementing the curriculum in the practice of the day.

Introduction: One of the central axes provided by the Mais Médicos (More Doctors) Program to Brazil foresee the restructuring of Family and Community Medicine residencies in the country, so they could fit the new legislation, being a prerequisite for other medical residencies in the nation. For this change, existing programs need to tailor their programs so that they are in line with what is expected of a Family and Community Physician. Objective: To analyze the experience of the Federal University of Uberlândia and the methodology used in the curriculum reform of the Residency Program in Family and Community Medicine. Methods: Case Study with documental analysis about the product, minutes and other documents built during the three workshops of curriculum reform implemented, beyond the regulatory milestones. Results: The methodology used in these workshops embodied the Arch of Maguerez as a problematizing strategy that dialogues with the Progressive Pedagogy of Paulo Freire. In order to participate in the workshops, residents, managers, preceptors and teachers were invited. We worked with the strategic planning matrix Analysis SOWT (Strength, Opportunity, Weakness and Threat) to carry out the situational diagnosis of the program; the stages to be developed, as well as the pedagogical principles used and the evaluation tools were also mentioned. Conclusion: There was a significant change in the residency program, mainly involving preceptors and residents engaged in the implementation of this new proposal. The challenges encountered were partially overcome, but there are still issues related mainly to the teaching-service dynamics that needs to be better structured for the implementation of the new program.

Introduction: The Child Mortality Coefficient, an indicator of the social and health conditions of the population, has the capacity to guide the proposal of public policies, installation and forecasting of human resources in health. Territories with high infant mortality tend to be more vulnerable and require more structured primary care. Objective: To map infant mortality and describe the geographic distribution of primary care services and human resources (concentration and care “gaps”) in Porto Alegre, in the years 2010 and 2014. Methods: Descriptive study, ecological design, employing secondary data available in health information systems. Data processing was performed by the Enyalius framework. Results: Of the 143 services, 65% have family health, with coverage of 36.5% of the population. The number of users adjoined per service ranges from 700 to 115,673 inhabitants; 35% of the services have less than 4,000 adjoined inhabitants. The distribution of doctors and nurses ranged from 0.14 to 5.71 per 4,000 inhabitants. Services with a high population density have a traditional operating model and a professional deficit. The regions of the Islands and of the Extreme South, places with high infant mortality, present, in a larger territorial area, an adequate number of doctors and nurses. There was a high heterogeneity in the distribution of infant mortality (zero to 52.63 per 1,000 live births) in 2014. Conclusion: One-third of the Porto Alegre population is assisted by family health. Locations with high infant mortality presented a number of doctors and nurses close to that recommended. This study generates hypotheses for future epidemiological investigations in the primary care area.

Introduction: The consultation is central in the work of the family doctor. The assessment of the resident’s performance and discussions about right guidance should be encouraged. Objective: To discuss the use of Miniex to evaluate the resident’s sequenced performance during consultations. Methods: Explanation about the theoretical discussions about the development of medical consultation followed by application of Miniex with evaluation focused on the expected competencies of the family and community doctor. Discussion: Manuals of residential programs and related associations have sometimes cited the Miniex as a possibility of evaluation of the resident but do not guide their systematic use, which could leave little efficient and detached its application. In addition, little discussion exists on the interpretation of the components of the method and the expected model of ideal consultation in the different specialties. Conclusion: Miniex is a powerful tool for change but its use should point to a professional model and be stimulated throughout the residency program.

Home Care (HC) is an expertise area for several specialists, such as Family Physicians, Geriatricians, Pediatricians and Internal Medicine. Due to its specificities and within its practice field, it demands competences that are not contemplated apart in any medical specialty, and the time and structure required to acquire them surpasses the insertion capacity in the current programs. This care type expansion represents a growing demand for training, requiring HC inclusion as a potential field of work for these specialists, conceiving the need for an additional year for the formation of specific features as an activity area. We discuss training strategies, practice fields and programmatic structure required to consolidate this proposal. We expect that this article can subsidize the natural construction of this specialty within the scope of health medical practice.

Objective: To evaluate the effectiveness of the tobacco control program in a city in southern Brazil. Methods: A retrospective cohort study was carried out, which analyzed the results of the Health Units that participated in the Smoking Control Program in the city of Tubarão (SC), from 2014 to 2016. Results: Data from 106 participants were analyzed, mostly women with mean age of 51.0±10.9 years. The effectiveness of the program was 51.9%, with a mean time for smoking cessation of approximately three weeks. Female Individuals who participate in less than four meetings present greater difficulty in quitting smoking. Conclusion: The program has good efficacy, compatible with other similar programs in Brazil and exterior. Nicotine dependence and use of bupropion were not determinant factors in the outcome and the period when the program was most effective in tobacco cessation were the first three weeks.

Objective: To describe the actions developed by the physician during his actuation in the rural area from Lagoa de Pedras/RN from September 2013 to October 2015. Methods: Field diaries were used, the analysis by categories of experience and the Popular Health Education. Results: The following actions were developed - refresher courses for health professionals, Social Control fortification, therapeutic groups in mental health and men’s health and a specific activity with systemic arterial hypertension and diabetes mellitus. Conclusion: Through the articulation between the Municipal Health Office, the health workers and the population, a new routine of experiencing the health-disease-care process is set up for all who make up the local health.