The trajectory of the national policy for the reorientation of professional training in health in the Unified Health System (SUS)

• Published in: Ciência & saude coletiva 2013-06, Vol.18 (6), p.1613-1624
• Main Authors: Dias, Henrique Sant'anna, Lima, Luciana Dias de, Teixeira, Márcia
• Format: Article
• Language: Portuguese
• Subjects: Brazil; Delivery of Health Care - history; Delivery of Health Care - manpower; Health Personnel - education; Health Personnel - trends; Health Policy; History, 20th Century; History, 21st Century
• ISSN: 1678-4561
• DOI: 10.1590/S1413-81232013000600013

This paper examines the national policy and its antecedents for reorientation of professional health training implemented after 2003. It highlights landmarks and transformations in the course of policies between 1980 and 2010, elements of continuity and change and the connections between past and current policy initiatives. The study involved a review of the literature on the subject and document analysis supported by theoretical analysis of public policies, particularly historical institutionalism. The results point to four different moments during the trajectory of the policy, marked by changes in the initiatives of reorientation of higher education in health: antecedents; initial experiences; university protagonism; broadening and enhancement. As an element of continuity, there is the permanence of objects in the guiding principles advocated in the policies. The evidence of implementation expresses prospects of enhancement, with diversification of mobilized actors and organizations, and more projects implemented. The accumulated experience suggests structural maturity of the structural bases of action and the main changes relate to the enhancement of decision-making bodies of the SUS and the approximation to the process of decentralization and regionalization of national health policy.