Oral health technicians in Brazilian primary health care: potentials and constraints (original) (raw)
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Exploring professionalization among Brazilian oral health technicians
Human Resources for Health, 2012
Professional dental auxiliaries emerged in the early 20th century in the United States of America and quickly spread to Europe and other regions of the world. In Brazil, however, oral health technicians (OHTs), who occupy a similar role as dental hygienists, had a long journey before the occupation achieved legal recognition: Brazilian Law 11.889, which regulates this occupation in the country, was only enacted in 2008. The aim of this paper is to review the literature on the professionalization of OHTs, highlighting the triggering, limiting and conflicting aspects that exerted an influence on the historical progress of these professionals in Brazil. We have tested Abbott's and Larson's theory on professionalization, against the history of OHTs. A number of different dental corporative interests exerted an influence over professionalization, especially in discussions regarding the permissible activities of these professionals in the oral cavity of patients. With primary health care advances in Brazil, the importance of these professionals has once again come to the forefront. This seems to be a key point in the consolidation of OHTs in the area of human resources for health in Brazil.
Acta Scientiarum Health Science
The aim was to identify the perception of Oral Health Planning (OHP) of basic care (BC) dental surgeons (DSs) in João Pessoa, Paraíba State, Brazil. Seventeen BC DSs from João Pessoa were interviewed. A qualitative analysis was performed using the Discourse of the Collective Subject (DCS) methodology. DCS obtained: Impact - “My work is effective when the user’s need remains at the BC”. Social Control - “The population participates in the organization of promotional activities, but I think it doesn’t have enough maturity to opine on OHP”. OHP Basis and Organization - “The OHP has a diverse organization and is based on user needs”. It can be concluded that the knowledge of the DSs on OHP is varied. There is limited understanding about problem-solving. Social control is considered incipient and weak. It is understood that the organization of the local OHP assumes a diverse character and should be based on user demands.
Perceptions of primary health care service users regarding dental team practices in Brazil
Primary health care research & development, 2017
The Unified Health System (SUS) is the Brazilian set of public health services that offers global access to health care and disease treatments for all citizens. These services have been evaluated by means of a national survey assessing the users' perceptions. Aim To explore and characterize the SUS users' perceptions regarding primary dental team practices in the five Brazilian geographical regions. Descriptive study. The sample consisted of 37 262 subjects. Data were collected by means of the Ministry of Health survey, conducted between 2012 and 2014. Variables used in the present study are associated with SUS users' perspectives of satisfaction, access, and use of services. The study utilized bivariate data analysis, and dichotomous variables were derived for analysis following 95% reliability. Findings This study observed similarities and proportionality of perceptions in the Brazilian territory. In most macro-regions, dental teams did not develop an active search for...
Brazilian Oral Research, 2015
Comprehensiveness relates both to the scope of services offered and to a holistic clinical approach. The aim of this study was to identify the perception of Brazilian dentists regarding key concepts of comprehensiveness and its importance in primary health care oral health services performed in the public sector. Focus groups were conducted to explore three main concepts, 'patient welcoming', 'bonding' and 'quality of care', as well as their aspects. In total, there were four focus groups comprising seven general dentists, all of whom had at least two years of experience in primary care, from municipalities of varying sizes. Discussions of approximately 60 minutes were conducted, audio-recorded and transcribed. The data were analysed by qualitative thematic analysis, in line with the framework approach. The general dentists reported that they are aware that in the Brazilian Health System, the onset of patient care by primary health care services must happen through 'patient welcoming.' Nevertheless, they suggested that this action is often performed poorly due to the large volume of patients. Although they knew the importance of 'bonding', they realised that there is a lack of education preparing professionals to address interpersonal and social issues. They were aware that 'quality of care' is related to multiple factors. Comprehensiveness, as an approach in dental public health practices, needs to be enhanced, and there is evidence that primary care dentists are aware of the need for such an approach.
2014
Introduction: With the reorganization of oral health policy in 2004, the community health agent is regarded as a facilitator of oral health practices in her area. Objective: To identify knowledge and practice of community health agents in oral health care. Material and method: This is a qualitative study, based on the theory of social representations, and the data were collected through semi-structured interviews, using the collective subject discourse as the technique of tabulation and analysis of data. The sample consisted of 11 interviews, delimited by saturation. Data collection was conducted during the period April-June 2010, in Dourados, Mato Grosso do Sul. Result: The results indicate that respondents understand what oral health is, realize the impact of oral health on overall health, guide the community regarding oral health carein their work practices, operate and provide care in the basic health unit, but have not been trained to act as instructors. Conclusion: The communi...
Describing the Primary Care Actions of Oral Health Teams in Brazil
International Journal of Environmental Research and Public Health, 2015
Objective: To describe the primary care actions performed by oral health teams (OHTs) that participated in a large national survey led by the Ministry of Health in 2012. Methods: A total of 12,403 dentists from OHTs completed a set of survey questions (response rate = 85.01%) on the organization of care, basic dental procedures and oral health surveillance actions of OHTs. Descriptive and hierarchical cluster analyses were developed. Results: The majority of OHTs (85.2%) reported that they performed "patient welcoming". The delivery of services was based on a patient's identified disease risk (83.1%), and continuity of care was ensured by 85.9% of OHTs. Individual preventive, restorative and surgical procedures were performed by the majority of the teams; however, screening for oral cancer and construction of dental prostheses/dentures occurred less frequently. Cluster 1 was composed of OHTs with the lowest proportion of oral healthcare actions related to oral cancer and dental prostheses/dentures, and the Southeastern and Southern regions had higher proportions of OHTs from cluster 2. Conclusions: OHTs adhere to some OPEN ACCESS Int. J. Environ. Res. Public Health 2015, 12 668 of the principles of primary care organizations; however, the teams perform fewer actions related to oral cancer treatment and rehabilitation with complete dentures. The geographical distribution of the clusters was unequal in Brazil.
Disciplinarum Scientia, 2022
Aiming to evaluate the profile of dentists working in the public health network of Santa Maria/RS, Brazil, and analyze their perception about service conditions and the new financing program for primary care, a study was conducted with 27 dentists working in the municipal public health network. This work is a qualitative quantitative cross-sectional study with participation of the professionals to verify socioeconomic variables, work process and their perception about the change in financing of primary care. This information was analyzed descriptively. The research results found more experienced professionals, with graduate degrees and a longer time working in public health. Many of them have complementary activities and consider their remuneration to be regular. In the professional practice they consider important to have technical, relational, and personal skills, and report facing challenges mainly related to management (lack of materials and delay in repairs), users (high demand) and the practice of the profession (lack of appreciation). Not everyone was aware of the new funding for Primary Care-Previne Brasil Program-, so there was no consensus about the benefits and harms of its implementation. Considering the lack of research in this area, this study did not aim to exhaust the theme, but to stimulate new research. Knowing the profile of professionals and their perception of the work process is important for the development of public health policies. Thus, it is expected that the data collected, and the results presented when they reach the government, contribute to the qualification of services through the training of professionals and to assist in the planning and implementation of policies that enhance the dentist's role in public service.
RGO - Revista Gaúcha de Odontologia
Objective: The aim of this study was to evaluate both the managers’ and dental surgeons’ perception about the organization of oral health actions in primary care, regarding the work process, planning and social control, in a health micro region. Methods: Qualitative study case with the performance of interviews with oral health managers and focal group with dental surgeons. The content analysis proposed by Bardin was used. Results: The management of the planning and work process is characterized by isolated actions, low institutional support and verticalized authoritarian processes. In the scope of primary care, there is no integrality nor intersectoriality. The managers and dental surgeons have little access to the fundamental indicators and parameters to the initial diagnosis of the planning. Conclusion: The National Program of Improvement to the Access and Quality in Primary Care allowed a possible breakthrough in the current model, with the implementation of new ways of work org...
Theorization about the limits to the inclusion of oral health teams in the Family Health Strategy
Ciência & Saúde Coletiva
This study aimed to theorize, by means of social actors’ conception, about the reasons for the non-inclusion of oral health in the Family Health Strategy (FHS) in the city of Juiz de Fora, Minas Gerais, Brazil. This is a qualitative, exploratory, descriptive, and analytical study based on the grounded theory methodology and the National Oral Health Policy. Eleven interviews were performed with public managers, delegates who participate in the municipal health council, and dental surgeons who belong to the public health service. The theorization of the study was created through the data analysis process, which resulted in “a consequence of the dominant disease-centered oral health care model” as the main category. Data were categorized according to a methodological framework. The health concept set forth by local social actors contributed to the non-inclusion of oral healthcare teams (OHTs) in the FHS. This theorization identified the origins of the studied phenomenon and can aid in ...
Human Resources for Health, 2013
Background: To describe some sociodemographic and educational characteristics of oral health technicians (OHTs) in public primary health care teams in the state of Minas Gerais, Brazil. Methods: A cross-sectional descriptive study was performed based on the telephone survey of a representative sample comprising 231 individuals. A pre-tested instrument was used for the data collection, including questions on gender, age in years, years of work as an OHT, years since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. The descriptive statistic was developed and the formation of clusters, by the agglomerative hierarchy technique based on the furthest neighbour, was based on the age, years of work as an OHT, time since graduation as an OHT, formal schooling, individual income in a month, and participation in continuing educational programmes. Results: Most interviewees (97.1%) were female. A monthly income of USD 300.00 to 600.00 was reported by 77.5% of the sample. Having educational qualifications in excess of their role was reported by approximately 20% of the participants. The median time since graduation was six years, and half of the sample had worked for four years as an OHT. Most interviewees (67.6%) reported having participated in professional continuing educational programmes. Two different clusters were identified based on the sociodemographic and educational characteristics of the sample. Conclusions: The Brazilian OHTs in public primary health care teams in the state of Minas Gerais are mostly female who have had little time since graduation, working experience, and formal schooling sufficient for professional practice.