A contribuição do Proadi-SUS para o cumprimento dos objetivos do Plano Nacional de Saúde (2020-2023): ênfase na formação e qualificação de profissionais de saúde [dissertação]. Brasília – DF

Abstract

Introduction: The training and qualification of health professionals are fundamental strategies for strengthening the Brazilian Unified Health System (SUS), especially in a context marked by regional inequalities, technological advances, and emerging epidemiological challenges. In Brazil, weaknesses persist in the distribution, training, and qualification of the health workforce, particularly in primary health care and historically underserved regions. In this context, the Institutional Development Support Program for the SUS (Proadi-SUS), which is the object of analysis in this study, emerges as a relevant initiative. Proadi-SUS seeks to strengthen actions within the Unified Health System through a strategic partnership between the Ministry of Health and philanthropic hospitals recognized for their excellence nationwide. These hospital institutions benefit from tax immunity and, in return, develop projects whose objectives are aligned with federal SUS priorities. Objective: To analyze the contribution of the Institutional Development Support Program for the SUS (Proadi-SUS), during its 5th three-year cycle (2021–2023), to the achievement of the strategic objectives of the 2020–2023 National Health Plan, with emphasis on the training and qualification of health professionals. Methods: This is a descriptive, exploratory, and analytical study with a mixed-methods approach, based on documentary analysis of projects implemented under Proadi-SUS during the 5th three-year cycle (2021–2023), using data from the Proadi-SUS Results Panel made publicly available by the Brazilian Ministry of Health. Qualitative and quantitative analyses were conducted regarding project areas of activity, territorial scope, number of trained professionals, educational modalities, financial resources allocated, and alignment with the strategic objectives of the 2020–2023 National Health Plan.Results: A total of 169 projects classified within the Human Resources Training area were identified, linked to multiple strategic objectives of the National Health Plan. The Human Resources Training area accounted for 37 projects, corresponding to 22% of the total. Data were analyzed qualitatively and quantitatively regarding themes, territorial scope, and alignment with national planning objectives. The results showed that most projects, regardless of area of activity, were associated with fostering scientific knowledge production (106 projects) and improving SUS management (74 projects) in relation to the objectives of the National Health Plan. It was also observed that Proadi-SUS projects were not evenly distributed across Brazilian states, with the highest number of initiatives concentrated in São Paulo (34 projects), Rio Grande do Sul (33), Bahia (30), and Rio de Janeiro (30). This pattern reveals an unequal territorial distribution of actions, possibly associated with greater institutional capacity and the presence of hospitals of excellence in these states. Regarding the Human Resources Training area, the results showed a significant increase in the number of qualified professionals in the final year of project implementation, reaching 81,805 professionals. Improving SUS management to ensure equitable access to quality health goods and services (present in 25 projects) was the most frequently observed objective among projects in this area. Territorial scope was identified as national in 32 of the 37 projects classified within the Human Resources Training area, while only a few projects (no more than five) were located in specific Federative Units. Conclusion: Proadi-SUS plays a strategic role in strengthening the SUS by articulating financial resources, technical-scientific expertise, and actions aligned with national health priorities. The program’s educational initiatives contribute to workforce qualification, improved management, and strengthened care processes, with potential indirect impacts on the quality, effectiveness, and equity of health services. Despite this potential, challenges remain related to the concentration of projects and resources in the South and Southeast regions, the qualification of professionals in underserved areas, and the insufficient coverage of certain National Health Plan objectives, such as expanding population access to medicines and strategic supplies and promoting Indigenous Health. In this context, strengthening governance, planning, monitoring, and evaluation is essential to increase the program’s effectiveness and its contribution to the institutional development of the SUS.