Effects of the Mais Médicos Program on Primary Health Care and its impacts on health: a systematic review

Abstract

The distribution of doctors in Brazil is marked by inequalities, impairing integral and universal access to health, the basis of the Unified Health System. The Mais Médicos Program reached the peak of emergency provision in 2016, with 18,088 doctors in 4,509 municipalities, one of the most significant interventions of its kind in the world. A systematic review was conducted to gather evidence of the Program’s effects on Primary Health Care and impacts on the health of the population served. 570 studies were extracted, and the final selection included 32 articles. Regarding the effects of the Program, there was a rapid expansion in coverage and improvement in the comprehensiveness and humanization of Primary Health Care and a significant impact on hospitalizations due to conditions sensitive to this care, reducing approximately 23,000 hospitalizations in three years and saving R$30 million for the Unified Health System. Points that were detrimental to the potential impact of the Program were also identified: deviations in focus, changes in priority criteria, and improper replacement of doctors already hired by others from the Mais Médicos Program, in addition to the rupture caused by the departure of 8,500 Cuban doctors in November 2018. It is estimated that the relaunch of the Program in 2023, mainly based on existing evidence, will promote the continuity of its progress.

Keywords
Mais Médicos Program; primary health care; systematic review; distribution of physicians; health systems