Trends in labor contracting in the family health program in Brazil: A telephone survey

The Family Health Program - PSF - is one of the most important governmental interventions implemented in Brazil to improve primary health care by providing a comprehensive range of preventive and curative health care services delivered by a team composed of physician, nurse, nurse assistant, and community health workers and a team of dentist, dental hygienist and dental assistant. Each team is responsible for the care of the families in a specific geographic area, usually consisting of about 3,000 to 4,500 people. It is estimated that almost 400 thousand health professional jobs are directly involved in the conduction of the Program. This paper analyses the data of two national surveys carried out in Brazilian municipalities in 2001 and 2006 to study contracting out and the kinds of labor relationships between the Program and its workers in order to identify the main changes in the labor market in PSF. In 2001 the data were collected in a randomized sample of 759 municipalities out of 3,225 municipalities where the Program was already working, stratified by geographical location and population size. The 2006 survey was applied to a sample of 855 municipalities out of 4,884 that had implanted the PSF that time. In the 2006 survey the municipalities were selected based on the 2001 survey to allow comparison with the data collected in 2001 (187 municipalities were added at random to complete the sample).  The survey data were collected through computer-assisted telephone interviews (CATI) with local governmental managers, human resource managers or their equivalents. The 2006 survey allowed concluding that there is still a high level of poorly paid jobs as well as non-compliance with legal requirements when it comes to hiring professionals, even though, when compared to the results of the 2001 survey, one can find a reversion trend in this situation.