Abstract:
The aim of this study was to analyze the experiences of primary healthcare workers in the public health systems in Colombia and Brazil in relation to the neoliberal logic. These two cases are relevant to public health research, as examples of health systems that emerged from opposing guidelines: the Colombian system was created at the government level with a marked private-sector influence, while the Brazilian system was an important conquest by social movements. Based on the Social Psychology of Work, this was a qualitative and empirical study. In-depth reflexive interviews were conducted with two groups of primary healthcare and administrative workers: one in Bucaramanga, Colombia, and the other in Campinas (São Paulo State), Brazil. Content analysis was used in the analytical process. According to the study, in both countries the main experiences of healthcare workers involve the changes in working conditions, relations, and organization. In the Colombian context, we identified the central problems in the transition induced by the reform that established the country’s current health system. These problems are expressed in the deterioration of relations with health system users, as well as in the configuration of healthcare teams, marked by conflicting employment arrangements in the healthcare staff. The latter condition also appears in the Brazilian context, as a result of outsourcing, which appears to have become an effective mechanism for undermining the Brazilian Unified National Health System (SUS), facilitating its dismantlement and pointing it in the same direction as the Colombian system.
Keywords:
Health Personnel; Health Care Reform; Privatization; Health Systems