Gaps in health personnel at the first level: viability of the MAS-Bienestar model in Veracruz

Abstract

Objective: To evaluate the feasibility of the Health Care Model for Wellbeing (MAS-Bienestar) at the primary care level (PNA) regarding Human Resources for Health in Veracruz in 2020.

Materials and Methods: A Quantitative, cross-sectional and comparative analysis study based on secondary sources. SINERHIAS-2020, INEGI and statistical yearbooks. For each health jurisdiction, indicators were calculated for RHS density/10,000 inhabitants, gaps (difference between reference and observed density), Institutional coverage (% CI = actual/proposed RHS x 100), age distribution, by sex and profession, in NAP units of 11 health jurisdictions in Veracruz.

Results: The state density was: 7.25 RH/10,000 inhabitants. (gap 17.75, % CI 46.4%). Differences were observed by jurisdiction: Córdoba 5.50 (33.1 % CI), Coatzacoalcos 9.46 (55.9 % CI). Female predominance: 69.3%, age groups between 35-54 years (31.2%), nursing represented 44.3% and medicine 28.9%. The expanded team accounted for 26.7%. Overall, the results show three main patterns: an age concentration of the workforce in middle ages, a marked feminization of the health workforce, and a predominance of the basic team over the extended team at the first level of care. These results show that the implementation of the model is conditionally feasible, provided that appropriate corrective actions are implemented.

Conclusions: The feasibility of the MAS-Bienestar model at the primary care level is limited by the low density and jurisdictional inequality of the health workforce. Without strengthening multidisciplinary teams, the model risks reproducing the shortcomings of previous schemes, thereby hindering comprehensive care and sustainable universal coverage.

Keywords: Health care models; Human resources for health; Primary health care; Universal health coverage.