Implementation challenges and workforce distribution of multiprofessional primary care teams: a national survey
1
Center for Education in Public Health (NESCON), Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
2
Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
Popul. Med. 2026;8(Supplement Supplement 1):A3530
ABSTRACT
INTRODUCTION:
In 2023, Brazil’s Ministry of Health launched the eMulti (Multiprofessional Teams in Primary Health Care) program to strengthen the Unified Health System by integrating diverse health professionals into Primary Health Care (PHC). These include physiotherapists, psychologists, social workers, nutritionists, pharmacists, occupational and speech therapists, physical educators, and medical specialists. Operating alongside Family Health Teams, eMulti aims to expand access, improve service resolutivity, and promote comprehensive care through matrix support and individual, collective, and home-based interventions. However, its consolidation faces structural challenges. This study analyzes the availability of multiprofessional services, eMulti implementation, and recruitment barriers across Brazilian municipalities.
METHODS:
A mixed-mode survey was conducted with municipal health authorities using telephone interviews and an online questionnaire. Municipalities were stratified by region and by the Equity and Workforce Index (IED). Data were collected between August 2024 and April 2025. The instrument addressed workforce organization, service availability, eMulti implementation, recruitment, and provision challenges. Descriptive and comparative analyses were performed, focusing on disparities between high- and low-vulnerability municipalities.
RESULTS:
A total of 1297 municipal authorities responded. Physiotherapists, psychologists, nutritionists, and pharmacists were available in most municipalities, although smaller and more vulnerable areas reported more service gaps. Medical specialties remained concentrated in specialized care. eMulti was implemented in 75% of municipalities, but only 22% had dedicated coordination, with management typically absorbed by PHC coordinators. The main recruitment barriers were insufficient financial resources and local labor market shortages, particularly for occupational and speech therapists. More vulnerable municipalities showed lower service diversification and a greater reliance on external referrals.
CONCLUSIONS:
While eMulti has expanded the scope of PHC, its consolidation is hindered by financing constraints and health workforce shortages. Addressing these structural inequalities is essential for multiprofessional care to achieve equitable health outcomes across Brazil.
In 2023, Brazil’s Ministry of Health launched the eMulti (Multiprofessional Teams in Primary Health Care) program to strengthen the Unified Health System by integrating diverse health professionals into Primary Health Care (PHC). These include physiotherapists, psychologists, social workers, nutritionists, pharmacists, occupational and speech therapists, physical educators, and medical specialists. Operating alongside Family Health Teams, eMulti aims to expand access, improve service resolutivity, and promote comprehensive care through matrix support and individual, collective, and home-based interventions. However, its consolidation faces structural challenges. This study analyzes the availability of multiprofessional services, eMulti implementation, and recruitment barriers across Brazilian municipalities.
METHODS:
A mixed-mode survey was conducted with municipal health authorities using telephone interviews and an online questionnaire. Municipalities were stratified by region and by the Equity and Workforce Index (IED). Data were collected between August 2024 and April 2025. The instrument addressed workforce organization, service availability, eMulti implementation, recruitment, and provision challenges. Descriptive and comparative analyses were performed, focusing on disparities between high- and low-vulnerability municipalities.
RESULTS:
A total of 1297 municipal authorities responded. Physiotherapists, psychologists, nutritionists, and pharmacists were available in most municipalities, although smaller and more vulnerable areas reported more service gaps. Medical specialties remained concentrated in specialized care. eMulti was implemented in 75% of municipalities, but only 22% had dedicated coordination, with management typically absorbed by PHC coordinators. The main recruitment barriers were insufficient financial resources and local labor market shortages, particularly for occupational and speech therapists. More vulnerable municipalities showed lower service diversification and a greater reliance on external referrals.
CONCLUSIONS:
While eMulti has expanded the scope of PHC, its consolidation is hindered by financing constraints and health workforce shortages. Addressing these structural inequalities is essential for multiprofessional care to achieve equitable health outcomes across Brazil.
| eISSN: | 2654-1459 |
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