2 2 The permanent education of health care professionals has been increasing in relevance in the country, which is a result of the actual demands generated by the consolidation of the Sistema Único de Saúde (SUS) [Single Health System] and as of redesigning derived from the Brazilian Education Reform. The changes held in public health in the last few years in Brazil, with the strong decentralization of services and dislocation of performance responsibility and health care offer to local level, supported by the re-orientation of the service model, have necessarily forced changes in the development process of health care professionals. The development of human resources is a strategical issue not only in Brazil, but also in countries whose policy is oriented towards educational processes linked to the needs pointed out by the health care system, which requires quality professionals to act in different sub-sectors, areas and services, so as to contribute to the fostering of the improvement in social and health indicators at any level in the System. In this environment of changes, the Projeto de Profissionalização dos Trabalhadores da Área da Enfermagem (PROFAE) [Professional Qualification Project of Workers in the Nursing Area], as a strategy of the Ministry of Health to improve the quality of the services rendered by the nursing workers at the facilities of the Sistema Único de Saúde is created in Three factors were decisive for the acknowledgement of PROFAE's implementation, in the academic and service circuits, as an initiative of high social significance: the absence of qualification of the workers who acted in the many health areas and activities, in the field of Nursing, risk of unemployment as a result of illegal practice and risk subjected by the population in view of the low quality of the actions performed by these workers
3 3 218,244 people enrolled in the Nursing Aide Course 207,844 people graduated as Nursing Aides 80,124 graduates as Nursing RESULTS 482 Technicians qualified 82,029 tutors people enrolled in the Nursing Technician Course PROFAE has been initially structured for performance in four years (2000/2004). In view of an efficient management and overcoming of its goals, its actions were expanded and time limit was renegotiated to It was developed with resources derived from a loan made from the Banco Interamericano de Desenvolvimento (BID) [Interamerican Development Bank], from the National Treasury and from the Fundo de Amparo ao Trabalhador (FAT) [Workers's Support Fund]. UNESCO, the Organization for the United Nations for Education, Science and Culture, offers support and technical cooperation as an international cooperation agency.
4 4 RESULTS 26 modernized ETSUS 9 reformed schools (MS/Profae - ME/Proep) 11 new ETSUS created and 8 already modernized Management Information System (SIG-PROFAE) developed and used by regional operators/ agencies / MS 13,161 nurses specialized in Professional Education in the health care area 9 financed architectural projects PROFAE GOALS AGREED UPON WITH BID Qualification of 180 thousand Nursing Aides out of the 225 thousand workers enrolled Graduation of 72 thousand Nursing Technicians out of the 90 thousand Nursing Aides enrolled Pedagogic Graduation of 12 thousand nurses to act as teachers in professional education courses Strengthening and modernization of SUS Technical Schools and support to the creation of new Technical Schools
5 5 Creation of Network of SUS/RET-SUS Technical Schools RET-SUS monthly magazine 12 prepared researches/ studies RESULTS 30 financed research projects 8 issues of Formação magazine 4 implemented work stations Investment in physical structure and equipment Creation of technical schools in 11 states Management strengthening Investment in information systems Implementation of Work Stations for the development of studies and research for the Follow-up of Work Market Signs in the Health Care Sector, with emphasis on Nursing
6 6 6 PROFAE EXECUTION Involvement of the three governmental levels S ince the establishment of the Sistema Único de Saúde, in 1988, decentralization is the word of order for the system services and management. This guiding principle of SUS is a reality both at large urban centers and in the smallest Brazilian municipalities. This new paradigm has generated needs with regard to the professional qualification of the workers in the several work stations distributed throughout the country, especially in the area of basic health care. With this new view in relation to local realities, PROFAE has expanded its performance by offering courses in a decentralized way, providing classes in 2,617 Brazilian municipalities, meeting the needs of workers from 5,077 municipalities and, thus, getting as close as possible to the worker to be qualified. For the development of the decentralized classes, the project has established partnerships with SUS managers, at the federal, state and municipal levels, trying to find conditions for the implementation of classes in the municipalities and also, with the state systems for education regulation so that they recognize the space outside the school walls, as spaces liable to be developed in educational processes.
7 7 7 PROFESSIONAL QUALIFICATION The search for quality in health care T he development of SUS human resources, in line with the principles and guidelines assured by the constitution, historically represents one of the major challenges in the public health field, being one of these the professional development that meets the needs of SUS. There is a wide spectrum of work fronts at the basic health care units as well as in the intermediate and high complexity units. This growing scenario, mainly during the last decade, puts on the agenda of public policies the conviction that one must act in professional education. PROFAE is part of this mosaic of actions, in the area of intermediate level workers' development amidst the universe of professionals inserted in the health care services, in the qualification of the establishment of staff involved in the process and also encouraging the articulation of the schools with SUS managers to meet their demands.
8 8 8 The Ministry of Health, through the establishment of this policy, has conclusively incorporated professional development into its priority agenda, being PROFAE a good example of implementation of this decentralization strategy established by SUS. The operational model that was adopted included centralized management, with decentralized execution, in addition to other also decentralized management structures. This management design envisaged to warrant quality to the courses, with significant echo on humanization and qualification of health care services. Eloquent sign of importance of nursing professionals at the Sistema Único de Saúde: the category answers for 25.7% of the total 2,180,568 workers in the health care area gathering 45 technical and upper level professions active in all levels of health care.
9 9 9 Nurses These are the main agents involved in the work supervision process of the nursing aides and technicians, in the health services and in the teaching-learning process at the human resource development institutions. They play an unquestionable leading role. Nursing Technicians Graduated by intermediate level professional qualification schools, the nursing technicians act mainly in the intermediate to high complexity health services. Nursing Aides They represent the support of all the nursing work in Brazil. They are graduated from professional education school and are the professionals who take direct care of the patient in the day-to-day health services.
10 10 10 PROFAE ORGANIZATION Education and Professionalization Management Professional Qualification of Nursing Aide Complementation of Qualification of Nursing Aide to Nursing Technician Complementation of Intermediate Education Gerência de Fortalecimento Institucional Pedagogic Development of Teachers Competence Certification System Work Market Sign Follow-up System in the Health Care Sector, with emphasis on Nursing Strengthening of SUS Health Technical Schools
11 11 STUDENT ALLOWANCE 11 TEDUCATION AND PROFESSIONALIZATION he goal achieved was the intensive professionalization of nursing workers. The final objective accomplished was a high leap in the quality of public, private and philanthropic health service. There has been a concentrated effort in the valorization of the professionals, in an attempt to, on one hand to improve care to the population and, on the other, encourage the expansion of opportunities to large contingents of workers who may devote themselves to the informed and responsible exercise of their profession. In addition to professional qualification, PROFAE courses have consisted of great encouragement and incentive for these professionals to seek improvement in their levels of education. These workers, as PROFAE students, received each month the Auxílio Aluno [Student Allowance] destined for the partial coverage of their transportation and meal expenses. All courses, as well as the text books used, were provided by PROFAE free of charge.
12 12 12 "It is the consensus among health care area professionals and managers that the qualification of workers at this scale and within this timeframe has translated into positive impact on the quality of the services rendered to the population. However, this was not the only effect of PROFAE implementation. Its design brought many innovations that possibly will influence the present and future projects in the area of health care personnel education."
13 13 13 TDECENTRALIZATION OF PROFAE COURSES he Nursing Aide Professional Qualification course, as well as the courses in Nursing Aide Professional Qualification Complementation to Nursing Technician and the Intermediate Education Complementation had their performance decentralized. Regional agencies, operators, executors and decentralized classes made up this network. PROFAE resorted to a dynamic posture in order to reach its goals, by means of decentralization. Thus, the accreditation of the institutions for course supervision and execution was strongly intensified envisaging higher local presence so as to reach work locations and the residences of the workers in health service.
14 14 14 DECENTRALIZED EXECUTION Regional Agencies - institutions that are hired by mean of public bidding and are responsible for the supervision, monitoring and assessment of the courses of Nursing Aide Professional Qualification, Nursing Aide Professional Qualification Complementation to Nursing Technician and Intermediate Education Complementation. Operators - public or private institutions that are hired by means of bidding processes for the management of professional qualification courses. Executors - institutions that are accredited by the Educational System and subcontracted by the Operators for the performance of the courses.
15 15 15 PROFESSIONAL EDUCATION PFOLLOW-UP AND MONITORING OF PROFESSIONAL EDUCATION COURSES ROFAE brings in its conception the proposition to supervise and monitor the course of its activities. Aiming at meeting its conceptions, Profae, in its structure, creates the Regional Agencies, which have the objective of supervising, monitoring and assessing the schooling and professional courses. Supervision, in this context, is a process of follow-up and effective evaluation, so as to warrant the quality of the process and not an inspection and control mechanism. Monitoring, in this approach, means to follow up and control through instruments construed for such a purpose, and evaluation is part of monitoring. The action of supervising is inserted into the area of relationships between the Ministry of Health, the Regional Agencies and the Operators/Executors (schools) and serves as evaluation instrument, capable of establishing dialogues, seeking consensus to construe alternatives and solutions adequate to the needs of the Project in a shared way. This action, performed each month, has generated impact on the pedagogic orientation and on management control, assuring quality to the Project courses and good management capability.
16 16 BINSTITUTIONAL STRENGTHENING uilding, redesigning and providing technical and financial support for the development of education and professional qualification process was the main objective of Institutional Strengthening, acting in the diversity of health contexts and spaces, by means of the articulation among the several formal instances, in the field of professional education, committed with the qualification of human development of the workers, with the management of the services and with the regulation of the work market in the health care area. The universe that has been benefited, as a priority, is that of human resources linked to the Sistema Único de Saúde. With the strengthening of these mutually solidary instances, institutional mechanisms were created so as to warrant the future consolidation of the entire system of education and professional qualification in the health care area. The permanent education of all the workers is our final target.
17 17 17 PEDAGOGIC EDUCATION - SPECIALIZATION FOR PROFESSIONAL EDUCATION IN HEALTH / NURSING Recording the experience T he qualification of a large number of teachers for the intermediate level professional education is a challenging goal at any area. In the case of the professionals who act in the health care area, it requires taking into consideration the limits imposed by their work conditions, translated into the multiple links, lack of time to attend conventional classes and impossibility of commuting to educational institutions. The Pedagogic Education Course was implemented with the objective of supplying the specific demand of professors in this area. The reality experienced by these professionals has defined distant education as the most appropriate methodological strategy, so that spatial and temporal distances could be overcome, without giving up qualified and organic educational processes to SUS developing needs.
18 18 18 DIDACTIC MATERIAL Because of the absence of access to technology on the part of the target public of the Pedagogic Education Course, consisting of nurses who teach professional education and as a way to disseminate more broadly the contents of the Course, the pedagogic option for Distance Education is supported by didactic material divided into 3 nuclei: contextual, structural and integrating, student's guide and tutor's book.
19 19 19 TPEDAGOGIC EDUCATION ASSESSMENT RESEARCH he central objective of the first research was to widen the possibilities to build and redirect strategies in the scope of health development processes. It aimed at knowing the experienced lived by nurses/teachers graduating from classes started in 2001 and 2002, in view of the proposal of the Pedagogic Education Course. The focus of the second assessment research proposed to the graduating individuals from the classes implemented in 2003 and 2004 was to know approximations and distances occurred between the experience lived by nurses/teachers and the proposal of the Pedagogic Education Course, in addition to contributing for the evaluation of management strategies of educational processes in the health care area, notably the ones relative to pedagogic support, the development and the continued education of tutors.
20 20 20 ITUTORS' EDUCATION n order to meet the demand foreseen for 12,000 nurses/teachers, initially 482 tutors were qualified, in the physical attendance form, aiming at the construction of competences related to the learning capabilities and to the boundary of interdisciplines, also involving the competence of scientifically research and generate relevant knowledge. The continued education of tutors of distant pedagogic education - Seiva Project - was held in three classes, with the participation of 323 tutors. The crossed paths in accordance with work dynamics in line with the activities proposed.
21 21 21 IPEDAGOGIC FOLLOW-UP OF TEACHERS n the area of health public policies, the education for teachers in the health care area - Nursing, with pedagogic support of a decentralized tutorship, in all regions of the country was a novel proposal. It became possible by means of the consolidation of a Rede de Núcleos de Apoio Docente (NAD) [Network of Teaching Support Nuclei], consisting of 45 Upper Level Teaching Institutions. The formalization of this partnership took place by means of a Convênio de Cooperação Técnica [Technical Cooperation Covenant] between the teaching institutions and Fiocruz/ENSP, aiming at assuring the technical and pedagogic follow-up of the Course, in addition to enabling the institutions to co-certify the students/teachers of the Course.
22 22 22
23 23 23 TEXPANSION OF TEACHING EDUCATION IN HEALTH CARE PROFESSIONAL DEVELOPMENT - PROPOSAL he teaching education of nurses by PROFAE, as specialists, has indicated as possible and necessary the expansion of educational processes in the pedagogic area for the set of professionals involved in teaching for the qualification of SUS workers. The proposal for the teaching education in the various areas demanded by SUS must take into account the pedagogic educational experience of the Nursing category, as strategic line of intervention in the interface of the school and of the services. Such an option is owed, in particular, to the highlights of this proposal, compatible with the demands of other professional categories, in the present context: the option for an education on a critical-reflexive basis, turned to the understanding of health and education as social practices construed historically and the use of distance education as a modality that is most compatible with the concrete reality of the health care service professionals.
24 24 24 SYSTEM FOR COMPETENCE CERTIFICATION - SCC The challenges of evaluating competences in their multiple dimensions T he proposal to create the competence certification system at PROFAE and Ministry of Health is unique because there was no record of national actions or experiments in the health care area that could serve as a model for its implementation. The construction of this system started to have a twice pioneering and innovating character: a novel experience in the health care sector, developing methodologies and strategies that would adapt to the specifications and scope of a regular profession and that could incorporate the reasoning of work reality into the educational processes, not reducing the competences to mere task descriptions.
25 25 (Norm for the Certification of Professional Competences of the Nursing Aide graduating from Profae Courses. MS/ 2000) The conception, structuring and implementation of the professional certification system have foreseen, as a fundamental issue, a careful and pondered operational process, particularly as it regards the required reorganization of professional education. The SCC is being implemented gradually, in depth and wide and large, warranting full participation of the many players involved in the theme, as well as the search for a consensus among them. Furthermore, the implementation of this system requires the articulation among its many actions, so as to adapt the political interests of the many social players to the demands of technical-operational nature. The first product presented by PROFAE in the consolidation of the certification system was the "Norm for the Certification of Professional Competences of the Nursing Aide", approved by the Conselho Consultivo Nacional of SCC [National Advisory Council of SCC] for purposes of performance of the pilot test of the certification (performed in Espírito Santo in 2002). In this Norm, the concept of "competence" was defined, as prepared under the view of PROFAE.
26 26 26 EXPECTATIONS WITHIN THE REACH OF THE SCC Safe guidance for the design of educational programs and curricula for technical level professional development. Therefore, it makes possible the perspective of permanent education by means of the verification of the deficits presented by the workers. Recognition of the competence acquired in the scope of the workers graduating from PROFAE qualification courses, irrespectively of location, as well as the possibility or opportunity to complement, correct, improve and update his competences. Offer of professionals to the health care services, warranting quality performance in terms of competences, enabling the increase in the level of quality for selection and qualification of the health care work force.
27 27 27 PROJECT UNDER EXPANSION - SCC Subsidy the preparation of the proposal of Professional Certification Policy in Brazil, articulating, in this action, the Ministries of Education and Work and the Personnel Commission of the Brazilian Certification System. Validate the methodology, the strategies and the process of qualitative evaluation proposed by PROFAE. Show the viability and the importance of a certification process, linked to professional education and educational evaluation. Generate information on the professional education implemented by PROFAE. Confirm the strengthening of the process of nursing aide education by means of data and information that subsidy the teaching institutions.
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29 29 29 ITECHNICAL SCHOOLS OF SUS - ETSUS t was as of the 80's that SUS Technical Schools (ETSUS), public institutions kept by SUS, were created as an alternative to the facing of the problem of low qualification of the work force employed in the health care services, risking the health of the user population. The main target was to qualify the professionals employed at the health institutions that did not have specific qualification for the functions they performed. ETSUS have always kept their activity centered on the offer of professional education for the health care workers and its complementary proposal is to perform assistance to governmental agencies in issues relative to human resource area for intermediate and basic levels, in the articulation with city halls and health municipal secretariats, in the identification of sources of resources and in development of methods, techniques and innovating curricula in the area of Professional Health Education.
30 30 30 These schools, decentralized and with their axes on the methodology of teaching-service integration, has as main commitment the implementation and consolidation of the system. They have a degree of flexibility and potential performance which enables meeting demands in human resource education fast and efficiently. Expansion of ETSUS The ETSUS were, in 1999, made up by 26 institutions and with the implementation of PROFAE, the network of ETSUS today consists of 37 schools, distributed throughout all the units in the Federation. At PROFAE, 461,318 workers have been enrolled for the technical and nursing aide courses with an effective participation of 319 projects relative to 189 executors of which 24 ETSUS in operation at the time, which organized and performed courses in 982 main municipalities of classes with students derived from 2,414 Brazilian municipalities, which corresponds to meeting 43.3% of the Brazilian municipalities.
31 31 31 More than 25% of the total enrollments and approvals in the courses of Nursing Aide and Technician in the scope of the Project were performed by 24 SUS Technical Schools, which corresponds to 12.7% of the total of the schools that participated as PROFAE executors. Centros de Referência SUS Technical Schools, as political, technical and financial investment, have the potential to effectively become established as reference centers for professional education of workers in the health care sector, thus performing its strategical role in the arrangement of the development of human resources for SUS. The results presented by the ETSUS after PROFAE implementation, reinforce the political proposal of the Ministry of Health in expanding the investments to the modernization and strengthening of these schools, including the incentive to the teaching qualification, to the production and to the
32 32 32 dissemination of knowledge and technical-scientific information and the expansion of the reform/ construction of RET-SUS. The professional health education policy under the leadership of SGTES/DEGES, based on the strengthening of the entire public network of technical education in the area, with the support to institutional development of the 37 existing ETSUS, includes the opportunity of professional qualification for other occupations and technical professions already considered as SUS requirements. The most evident example in this scenario is the education of Agentes Comunitários de Saúde [Community Health Agents], the qualification of Auxiliar de Consultório Dentário [Dental Office Aide], the education of Técnicos de Higiene Dental [Technicians in Dental Hygiene], of Técnico de Vigilância em Saúde [Technician in Health Surveillance], of Técnicos de Registros e Informações nos Serviços de Saúde [Technicians of Health Service Records and Information] and of Técnicos de Laboratórios de Biodiagnóstico [Technicians of Biodiagnostic Laboratories], among others.
33 33 33 Investment Lines at ETSUS Management Model Continued Education Strengthening of Pedagogic Activities Political-pedagogic Project Education Technology Technical-managerial Improvement Information and Computer System Assessment System Work and Educational Market Follow-up Library (technical-scientific documentation) Physical network and equipment
34 34 34 TPROFESSIONAL MASTER'S IN WORK AND HEALTH EDUCATION MANAGEMENT he establishment of a Master's degree in the area of work and health education management has the objective of promoting the qualification of the managers and technical teams at the Escolas Técnicas de Saúde (ETSUS), and managers of human resources of the State health secretariats, major responsible for the educational process for the Sistema Único de Saúde, to act as developers and inducers of processes of change at their work environments, through the adoption of new concepts and practices, developing high applicability products for the development of SUS. The Professional Master's Degree in Work and Health Education Management envisages to provide opportunity for the students to develop "technical-scientific products" compatible with the reality and need of the services, whether in management or organizational aspects, aiming at providing
35 35 35 solid subsidies to the solution of relevant issues involving the human resource area. The expectation is that financing reaches 150 professionals acting in this area. Customers The course will be directed at managers and professors of SUS Technical Schools and managers of human resources of state health secretariats, mainly responsible for the educational process for the Sistema Único de Saúde. Priority Areas The Professional Master's Curriculum in Work and Health Education Management should be structured foreseen as a priority the four areas described below:
36 36 36 Public Policies and Health Systems Professional Work and Organization Management of People and Management in Health Systems Educational Policies and Processes
37 37 37 TPROGRAM OF INCENTIVE TO RESEARCH AT SUS TECHNICAL SCHOOLS he search for consolidating research as educational principle linked to work, as understood by the Secretariat of Work and Health Education Management as fundamental premise to the qualified development of health care workers, is the aim of this Program of Promotion and Incentive to Research and Technological Development at the ETSUS. From this point of view, scientific investigation should be integrated with an educational project that permits students and teachers to perceive society as the location of man's creation and bet on the discoveries/inventions and on the continuity and ruptures along the long way crossed by science, as a society project in favor of mankind. This vision of knowledge production turned to professional health education is articulated to the perception that the world of work, health and education intertwined in a contradictory way and that
38 38 38 a professional qualification - in favor of the transformation of the conservative ways of teaching and learning - should have as basis the conception of this process as a mechanism created by social relations. One must invest and promote the production of critical reflection of the processes under way and their reconstruction, in a continuing action-reflection-action so that we can produce new educational actions in light of the changes required for the development of the professionals in the health care area. The research projects are directly related to SUS Technical Schools, linked to the State Secretariats and/or Municipal Secretariats of Health/Education and Universities comprising the Network of Technical Schools of SUS (RET-SUS), as well as be turned toward the generation of knowledge on the technical level professional education in the health care area.
39 39 39 TJOB MARKET IN THE HEALTH SECTOR WITH FOCUS ON NURSING he System of Work Market Sign Follow-up of the Health Sector with Focus on Nursing (SAMETS) was designed to fill in the gaps of production and dissemination of information, by means of the analysis of secondary data and quantitative and qualitative research. The follow-up of signs was sought or an in-depth knowledge of the Health Sector, with focus on Nursing, in the scope of the job and educational markets, as they refer to occupation and employment, educational and professional development and regulation of the professional practice. Under this view, SAMETS had the objective of presenting systematized statistical information in three thematic axes - job market, educational market and regulation of the professional practice -, attempting to gather, analyze and disseminate information on the markets of work and education of the health professionals, particularly those in the nursing area, aiming at generating subsidies for the guidance of PROFAE management decisions and the other educational and regulatory agencies of SUS human resources.
40 40 40 Thematic Axes Job Market Educational Market Regulation of Professional Practice Work Stations Implemented Station of Work NESCON/UFMG Station of Work IMS/UERJ Station of Work EPSVJ/FIOCRUZ Station of Work CETREDE/IDT/UFC
41 41 41 Formação Magazine The journal was born together with the implementation of PROFAE. Its purpose is to publish results of original research, revisions, assays, opinions, reports, and articles excerpted from papers and theses, which contribute to the development of the knowledge in the health educational area. It has a distribution of 30 thousand copies, being free of charge. The publication represents an important contribution to the health sector professionals, particularly those in the area of nursing. Formação Magazine 01: Professional qualification and quality health Formação Magazine 02: To humanize health care services: a matter of competence Formação Magazine 03: Education, professionalization and health: aspects of citizenship Formação Magazine 04: Education of teachers: the new teachers in basic and professional education Formação Magazine 05: Technical Health Education in SUS context.
42 42 42 Formação Magazine 06: Health Work Market Formação Magazine 07: Evaluation of PROFAE impact on the quality of health services Formação Magazine 08: Studies, reflections and experiences in health professional education Studies made Station of Work NESCON/UFMG Health Work Market - sector, legal-institutional and occupation dimensions: a study as of RAIS/TEM. Teaching Work Market at Executing Technical Schools Qualified by PROFAE in the Southeast Region. Institutional Profile and Teaching Work Market at Executing Technical Schools of PROFAE: Southeast Region.
43 43 43 Station of Work IMS/UERJ Brazilian Classification of Occupations (CBO) : perspectives for market analysis of nursing work. Teaching Work Market at Executing Technical Schools Qualified by PROFAE in the Southern Region. Institutional Profile and Teaching Work Market at Executing Technical Schools Qualified by PROFAE. Station of Work CETREDE/IDT/UFC Analysis of the Offer of Professional Education of Nursing Technical Level.
44 The Technical Occupations in the Health Establishments: a study as of data from Medical-Sanitary Assistance Research - MAS/2002. Changes in Professional Education and the Challenges for SUS Technical School Network: an analysis of the technical course plans. Station of Work EPSVJ/FIOCRUZ Regional Characteristics of the Nursing Job in Brazil: Nursing: market and professional regulation. Work Conditions of Health Technical Level Personnel.
45 45 AND MORE AND MORE PROFAE, in addition to meeting the goals agreed upon, has exceeded the numbers of the Teaching Education, Professional Qualification of Nursing Aide and Nursing Technician. Because of competent management, it was also possible to add the following actions: Monthly offer of Student Allowance; Collection of 8 text books for the support to the course of nursing aide distributed to each student; Complementation of Nursing Aide to Nursing Technician; Offer of Professional Master's; Conception and preparation of Pedagogic Education for the teachers of the other professional health categories; Construction/expansion and equipment for the ETSUS; Development of studies and research in all RET-SUS. This performance accredits presenting a proposal for the expansion in the education of approximately 750 thousand workers of intermediate level at SUS, in the areas of: Surveillance; Odontology; Biodiagnostics; Equipment maintenance; Complementation of Nursing Aide to Nursing Technician; Community Health Agent; Post-technical specialization for the elderly provider; Post-technical specialization in dialysis; This proposal, prepared by SGTES/MS, is being evaluated by the Secretariat of International Affairs/ Ministry of Planning and has the interest and the support of a financing source - BID.