Ss40-07 Technical and Pedagogical Support (Matrix) for Basic Occupational Health Services (Bohs) in Sus, the National Health System in Brazil

Abstract Introduction Recent changes in working conditions, loss of social protection and increasing informality underline the importance of primary healthcare (PHC) to guarantee Universal Occupational Health Coverage. Basic Occupational Health Services (BOHS) can support a major part of all workers without access to expert-based occupational health services. In Brazil, the BOHS proposal is favored within the National Health System (SUS), guaranteed in the Federal Constitution (1988). In this network, PHC is the gateway and coordinator. Permanent training, technical and pedagogical support (Matrix training) of health teams are essential, provided by Reference Centers for Workers’ Health (Cerest) and institutions also from the labor side. Materials and Methods A successful experience is developed in the municipality of Betim, Minas Gerais. PHC professionals were covered from 13 municipalities (732,000 inhabitants) with various industries, commerce, and many small and micro companies. Work at home is prevalent. Results The Matrix support began in 2006 by decentralizing workers' health actions to the SUS network, with a broad training program and organizing reference units for treating workers' health problems. Formalization followed in a Municipal Decree in 2016 (workers’ health protocol). Several programs were implemented on surveillance of work-related injuries and of working conditions, and assistance actions covering the SUS network with meetings, online contacts, education, and face-to-face meetings at PHC units. Conclusions The successful experience shows exciting possibilities. Challenges remain in the support of municipal management, insufficient Cerest centres, high turnover of professionals, and availability of health teams given the high demands in PHC