Current work

In the city of Rio de Janeiro, I work as advisor to the Superintendency of Primary Care at the Municipal Health Department, as part of the Núcleo de Inteligência Assistencial (Healthcare Intelligence Unit). This group uses electronic health records and vital statistics to create digital innovations that support healthcare professionals in patient care and help local managers monitor team performance. Through my work, I seek to ensure that these innovations not only provide information on professional performance and indicators but also have the potential to transform daily practice through an educational and formative approach. In this way, I aim for these technologies to promote the development of clinical, professional, and teamwork competencies.

To make this shift possible — moving from a traditional logic centered on indicators and targets to a formative perspective that values the potential of each professional to improve their practice — knowledge in epidemiology, public health, and family medicine is essential, but not sufficient. That is why I incorporate mixed-methods research and implementation research into my work, as they are powerful tools to address the most fundamental challenges faced by healthcare professionals and to adapt the design of technological innovations to their real needs.

At UNA-SUS — the Open University of the Brazilian National Health System, an initiative of the Ministry of Health based at Fiocruz in Brasília — I serve as advisor to the Executive Secretariat. UNA-SUS is a collaborative network of public universities that provides distance-learning courses for health professionals across the country. Its mission is to support training and continuing education, contributing to the improvement of services within Brazil's Unified Health System (SUS).

In recent years, I have focused my work on two main fronts: (1) the development of innovative educational activities for national programs aimed at the provision and retention of physicians in Primary Health Care in Brazil — the Mais Médicos Program and the Médicos pelo Brasil Program; and (2) international cooperation to strengthen health training in Portuguese-speaking countries.

Within the national programs for physician provision and retention (front 1), the educational innovations I have developed include the design of distance preceptorship activities and synchronous small-group sessions for training in clinical communication, clinical reasoning, evidence-based medicine, and the care of patients with multimorbidity, polypharmacy, and complex health needs. These activities are part of the Specialization in Family and Community Medicine, a two-year program.

In addition to asynchronous tutored activities, students participate in weekly synchronous sessions in groups of 12 physicians in training, each accompanied by a facilitator. These sessions are supported by video lectures, practical exercises, instructional videos, and manuals guiding the 1,500 facilitators in conducting each activity. Throughout the two years of specialization, students share real video-recorded consultations for group discussion using the ALOBA methodology, and present real clinical cases that serve as the basis for collective learning.

The first edition of this Specialization was delivered by eight Brazilian universities and involved 40 coordinators, 1,500 facilitators, and 16,000 physicians in training across the country, including rural areas, remote regions, quilombola communities, indigenous communities, riverside populations, and persons deprived of liberty. Building this broad governance structure has ensured that information, guidance, and feedback circulate in a timely manner in both directions — from the national coordination at UNA-SUS to the students and, in turn, from students' experiences and demands back to us. This dynamic strengthens pedagogical quality, ensures alignment with national training standards, and allows for the constant improvement of the teaching and learning experience offered by UNA-SUS.

At present, the materials produced for these activities are being converted into three books so that physicians working in Primary Care, university faculty, and preceptors in residency programs can use them as teaching references in training sessions, thereby expanding the reach and practical usefulness of the developed content.

Regarding international cooperation initiatives to strengthen health training in Portuguese-speaking countries (2), I worked to establish collaboration between Brazil and Angola for the creation of a hub for the production and delivery of distance-learning courses for health professionals in Luanda — see details in the Angola section. We are currently developing a training program to strengthen Primary Health Care in Portuguese-speaking countries. As a first step, we have begun producing a pilot module focused on the concept of Models of Care, presenting its key principles and demonstrating how models of care are currently structured in Lusophone countries.

Since October 2022, I have been collaborating with the College of General and Family Medicine of the Order of Physicians of Angola. My work in the country involves stakeholder engagement and leadership mobilization, focusing on strategies to strengthen Primary Health Care and Family Medicine training.

At present, we are preparing a policy briefing that outlines priority actions to improve the training of family physicians and reinforce Primary Health Care in Angola. In parallel, I am promoting collaboration between Brazil and Angola to establish a hub for the production and delivery of distance-learning courses for health professionals, in partnership with UNA-SUS. This initiative led to the signing, in March 2024, of a Memorandum of Understanding between Fiocruz and Agostinho Neto University, laying the groundwork for the new digital health training hub in the country.

During this period, I have also taken part in academic and training activities in Luanda and Lubango, focusing on clinical reasoning, evidence-based medicine, and research capacity-building, working with Family Medicine residents and faculty. Among the outcomes of this partnership, we published the first scientific article on Family Medicine training in Angola, which has strengthened the visibility of the specialty and paved the way for new initiatives.

My work in Mozambique also involves stakeholder engagement and leadership mobilization, with the goal of developing strategies to strengthen Primary Health Care and Family Medicine training, helping the country move toward a more integrated, comprehensive, and sustainable system of care.

Since 2019, when I established the first contact with Dr. Yolanda Marcelino during the WONCA Africa conference in Kampala, Uganda, I have been collaborating with the College of Family Medicine of Mozambique. This partnership resulted in the publication of a scientific article on Family Medicine in Mozambique, marking the beginning of an academic cooperation that has consolidated over the years. Since March 2025, I have been working with a group of young leaders in Mozambican Family Medicine, graduates of the Eduardo Mondlane University, in conducting the MATAPA Project — an innovative project for the transformation of primary health care in the country. Through participatory research, we analyzed the weaknesses of the current healthcare model in the country and developed a proposal for a new Model of Care, capable of enabling the transition from a verticalized and selective format to a comprehensive model, centered on people's health needs and continuous over time.

Currently, we are initiating the implementation of the MATAPA PROJECT in three health units in the Municipality of Maputo.

Since 2015, I have been an active member of the Besrour Centre, regularly participating in the meetings it promotes. I collaborate on initiatives focused on capacity-building in scientific research and on connecting colleagues from Portuguese-speaking countries with the global collaboration network fostered by the Centre.

The Besrour Centre was initially based at the College of Family Physicians of Canada. Despite its recent relocation to the University of Oxford, its vision remains that of a world where no one is left behind in access to quality primary care, and its mission is to foster collaboration to advance Family Medicine internationally. Its values include equity (recognizing the dignity of every human being and supporting the fair distribution of resources and access for marginalized and vulnerable groups), justice (advocating for the right of all individuals to fair and impartial access to the benefits of society, including the right to health), excellence (upholding the highest standards of quality, patient-centered care, integrity, professionalism, and leadership), reciprocity (promoting collaborative and multidirectional exchange of experiences, knowledge, and capacity-building among partners and communities), and respect (valuing the cultures, norms, and perspectives of each individual).

Find the Evidence is an open-access course on Evidence-Based Medicine, focusing on clinical decision-making for healthcare professionals in Mozambique, Angola, and other CPLP (Community of Portuguese Language Countries) nations. It was developed from classroom materials collected over the years, which I chose to present in a more interactive and accessible format for both students and teachers. Concepts and tools are integrated into the platform with hyperlinks connecting terms and ideas. The text is written in a direct language, free of unnecessary jargon. Instead of long chapters, I opted for short, self-contained entries linked to one another, allowing each professional to build their own reading path according to their specific questions.

The examples presented reflect real clinical cases from low- and middle-income countries, including malaria prevention during pregnancy, cervical cancer screening in low-resource settings, and intensive care decisions with limited resources.