Background: This study aimed to identify sociodemographic and occupational factors associated with facing moral dilemmas among workers at the Federal University of Pelotas-RS Teaching Hospital who worked on-site during the pandemic. Methods: A cross-sectional study was conducted in 2020 with all workers, including health professionals, support staff, and administrative personnel. Questions about moral dilemmas were grouped into two outcomes: witnessing behaviors or attitudes, and feeling pressured to act in disagreement with what they believed was right. Associations were estimated using Poisson regression with robust variance, based on a hierarchical model. Results: A total of 1,158 workers participated, most of whom were women (76.1%). The prevalence of moral dilemmas was 44% for witnessing and 15% for feeling pressured. Younger age, higher education, being a resident, working both day and night shifts, lack of PPE, and having an active or high-strain job were positively associated with both types of dilemmas, whereas the availability of social support and adequate resting areas reduced their occurrence. Conclusions: Reducing moral dilemmas requires promoting democratic leadership, ensuring adequate staffing, strengthening professional autonomy, encouraging social support, and creating rest spaces. These arrangements are essential for promoting workers’ psychological well-being.

An efficient relationship between the various levels of the healthcare network is crucial for ensuring high-quality care. This study analysed the OHT's working process in primary health care in Brazil, examining its relationship with the healthcare network according to geopolitical regions, population size, the Human Development Index (HDI), and oral health coverage in municipalities. A cross-sectional study of 22,993 OHTs that participated in the third cycle of the External Evaluation of the Program for Improvement of Access and Quality in Primary Care (PMAQ-AB) (2017/2018) was carried out in Brazil. The prevalence and the association between the contextual variables of the included municipalities and the OHT working process were assessed. The provision of reference services for OHTs and the use of protocols for referrals are nearly universal. However, 53% of the teams indicated that emergency services are unavailable outside OHTs' working hours, and 30% did not have records of users referred or received referral feedback. Less than 73% of healthcare networks and specialities offered matrix support to OHTs. Most evaluated aspects showed lower prevalence in the Northern region, in cities with lower HDI and smaller populations. Emergency dental services must be expanded, matrix support strengthened, and counter-referral implemented. Guaranteed access to computers, the Internet, telephone, system interoperability, and regionalisation can facilitate networking. Priority should be given to remote regions and small municipalities. This would increase primary care's solubility, continuity, and comprehensiveness and promote equity.