Regionalização e acesso à saúde nos estados brasileiros: condicionantes históricos e político-institucionais
Abstract: This article examines the healthcare regionalization process in the Brazilian states in the period from 2007 to 2010, seeking to identify the conditions that favor or impede this process. Referential analysis of public policies and especially of historical institutionalism was used. Three dimensions sum up the conditioning factors of regionalization: context (historical-structural, political-institutional and conjunctural), directionality (ideology, object, actors, strategies and instruments) and regionalization features (institutionality and governance). The empirical research relied mainly on the analysis of official documents and interviews with key actors in 24 states. Distinct patterns of influence in the states were observed, with regionalization being marked by important gains in institutionality and governance in the period. Nevertheless, inherent difficulties of the contexts prejudice greater advances. There is a pressing need to broaden the territorial focus in government planning and to integrate sectorial policies for medium and long-term regional development in order to empower regionalization and to overcome obstacles to the access to healthcare services in Brazil.
Cites background from "Regionalização e acesso à saúde nos..."
...…decentralization to the municipalities, and another, in the 2000s, with greater emphasis on regionalization, designed to overcome the obstacles arising from highly unequal service provision, but still with little impact on the functional organization of the health system (Lima et al., 2012)....
...…and fair integration of such programs and services according to the supply and needs found in a particular social-sanitary context, optimizing human and technological resources in the regional health complex, catalyzing shared policies and responsibilities between the actors (Lima et al., 2012)....
Cites background or result from "Regionalização e acesso à saúde nos..."
...Very few analyse the factors that influence healthcare networks implementation (de Lima et al. 2012)....
...This coincides with the few published evaluations, which show that despite the high number of municipalities that signed the Health Pact (de Lima et al. 2012)—the number differs by state and Pernambuco is somewhere in the middle (Ministério de Saúde 2012)—few have planned and developed healthcare…...
...…that signed the Health Pact (de Lima et al. 2012)—the number differs by state and Pernambuco is somewhere in the middle (Ministério de Saúde 2012)—few have planned and developed healthcare networks or implemented the necessary tools for doing so (PDR, CIR, etc.) (de Lima et al. 2012)....
...As signalled by some authors (de Lima et al. 2012), it is unlikely that CIRs can operate without funding and an administrative structure, and without defining those competences of the states and/or municipalities that are to be transferred, or how they should be co-ordinated among these entities to…...
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