Regionalização e acesso à saúde nos estados brasileiros: condicionantes históricos e político-institucionais
Luciana Dias de Lima,Ana Luiza d'Ávila Viana,Cristiani Vieira Machado,Mariana Vercesi de Albuquerque,Roberta Gondim de Oliveira,Fabíola Lana Iozzi,João Henrique Gurtler Scatena,Guilherme Arantes Mello,Adelyne Maria Mendes Pereira,Ana Paula Santana Coelho +9 more
TLDR
In this article, the authors examined 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.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.read more
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Regional governance: strategies and disputes in health region management.
TL;DR: The characteristics identified a regionalized system with a conflictive pattern of governance and intermediate institutionalism and the regional interagency committee’s managerial routine needs to incorporate more democratic devices for connecting with educational institutions, devices that are more permeable to social demands relating to regional policy making.
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Tipologia das regiões de saúde: condicionantes estruturais para a regionalização no Brasil
Ana Luiza d'Ávila Viana,Aylene Bousquat,Ana Paula M. Pereira,Liza Yurie Teruya Uchimura,Mariana Vercesi de Albuquerque,Paulo Henrique dos Santos Mota,Marcelo Marcos Piva Demarzo,Maria Paula Ferreira +7 more
TL;DR: In this article, a caracterizacao das regioes de saude brasileiras, a partir da tipologia apresentada, demonstra heterogeneidade do territorio nacional e a complexidade de organizar sistemas of saude regionais.
Governança regional: estratégias e disputas para gestão em saúde Regional governance: strategies and disputes in health region management
TL;DR: In this article, a qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil was conducted to analyze the regional governance of the health system in relation to management strategies and disputes.
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Regional-based Integrated Healthcare Network policy in Brazil: from formulation to practice
Ingrid Vargas,Amparo Susana Mogollón-Pérez,Jean-Pierre Unger,Maria Rejane Ferreira Da-Silva,Pierre De Paepe,María Luisa Vázquez +5 more
TL;DR: The implementation of regional-based IHN policy in Brazil is hampered by the decentralized organization of the health system to the municipal level, suggesting the need to centralize certain functions to regional structures or states and to define better the role of the government levels involved.
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O processo de regionalização do SUS: revisão sistemática
Guilherme Arantes Mello,Ana Paula Chancharulo de Morais Pereira,Liza Yurie Teruya Uchimura,Fabíola Lana Iozzi,Marcelo Marcos Piva Demarzo,Ana Luiza d'Ávila Viana +5 more
TL;DR: It was found that the regionalization process is now underway in all spheres of government, subject to a set of challenges common to the different realities of the country, including, primarily, that committee-structured entities are valued as spaces for innovation, yet also strive to overcome the bureaucratic and clientelist political culture.
References
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The Brazilian Ministry of Health policy model in the 1990s
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Decentralization of governmental action in Brazil in the 90s: challenges of the political-institutional environment
TL;DR: In this article, an artigo realiza aproximacao as especificidades da descentralizacao da acao estatal ocorrida na Republica Federativa do Brasil nos anos noventa, apresentando condicoes do ambiente politico-institucional governamental that compuseram o cenario da implementacao de gestao descentralizedada do setor saude.
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História, saúde e seus trabalhadores: da agenda internacional às políticas brasileiras
TL;DR: In this article, the authors discuss the agenda for the training and management of the health workforce in Brazil from a historical viewpoint, especially as refers to its relations with the programs in this field developed by the Pan American Health Organization (PAHO) and by the World Health Organisation (WHO).