Health policy and management in the (re)construction of the Unified National Health System (SUS) in a large municipality: a case study of Sao Paulo, Brazil

Health policy and management in the (re)construction of the Unified National Health System (SUS) in a large municipality: a case study of Sao Paulo, Brazil

Author Pinto, Nicanor Rodrigues da Silva Autor UNIFESP Google Scholar
Tanaka, Oswaldo Yoshimi Autor UNIFESP Google Scholar
Spedo, Sandra Maria Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract The (re) construction of the Unified National Health System (SUS) in the Municipality of Sao Paulo, Brazil, from 2001 to 2008 was analyzed by means of a case study, using different sources: documents, interviews with key informants, and participant observation. Health policy and health management were used as the analytical categories. The study selected and analyzed only the policies that were prioritized by the administration that took office in 2001 and that were maintained until 2008. The article discusses challenges for ( re) construction of the SUS in Sao Paulo, related to the political and institutional context and including the structural changes as implemented. Reorganization of the Municipal Health Secretariat in Sao Paulo enabled constituting and maintaining two municipal subsystems ( one hospital-based and the other outpatient). Negotiations between the Municipal, State, and Federal levels failed to make headway in order for the city of Sao Paulo to assume the de facto management of the entire health system, so that three public health subsystems coexisted ( two Municipal and one State). The Family Health Program was sustained politically, mainly because it was a Federal government priority and was not a trademark of the first Municipal administration.
Keywords Health Policy
Health Management
Health Systems
Single Health System
Language Portuguese
Date 2009-04-01
Published in Cadernos De Saude Publica. Rio de Janeiro: Cadernos Saude Publica, v. 25, n. 4, p. 927-938, 2009.
ISSN 0102-311X (Sherpa/Romeo, impact factor)
Publisher Cadernos Saude Publica
Extent 927-938
Origin http://dx.doi.org/10.1590/S0102-311X2009000400024
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000264900500024
SciELO ID S0102-311X2009000400024 (statistics in SciELO)
URI http://repositorio.unifesp.br/11600/43213

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