Thoughts on the development of active regional public health systems

Thoughts on the development of active regional public health systems

Author Chioro dos Reis, Ademar Arthur Autor UNIFESP Google Scholar
Menezes Soter, Ana Paula Google Scholar
Castro Furtado, Lumena Almeida Google Scholar
da Silva Pereira, Silvana Souza Google Scholar
Abstract Decentralization and regionalization are strategic themes for reforms in the health system. This paper analyzes the complex process of health regionalization being developed in Brazil. This paper identifies that the normative framework from the Brazilian National Health System, SUS has made advances with respect to its institutionalization and overcoming the initial centrality involved in municipalization. This has strengthened the development of regionalization and the intergovernmental agreement on health but the evidence points to the need to promote a revision. Based on document analysis, literature review and the views given by the authors involved in management in SUS as well as generating radically different views, the challenges for the construction of a regionalization that is active, is debated. We also discuss: its relations with planning and the dimensioning of service networks, the production of active care networks and shared management spaces, the inter-federative agreements and regional regulations, the capacity to coordinate regional systems and financing and the impact of the political dimension and electoral cycles. Regionalization (and SUS itself) is an open book, therefore ways and possibilities on how to maintain an active form of regionalization can be recommended.
Keywords Regionalization
Decentralization
Health management
Brazilian National Health System
Primary Health Care
xmlui.dri2xhtml.METS-1.0.item-coverage Rio De Janeiro
Language Portuguese
Date 2017
Published in Ciencia & Saude Coletiva. Rio De Janeiro, v. 22, n. 4, p. 1045-1054, 2017.
ISSN 1413-8123 (Sherpa/Romeo, impact factor)
Publisher Abrasco
Extent 1045-1054
Origin http://dx.doi.org/10.1590/1413-81232017224.26552016
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000400156900002
URI https://repositorio.unifesp.br/handle/11600/54813

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